Review: Pharmacodynamic monitoring of immunosuppression in kidney transplantation.
Advances in immunosuppressive therapies have improved kidney transplant outcomes. However, immunosuppressant drug-induced toxicities continue to reduce tolerability and impact patient and graft survival. A major ongoing challenge in kidney transplantation is to establish ways of tailoring immunosuppressant therapy so as to maintain efficacy while minimizing toxicity. Pharmacodynamic monitoring by direct measurement of immune cell function has the potential to personalize immunosuppression. The purpose of this review is to provide the clinician with an overview of the methodology and use of immune function monitoring in the field of kidney transplantation.
Barraclough
Katherine A
KA
Department of Renal Medicine, University of Queensland at the Princess Alexandra Hospital, Queensland, Australia. katherine_barraclough@health.qld.gov.au
Staatz
Christine E
CE
Isbel
Nicole M
NM
McTaggart
Steven J
SJ
D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D016903:Drug Monitoring / Q000379:methods*; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000009:adverse effects; D008213:Lymphocyte Activation / Q000187:drug effects; D015166:Monitoring, Immunologic; D057285:Precision Medicine; D011237:Predictive Value of Tests; D016176:T-Lymphocyte Subsets / Q000187:drug effects / Q000276:immunology; D016896:Treatment Outcome
D015415:Biomarkers; D007166:Immunosuppressive Agents