Maintenance immunosuppression in the renal transplant recipient: an overview.
Managing maintenance immunosuppressive regimens after kidney transplantation is often challenging and confusing, requiring careful attention to efficacy, dosing, adverse effects, and costs of multiple medications. Most protocols combine a primary immunosuppressant (cyclosporine or tacrolimus) with one or two adjunctive agents (azathioprine, mycophenolate mofetil, sirolimus, corticosteroids). Avoiding drug-drug interactions is a major part of effective immunosuppressant management, and special situations (eg, pregnancy, intravenous dosing, caring for minority patients) can prove especially daunting. This review summarizes available data regarding current practices in maintenance immunosuppression, emphasizing issues that arise in day-to-day management of renal transplant recipients.
Gaston
R S
RS
Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL 35294, USA. rgaston@nrtc.uab.edu
D044383:Black People; D065095:Calcineurin Inhibitors; D016572:Cyclosporine / Q000008:administration & dosage; D004347:Drug Interactions; D016903:Drug Monitoring; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects / Q000379:methods*; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D016030:Kidney Transplantation / Q000276:immunology*; D008134:Long-Term Care / Q000379:methods*; D009369:Neoplasms / Q000209:etiology; D009894:Opportunistic Infections / Q000209:etiology; D010349:Patient Compliance; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011248:Pregnancy Complications; D011297:Prenatal Exposure Delayed Effects
D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D016572:Cyclosporine