Drugs

, Volume 67, Issue 11, pp 1603–1627 | Cite as

Renal Transplantation in High-Risk Patients

Review Article

Abstract

Renal transplantation in high-risk patients is a growing phenomenon. More patients are progressing to endstage renal failure, in the setting of an increased incidence of diabetes mellitus and cardiovascular disease. Current organ shortages and the use of more marginal donors have affected both patient and graft survival. Acute rejection has been minimised under modern immunosuppression; however, patient and long-term allograft outcomes have not improved concurrently. Specific understanding of donor, recipient and allograft variables associated with stratification of patients as ‘high-risk for renal transplantation’ is necessary to facilitate appropriate peri- and post-transplant pharmacotherapy. Induction and maintenance immunosuppression choices are different for high-risk patients and must be made to ensure optimal immunosuppression, while limiting patient and allograft toxicity.

Keywords

Tacrolimus Acute Rejection Alemtuzumab Renal Allograft Graft Loss 

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© Adis Data Information BV 2007

Authors and Affiliations

  1. 1.Department of Pharmacy ServicesMedical University of South CarolinaCharlestonUSA
  2. 2.Department of Medicine, Division of Hypertension/Nephrology, Section of TransplantationUniversity of CincinnatiCincinnatiUSA

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