Immunosuppression in older renal transplant patients.
Renal transplantation procedures in patients older than 60 years of age have clearly improved in recent years. In the cyclosporin era, graft and patient survival are good. However, older patients exhibit a higher mortality, especially from infectious and cardiovascular causes, than young patients. In this article we review the immunosuppressive treatment in older patients, analyse what drugs can be used and finally propose several immunosuppressive combinations to treat this group of patients. Currently, new immunosuppressive drugs enable more flexible immunosuppressive protocols. Nevertheless, to avoid overimmunosuppression, elderly patients should be treated with lower doses and fewer immunosuppressive drugs.
Morales
J M
JM
Nephrology Department, Hospital 12 de Octubre, Madrid, Spain. jmorales@h12o.es
Campistol
J M
JM
Andrés
A
A
Herrero
J C
JC
D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D001379:Azathioprine / Q000627:therapeutic use; D002985:Clinical Protocols; D016572:Cyclosporine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006084:Graft Rejection / Q000188:drug therapy*; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011788:Quality of Life; D016019:Survival Analysis; D016559:Tacrolimus / Q000627:therapeutic use; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D009173:Mycophenolic Acid; D001379:Azathioprine; D016559:Tacrolimus