Therapeutic drug monitoring (TDM) of immunosuppressive drugs has evolved over the last few decades. The use of liquid chromatography–tandem mass spectrometry, for example, now provides robust and highly specific quantification in the clinical laboratory. Nevertheless, the measurement of immunosuppressive drug concentrations, even if carried out accurately and precisely, does not sufficiently re...

Recent advances in immunosuppressive drug regimens have changed the outcome after liver transplantation significantly in the last two decades. However, chronic rejection and long-term graft survival remains a major problem. Side effects like drug-induced nephrotoxicity, hypertension, osteoporosis, hyperlipidaemia and neuropathy of some immunosuppressive agents play an essential role in long-ter...

1. Centers for Diseases Control and Prevention. Updated interim recommendations: special considerations for clinicians regarding 2009 H1N1 influenza in severely immunosuppresed patients (on line). [Acessed on 2010 Sept 13]. Available from: http://www.cdc.gov/h1n1flu/immunosuppresion/ 2. Bacal F, Seguro LF, Ogawa T, Mangini S, Fiorelli AI, Bocchi E. Pneumonia por influenza A (H1N1) em paciente i...

Conventional therapeutic drug monitoring based on measuring of blood concentrations (pharmacokinetic) is important in the clinical management of immunosuppressive therapy in transplantation medicine. Since rejection or infection occurs at irregular drug concentrations, immunosuppressive drug therapy is often empiric and prophylactic in nature. In addition, blood immunosuppressant levels are onl...

Immunosuppressive drugs are now unavoidibly used after the transpantation of liver,heart and bone marrow, as well as in certain autoimmune diseases.among these agents,cyclosporine-A (CYA) is one of the most effective Immunosuppressants which is widely used.but as any Immunosuppressive agent,the use of CYA is not without harmful side effects.neurotoxin,nephrotoxic and hepatotoxic complications,m...

The immunosuppressive drugs used to prevent the rejection of transplanted organs have a narrow therapeutic index. Under treatment results in episodes of rejection leading to either damage or loss of the organ. Over immunosuppression increases the risk of infection and malignancy as well as drug specific complications including diabetes mellitus and nephrotoxicity. There is wide variation in the...

1. Justify the rationale for using multiple drug regimens in recipients of solid organ transplants. 2. Analyze the limitations of established immunosuppressive strategies. 3. Evaluate the relative benefits and risks of withdrawal and avoidance immunosuppressive strategies. 4. Design and implement immunosuppressive strategies aimed at decreasing toxicity and improving long-term patient outcomes....