The potential role of rapamycin in pediatric transplantation as observed from adult studies.
Although pediatric patient and renal graft survival rates have shown marked improvements during the past decade, the persistent toxicities of immunosuppressive drugs and chronic allograft attrition remain major obstacles in transplant therapy. Results in adult patients suggest that complete steroid withdrawal is possible in the majority of recipients under treatment with a cyclosporin A-rapamycin (CsA RAPA) regimen. Furthermore, preliminary studies suggest that a marked reduction in the dose of CsA may be possible under the umbrella of RAPA coverage. The gain in immunosuppressive efficacy afforded by RAPA has not only been obtained without an increased morbidity owing to infectious or neoplastic causes, but also with the potential for reducing the incidence and/or progression of chronic rejection.
Kahan
B D
BD
Department of Surgery, The University of Texas Medical School at Houston, 77030, USA. bkahan@orgtx71.med.uth.tmc.edu
D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000077552:Basiliximab; D002648:Child; D015331:Cohort Studies; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D016903:Drug Monitoring; D000068876:Fingolimod Hydrochloride; D006084:Graft Rejection / Q000517:prevention & control* / Q000628:therapy; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016030:Kidney Transplantation; D011409:Propylene Glycols / Q000627:therapeutic use; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D011993:Recombinant Fusion Proteins; D020123:Sirolimus / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D013110:Sphingosine / Q000031:analogs & derivatives; D013997:Time Factors; D020032:Tyrphostins / Q000627:therapeutic use
D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D011409:Propylene Glycols; D011993:Recombinant Fusion Proteins; D020032:Tyrphostins; C095512:alpha-cyano-(3,4-dihydroxy)-N-benzylcinnamide; D016572:Cyclosporine; D000077552:Basiliximab; D011505:Protein-Tyrosine Kinases; D000068876:Fingolimod Hydrochloride; D013110:Sphingosine; D020123:Sirolimus