Immunosuppressant prescription pattern and trend in kidney transplantation: A multicenter study in Korea

Abstract

BackgroundThe actual prescription pattern of immunosuppressive agents in kidney transplantation is unclear.MethodsWe investigated the pattern and trend of immunosuppressive treatment for kidney transplant patients in South Korea. A total of 636 patients at nine transplant centers were enrolled and followed for one year. We reviewed medical records and evaluated induction therapy, as well as the changing pattern and cause of maintenance therapy.ResultsMost patients (n = 621, 97.6%) received induction therapy often comprising basiliximab (n = 542, 85.2%). The triple therapy including calcineurin inhibitor, mycophenolic acid, and steroids was the major initial maintenance immunosuppression (n = 518, 81.4%), but its proportion decreased by 14% (81.4% to 67.5%) after 1 year. Almost 40% of patients changed immunosuppressive regimen during the 1-year follow-up, most often at an early period (60.2% within the first 4 months). The primary reason for the change was gastrointestinal discomfort (n = 113, 29.8%), followed by infection (112, 29.6%). The most common changing pattern was mycophenolic acid withdrawal (n = 155, 39.1%).ConclusionThe initial immunosuppressive regimen is prone to change within the first year of kidney transplantation. Further studies are needed to evaluate the benefits and risks in patients who changed immunosuppressants.

Clinical outcomes of kidney transplantation in older end‐stage renal disease patients: A nationwide cohort study

“…This trend reflected a tendency to lower the intensity of immunosuppressant treatment in the elderly patients because of the high frequency of immunosuppression-related complications. 21 The incidence of BPAR did not differ between the elderly and young patients in the LDKT and DDKT groups. However, high pre-transplant sensitization showed a differential impact on the elderly and young populations.…”

“…In regard to immune suppression regimen, the proportion of patients treated with cyclosporin instead of tacrolimus was higher in the elderly‐LDKT group. This trend reflected a tendency to lower the intensity of immunosuppressant treatment in the elderly patients because of the high frequency of immunosuppression‐related complications …”

Delivery of transplant care among Hmong kidney transplant recipients: Outcomes from a single institution

“…Genetic variations in drug metabolism have been reported for African Americans in the United States, as well as the possibility of the variation in a gene involved in the coagulation cascade contributing to increased acute rejection in African Americans . In contrast, studies of Asian recipients have suggested differences in the pharmacokinetics of mycophenolate compared to Caucasian patients given similar doses …”

Estado de salud periodontal de pacientes trasplantados renales y calidad de vida asociada. Estudio exploratorio

“…Los inmunosupresores y antihipertensivos empleados en este tipo de pacientes tienen el objetivo de prevenir y tratar el rechazo agudo y evitar la lesión crónica del injerto, minimizando los efectos adversos 46,47 . Un estudio realizado en México encontró que los inhibidores de calcineurina tienen una relación con la inflamación gingival o con el daño periodontal, mayormente la Ciclosporina A 48,49 ; este hallazgo es semejante al del presente estudio.…”