Current topics in immunotherapy and the role of the pharmacist on a solid organ transplant service.
Solid organ transplantation has become a well-accepted therapy for the treatment of end-stage disease of the liver, heart, kidney, and pancreas. The development of highly effective immunosuppressant drugs has led to major improvements in graft and patient survival over the last decade. In spite of this success the perfect immunosuppressive drug has yet to be discovered. Currently available agents have numerous short-term and, more disturbingly, long-term toxicities. This has led to the use of triple- and quadruple-drug regimens in an attempt to maintain good graft and patient survival rates with less toxicity. Multiple-drug combinations have questionable benefits compared to double-drug regimens containing cyclosporine and prednisone. With the advent of new immunosuppressant drugs, it will be important to perform randomized, controlled trials to assess their efficacy and toxicities in comparison with current regimens. Pharmacists who work with solid organ transplant teams can function as pharmacotherapists and provide skills such as pharmacokinetic and pharmacodynamic drug monitoring. In addition, they can become involved with clinical and laboratory-based research to assess the properties of conventional and newly developed immunosuppressive agents.
Shaefer
M S
MS
Department of Pharmacy Practice, University of Nebraska Medical Center, Omaha 68198.
D016572:Cyclosporine / Q000009:adverse effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007668:Kidney / Q000187:drug effects; D016030:Kidney Transplantation; D016031:Liver Transplantation; D016377:Organ Transplantation; D010595:Pharmacists
D007166:Immunosuppressive Agents; D016572:Cyclosporine