Böbrek naklinde kullanılan immünsüpresif tedaviler

Emin Taşkıran; Oytun Erbaş; Harun Akar

doi:10.5606/fng.transplantasyon.2016.009

Böbrek naklinde kullanılan immünsüpresif tedaviler

Öz

Böbrek nakli sonrası, indüksiyon immünsüpresyon tedavisi için konvansiyonel immünsüpresif tedavi yerine yeni keşfedilen antikorlarla kombine edilmiş standart immünsüpresif tedavi önerilmektedir. Bu ajanlar, anti-lenfosit antikorları (rATG, atgam, alemtuzumab), interlökin 2 reseptör antagonistlerini (basiliksimab), anti-CD20 antikorları (rituksimab) içermektedir. İdame immünsüpresyon tedavisi ise akut rejeksiyonu ve allogreft kaybını, önlemek için gereklidir. Bu ajanlar kalsinörin inhibitörlerini (siklosporin, tacrolimus), kortikosteroidleri (prednizon), antimetabolitleri (azatiyopürin ve MMF), mTOR inhibitörlerini (sirolimus) ve belatacepti içermektedir. Tüm rejimlerin etki ve yan etkileri yapılan çalışmaların ışığında tartışılacaktır.

Anahtar Kelimeler

Böbrek nakli,immünsüpresif ajanlar,immünsüpresif antikor

Kaynakça

Denton MD, Magee CC, Sayegh MH. Immunosuppressive strategies in transplantation. Lancet 1999;353:1083-91.
Halloran PF. Immunosuppressive drugs for kidney transplantation. N Engl J Med 2004;351:2715-29.
Wong W, Venetz JP, Tolkoff-Rubin N, Pascual M. 2005 immunosuppressive strategies in kidney transplantation: which role for the calcineurin inhibitors. Transplantation 2005;80:289-96.
Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group. KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant 2009;9:1-155.
Margreiter R. Efficacy and safety of tacrolimus compared with ciclosporin microemulsion in renal transplantation: a randomised multicentre study. Lancet 2002;359:741-6.
Johnson C, Ahsan N, Gonwa T, Halloran P, Stegall M, Hardy M, et al. Randomized trial of tacrolimus (Prograf) in combination with azathioprine or mycophenolate mofetil versus cyclosporine (Neoral) with mycophenolate mofetil after cadaveric kidney transplantation. Transplantation 2000;69:834-41.
Ahsan N, Johnson C, Gonwa T, Halloran P, Stegall M, Hardy M, et al. Randomized trial of tacrolimus plus mycophenolate mofetil or azathioprine versus cyclosporine oral solution (modified) plus mycophenolate mofetil after cadaveric kidney transplantation: results at 2 years. Transplantation 2001;72:245-50.
Gonwa T, Johnson C, Ahsan N, Alfrey EJ, Halloran P, Stegall M, et al. Randomized trial of tacrolimus + mycophenolate mofetil or azathioprine versus cyclosporine + mycophenolate mofetil after cadaveric kidney transplantation: results at three years. Transplantation 2003;75:2048-53.

Krämer BK, Montagnino G, Del Castillo D, Margreiter R, Sperschneider H, Olbricht CJ, et al. Efficacy and safety of tacrolimus compared with cyclosporin A microemulsion in renal transplantation: 2 year follow-up results. Nephrol Dial Transplant 2005;20:968-73.
Bunnapradist S, Daswani A, Takemoto SK. Graft survival following living-donor renal transplantation: a comparison of tacrolimus and cyclosporine microemulsion with mycophenolate mofetil and steroids. Transplantation 2003;76:10-5.
Goldfarb-Rumyantzev AS, Smith L, Shihab FS, Baird BC, Habib AN, Lin SJ, et al. Role of maintenance immunosuppressive regimen in kidney transplant outcome. Clin J Am Soc Nephrol 2006;1:563-74.
Atkison P, Joubert G, Barron A, Grant D, Paradis K, Seidman E, et al. Hypertrophic cardiomyopathy associated with tacrolimus in paediatric transplant patients. Lancet 1995;345:894-6.
Jarzembowski TM, John E, Panaro F, Manzelli A, Cabrera A, Greco A, et al. Reversal of tacrolimus-related hypertrophic obstructive cardiomyopathy 5 years after kidney transplant in a 6-year-old recipient. Pediatr Transplant 2005;9:117-21.
Binet I, Nickeleit V, Hirsch HH, Prince O, Dalquen P, Gudat F, et al. Polyomavirus disease under new immunosuppressive drugs: a cause of renal graft dysfunction and graft loss. Transplantation 1999;67:918-22.
Gaston RS. Maintenance immunosuppression in the renal transplant recipient: an overview. Am J Kidney Dis 2001;38:25-35.
Anglicheau D, Verstuyft C, Laurent-Puig P, Becquemont L, Schlageter MH, Cassinat B, et al. Association of the multidrug resistance-1 gene single-nucleotide polymorphisms with the tacrolimus dose requirements in renal transplant recipients. J Am Soc Nephrol 2003;14:1889-96.
Thervet E, Anglicheau D, King B, Schlageter MH, Cassinat B, Beaune P, et al. Impact of cytochrome p450 3A5 genetic polymorphism on tacrolimus doses and concentration-to- dose ratio in renal transplant recipients. Transplantation 2003;76:1233-5.
Tsuchiya N, Satoh S, Tada H, Li Z, Ohyama C, Sato K, et al. Influence of CYP3A5 and MDR1 (ABCB1) polymorphisms on the pharmacokinetics of tacrolimus in renal transplant recipients. Transplantation 2004;78:1182-7.
Meier-Kriesche HU, Li S, Gruessner RW, Fung JJ, Bustami RT, Barr ML, et al. Immunosuppression: evolution in practice and trends, 1994-2004. Am J Transplant 2006;6:1111-31.
Available from: www.ustransplant.org [Accessed on January 10, 2010].
Sollinger HW. Mycophenolate mofetil for the prevention of acute rejection in primary cadaveric renal allograft recipients. U.S. Renal Transplant Mycophenolate Mofetil Study Group. Transplantation 1995;60:225-32.
Shapiro R, Jordan ML, Scantlebury VP, Vivas C, Marsh JW, McCauley J, et al. A prospective, randomized trial of tacrolimus/prednisone versus tacrolimus/prednisone/ mycophenolate mofetil in renal transplant recipients. Transplantation 1999;67:411-5.
Ojo AO, Meier-Kriesche HU, Hanson JA, Leichtman AB, Cibrik D, Magee JC, et al. Mycophenolate mofetil reduces late renal allograft loss independent of acute rejection. Transplantation 2000;69:2405-9.
Meier-Kriesche H, Ojo AO, Arndorfer JA, Magee JC, Cibrik DM, Leichtman AB, et al. Mycophenolate mofetil decreases the risk for chronic renal allograft failure. Transplant Proc 2001;33:1005-6.
Srinivas TR, Kaplan B, Schold JD, Meier-Kriesche HU. The impact of mycophenolate mofetil on long-term outcomes in kidney transplantation. Transplantation 2005;80:211-20.
Schold JD, Kaplan B. AZA/tacrolimus is associated with similar outcomes as MMF/tacrolimus among renal transplant recipients. Am J Transplant 2009;9:2067-74.
Langone AJ, Chan L, Bolin P, Cooper M. Enteric-coated mycophenolate sodium versus mycophenolate mofetil in renal transplant recipients experiencing gastrointestinal intolerance: a multicenter, double-blind, randomized study. Transplantation 2011;91:470-8.
Allison AC, Eugui EM, Sollinger HW. Mycophenolate mofetil (RS-61443): Mechanisms of action and effects in transplantation. Transplant Rev 1993;7:129.

