Renal transplantation in high-risk patients.
Renal transplantation in high-risk patients is a growing phenomenon. More patients are progressing to endstage renal failure, in the setting of an increased incidence of diabetes mellitus and cardiovascular disease. Current organ shortages and the use of more marginal donors have affected both patient and graft survival. Acute rejection has been minimised under modern immunosuppression; however, patient and long-term allograft outcomes have not improved concurrently. Specific understanding of donor, recipient and allograft variables associated with stratification of patients as 'high risk for renal transplantation' is necessary to facilitate appropriate peri- and post-transplant pharmacotherapy. Induction and maintenance immunosuppression choices are different for high-risk patients and must be made to ensure optimal immunosuppression, while limiting patient and allograft toxicity.
Weimert
Nicole A
NA
Department of Pharmacy Services, Medical University of South Carolina, Charleston, South Carolina 29425, USA. weimert@musc.edu
Alloway
Rita R
RR
D000367:Age Factors; D006084:Graft Rejection / Q000517:prevention & control; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology*; D044469:Racial Groups; D012307:Risk Factors; D014019:Tissue Donors; D009927:Tissue and Organ Procurement
D007166:Immunosuppressive Agents