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Document Details
Document Type
:
Article In Journal
Document Title
:
What is the calcineurin inhibitor of choice for pediatric renal transplantation?
ما هو مانع الكالسينيرين للاختيار للنّقل الكلويّ الأطفال ؟
Subject
:
What is the calcineurin inhibitor of choice for pediatric renal transplantation?
Document Language
:
English
Abstract
:
.Cyclosporine microemulsion (CyA) and tacrolimus (Tac) are the principal immunosuppressants prescribed for adult and pediatric renal transplantation. In the majority of patients, these calcineurin inhibitors have been used in combination with other immunosuppressive drugs, such as azathioprine or mycophenolate mofetil (MMF). In this review we will address the question of what calcineurin inhibitor we should use in an individual pediatric renal transplant patient. Welldesigned randomized studies in children showed no difference in shortterm patient and graft survival with cyclosporine microemulsion and tacrolimus. However Tac is significantly more effective than CyA microemulsion in preventing acute rejection after renal transplantation in a pediatric population when used in conjunction with azathioprine and corticosteroids. This difference disappears when calcineurin inhibitors are used in combination with MMF as both Tac and CyA produce similar rejection rates and graft survival. However, Tac is associated with improved graft function at 1 and 2 yr post-transplant. Adverse events of hypomagnesaemia and diarrhea seem to be higher in Tac group whereas hypertrichosis, flu syndrome and gum hyperplasia occurs more frequently in the CyA group. The incidence of post-transplant diabetes mellitus was almost identical between Tac and CyA treated patients. The recommendation drawn from the available data is that both CyA and Tac can be used safely and effectively in children. However Tac may be preferable to CyA because of steroid sparing effect and less hirsutism. We recommend that cyclosporine should be chosen when patients experience Tac-related adverse events. Nevertheless, the best calcineurin inhibitor should be decided on individual patients according to variable risk factors, such as risk of rejection in sensitized patient or delayed graft function. The possibility of adverse events should also be considered
ISSN
:
1397-3142
Journal Name
:
Pediatric Transplantation
Volume
:
8
Issue Number
:
5
Publishing Year
:
1425 AH
2004 AD
Article Type
:
Article
Added Date
:
Monday, February 7, 2011
Researchers
Researcher Name (Arabic)
Researcher Name (English)
Researcher Type
Dr Grade
Email
جميلة قاري
Kari, Jameela
Researcher
Doctorate
Files
File Name
Type
Description
28894.pdf
pdf
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