Engelsk titel: Improved immunosuppression leads to better kidney transplantations
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Författare:
Ekberg, Henrik
Email: henrik.ekberg@med.lu.se
Språk: Swe
Antal referenser: 13
Dokumenttyp:
Översikt
UI-nummer: 12107443
Sammanfattning
The outcome after kidney transplantation has improved to a great extent over recent years. This is based on the development of safe and effective immunosuppression. Ciclosporin was first introduced in the 1980-ies and then tacrolimus and mycophenolate mofetil in the late 1990-ies. Large, clinical, multicenter trials were performed to verify the safety and efficacy of the novel drugs, but also to fine-tune the best combinations and levels of drugs. At this time patents of immunosuppressive drugs are lost and generic compounds are introduced. The definition and extent of research on these compounds are described in the article and an emphasis is put on the fact that the prescribed immunosuppressive drugs are not exchangeable. There is a risk of reduced efficacy of immunosuppression if patients are switched between drugs without proper monitoring of drug levels and verification of correct dosing. Reduced efficacy might reduce outcome in some cases. Adverse events and co-morbidity after kidney transplantation include cardiovascular disease, diabetes, infections and malignancy.