Ayrıntılar

Birincil Dil

Türkçe

Konular

-

Bölüm

Araştırma Makalesi

Yazarlar

Emin Taşkıran

Oytun Erbaş

Harun Akar Bu kişi benim

Yayımlanma Tarihi

1 Şubat 2016

Gönderilme Tarihi

1 Kasım 2016

Kabul Tarihi

-

Yayımlandığı Sayı

Yıl 2016 Cilt: 1 Sayı: 1

DOI

https://doi.org/10.5606/fng.transplantasyon.2016.009

IZ

https://izlik.org/JA69JP68TH

Kaynak Göster

RIS / Bibtex

APA

Taşkıran, E., Erbaş, O., & Akar, H. (2016). Böbrek naklinde kullanılan immünsüpresif tedaviler. İstanbul Bilim Üniversitesi Florence Nightingale Transplantasyon Dergisi, 1(1), 48-52. https://doi.org/10.5606/fng.transplantasyon.2016.009

AMA

1.Taşkıran E, Erbaş O, Akar H. Böbrek naklinde kullanılan immünsüpresif tedaviler. İstanbul Bilim Üniversitesi Florence Nightingale Transplantasyon Dergisi. 2016;1(1):48-52. doi:10.5606/fng.transplantasyon.2016.009

Chicago

Taşkıran, Emin, Oytun Erbaş, ve Harun Akar. 2016. “Böbrek naklinde kullanılan immünsüpresif tedaviler”. İstanbul Bilim Üniversitesi Florence Nightingale Transplantasyon Dergisi 1 (1): 48-52. https://doi.org/10.5606/fng.transplantasyon.2016.009.

EndNote

Taşkıran E, Erbaş O, Akar H (01 Şubat 2016) Böbrek naklinde kullanılan immünsüpresif tedaviler. İstanbul Bilim Üniversitesi Florence Nightingale Transplantasyon Dergisi 1 1 48–52.

IEEE

[1]E. Taşkıran, O. Erbaş, ve H. Akar, “Böbrek naklinde kullanılan immünsüpresif tedaviler”, İstanbul Bilim Üniversitesi Florence Nightingale Transplantasyon Dergisi, c. 1, sy 1, ss. 48–52, Şub. 2016, doi: 10.5606/fng.transplantasyon.2016.009.

ISNAD

Taşkıran, Emin - Erbaş, Oytun - Akar, Harun. “Böbrek naklinde kullanılan immünsüpresif tedaviler”. İstanbul Bilim Üniversitesi Florence Nightingale Transplantasyon Dergisi 1/1 (01 Şubat 2016): 48-52. https://doi.org/10.5606/fng.transplantasyon.2016.009.

JAMA

1.Taşkıran E, Erbaş O, Akar H. Böbrek naklinde kullanılan immünsüpresif tedaviler. İstanbul Bilim Üniversitesi Florence Nightingale Transplantasyon Dergisi. 2016;1:48–52.

MLA

Taşkıran, Emin, vd. “Böbrek naklinde kullanılan immünsüpresif tedaviler”. İstanbul Bilim Üniversitesi Florence Nightingale Transplantasyon Dergisi, c. 1, sy 1, Şubat 2016, ss. 48-52, doi:10.5606/fng.transplantasyon.2016.009.

Vancouver

1.Emin Taşkıran, Oytun Erbaş, Harun Akar. Böbrek naklinde kullanılan immünsüpresif tedaviler. İstanbul Bilim Üniversitesi Florence Nightingale Transplantasyon Dergisi. 01 Şubat 2016;1(1):48-52. doi:10.5606/fng.transplantasyon.2016.009