title: Personalization of the immunosuppressive treatment in renal transplant recipients: the great challenge in "omics" medicine.
abstract: Renal transplantation represents the most favorable treatment for patients with advanced renal failure and it is followed, in most cases, by a significant enhancement in patients' quality of life. Significant improvements in one-year renal allograft and patients' survival rates have been achieved over the last 10 years primarily as a result of newer immunosuppressive regimens. Despite these notable achievements in the short-term outcome, long-term graft function and survival rates remain less than optimal. Death with a functioning graft and chronic allograft dysfunction result in an annual rate of 3%-5%. In this context, drug toxicity and long-term chronic adverse effects of immunosuppressive medications have a pivotal role. Unfortunately, at the moment, except for the evaluation of trough drug levels, no clinically useful tools are available to correctly manage immunosuppressive therapy. The proper use of these drugs could potentiate therapeutic effects minimizing adverse drug reactions. For this purpose, in the future, "omics" techniques could represent powerful tools that may be employed in clinical practice to routinely aid the personalization of drug treatment according to each patient's genetic makeup. However, it is unquestionable that additional studies and technological advances are needed to standardize and simplify these methodologies.
authors.affiliation: Renal Unit, Department of Medicine, University of Verona, Piazzale A. Stefani, 1, 37126 Verona, Italy. gianluigi.zaza@univr.it.
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Zaza
authors.affiliation: Renal Unit, Department of Medicine, University of Verona, Piazzale A. Stefani, 1, 37126 Verona, Italy. simona.granata@univr.it.
authors.forename: Simona
authors.initials: S
authors.lastname: Granata
authors.affiliation: Renal Unit, Department of Medicine, University of Verona, Piazzale A. Stefani, 1, 37126 Verona, Italy. paola.tomei@univr.it.
authors.forename: Paola
authors.initials: P
authors.lastname: Tomei
authors.affiliation: Renal Unit, Department of Medicine, University of Verona, Piazzale A. Stefani, 1, 37126 Verona, Italy. alessandra.dallagassa@gmail.com.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Dalla Gassa
authors.affiliation: Renal Unit, Department of Medicine, University of Verona, Piazzale A. Stefani, 1, 37126 Verona, Italy. antonio.lupo@univr.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Lupo
mesh_terms: D001379:Azathioprine / Q000627:therapeutic use; D065095:Calcineurin Inhibitors / Q000627:therapeutic use; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000628:therapy*; D016030:Kidney Transplantation; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D010597:Pharmacogenetics; D057285:Precision Medicine
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D001379:Azathioprine