TY - JOUR T1 - Whose Genome Guides the Prescription After Allogeneic Transplantation? A Tissue-of-Origin Framework for Pharmacogenomic Sampling, Donor–Recipient Chimerism, and Drug-Specific Interpretation A1 - Aisha Rahman A1 - Johan de Vries A1 - Aiko Nakamura A1 - Grace Okafor JF - International Journal of Pharmaceutical Research and Allied Sciences JO - Int J Pharm Res Allied Sci SN - 2277-3657 Y1 - 2026 VL - 15 IS - 2 DO - 10.51847/RHFRWu8p3T SP - 181 EP - 191 N2 - Allogeneic hematopoietic stem cell transplantation creates a persistent interpretive problem for pharmacogenomics: DNA recovered from an accessible post-transplant specimen may belong partly or predominantly to the donor while drug metabolism and response involve distinct recipient and donor-derived tissues. To extend genotype-guided prescribing theory by specifying when a specimen-derived pharmacogene result can be assigned to the biological compartment responsible for a drug-specific effect. This nonempirical analysis integrates verified work on post-transplant sampling, lineage-specific chimerism assays, pharmacogene mechanisms, transplant pharmacokinetics, and genotype-based prescribing. Genotype attribution is treated as a conditional inference linking specimen composition, molecular origin, tissue persistence, the relevant pharmacological process, and time relative to transplantation. The analysis separates evidence that identifies donor or recipient DNA from evidence that establishes enzyme or transporter function and clinical actionability. Recipient-derived nonhematopoietic DNA may be needed to recover inherited metabolic genotypes, whereas donor-derived hematopoietic genotype could matter for selected cellular effects; the latter remains a testable drug-specific proposition, not a general dosing rule. The appropriate genome for prescribing is defined by the drug-relevant functional compartment and a validated sampling-to-phenotype relationship, not by donor chimerism or sampling convenience alone. UR - https://ijpras.com/article/whose-genome-guides-the-prescription-after-allogeneic-transplantation-a-tissue-of-origin-framework-wdpbakbcklntju3 ER -