Calcineurin inhibitors in paediatric renal transplantation
نویسنده
چکیده
(Suggestions are based on Level III and IV evidence) • In children treated with cyclosporin, 2 h peak cyclosporin level (C2) monitoring should be used in the initial post-transplant period, as the C2 level is a better predictor of cyclosporin exposure than C0 monitoring (Level III evidence). Limited data suggest that the C2 level should be maintained above 1500 ng/mL in the early post-transplant period (Level III evidence) to minimize the risks of acute rejection. • Tacrolimus may be preferable in some children and in adolescents because of the decreased incidence of hirsutism and gum hyperplasia in comparison with cyclosporin (Level I evidence, adult studies).
منابع مشابه
Role of Immunosuppression Minimization Protocols in Renal Transplantation
The subject of transplant immunosuppression has generated significant interest in recent years. Excellent immunosuppression, advances in surgical technique, post-transplantation care, and infection control have resulted in excellent outcomes. There is widespread support for the notion that the fundamental objective in transplant immunology should be the achievement of specific graft toleran...
متن کاملRepeated daclizumab administration to delay the introduction of calcineurin inhibitors in heart transplant patients with postoperative renal dysfunction.
Daclizumab is an interleukin-2 receptor antagonist which is used for induction therapy in heart transplant patients. It has few side effects and is associated with a low infection rate. Postoperative renal failure after heart transplantation is common and potentially fatal. The administration of calcineurin inhibitors in the postoperative period can aggravate the situation. We report the cases ...
متن کاملLong-Term Effects of Calcineurin Inhibitors on Renal Function After Liver Transplantation
The longer survival of liver transplant recipients has emphasized the need to consider complications that develop several years after liver transplantation, such as chronic renal dysfunction. Renal dysfunction has an impact on long-term posttransplant morbidity and mortality. The prevalence of chronic renal disease among liver transplant recipients varies widely from 10 to 78%. This renal dysfu...
متن کاملConversion of calcineurin inhibitors with mammalian target of rapamycin inhibitors after kidney transplant.
One way to overcome chronic allograft nephropathy induced by calcineurin inhibitors in immunosuppression protocols for organ transplants is to replace such inhibitors with mammalian target of rapamycin inhibitors, which are not clinically nephrotoxic because they have better renal function. If patients tolerate replacement, there could be a clear preference for mammalian target of rapamycin inh...
متن کاملSirolimus in renal transplantation.
Acute rejection episodes are now as low as 5-20% in the first year after renal transplantation; however, graft half-life has remained almost unchanged in the last decade. This statistic is mainly attributable to the side effects of immunosuppression, with loss of allografts due to the chronic allograft nephropathy that is a consequence of calcineurin inhibitor toxicity or hypertension. Patient ...
متن کامل