Solid organ transplant recipients are reliant on immunosuppressive drugs, which have a narrow therapeutic index, and are concurrently vulnerable to adverse drug events due to comorbidity burden and the complexity of their medication regimens. Urgent management of post-transplant complications often falls to the generalist clinician or critical care specialist. The purpose of this narrative review is to discuss innovations and bedside applications of pharmacogenomics and therapeutic drug monitoring applied to immunosuppression and agents frequently encountered in transplant recipients. Medication formulations will be given specific attention, as interchange is frequently required in the acute care setting. Bioassays quantifying immune system activity will be described with practical applications. A structured approach to addressing drug-drug, drug-gene, and drug-drug-gene interactions will be modeled using a case-based approach synthesizing pharmacogenomics, therapeutic drug monitoring, pharmacokinetics, and pharmacodynamic principles.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1002/phar.2798 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
COVID-19 mortality among solid organ transplant recipients and candidates before specific vaccine availability in Colombia.
J Infect Dev Ctries
December 2024
Infectious Diseases Research Group, School of Medicine, Universidad Nacional de Colombia (National University of Colombia), Bogotá, Colombia.
Introduction: Coronavirus disease 2019 (COVID-19) is a life-threatening disease that was declared a pandemic in March 2020. Organ transplant recipients are vulnerable to infection and complications from COVID-19. The objective of this study was to investigate the rates of infection, mortality, and case-fatality ratios (CFR) in solid organ transplant recipients and patients on the waiting list for organ allocation in the period prior to the availability of specific vaccines.
View Article and Find Full Text PDFIntestinal obstruction caused by disseminated mycobacterium avium complex disease following solid organ transplantation: a case report.
BMC Infect Dis
January 2025
Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan.
Background: Mycobacterium avium complex (MAC) is a common pathogen causing non-tuberculous mycobacterial infections, primarily affecting the lungs. Disseminated MAC disease occurs mainly in immunocompromised individuals, such as those with acquired immunodeficiency syndrome, hematological malignancies, or those positive for anti-interferon-γ antibodies. However, its occurrence in solid organ transplant recipients is uncommon.
View Article and Find Full Text PDFDevelopment of a Patient Reported Outcome Measure of Side Effects for Patients Taking Calcineurin Inhibitors: The FACIT-CNI-Ntx.
Am J Kidney Dis
January 2025
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, USA; Northwestern University Transplant Outcomes Research Collaborative, Comprehensive Transplant Center, Feinberg School of Medicine, Chicago, IL, USA; Centre for Patient Reported Outcomes Research, Department of Applied Health Sciences, University of Birmingham, Edgbaston, Birmingham, UK.
Rationale & Objective: Valid measures of side effects are important to inform clinical use of calcineurin inhibitors (CNIs). This study sought to develop and establish the content validity of a PRO measure to capture side effects among kidney transplant recipients taking CNIs.
Study Design: Qualitative interviews for concept elicitation and cognitive debriefing.
The risk of donor-acquired allergy in solid organ transplant recipients: a systematic review.
Ann Allergy Asthma Immunol
January 2025
Center for Drug Safety and Immunology, Vanderbilt University Medical Centre, Nashville, Tennessee, USA; Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Western Australia, Australia.
Background: Donor acquired allergy (DAA) occurs when donors transfer their allergies to recipients through solid organ transplant (SOT). However, the risk of DAA in recipients of organs from allergic donors has not been systematically characterized.
Objective: We sought to synthesize the available evidence on the risk of DAA in SOT recipients.
Letermovir-inclusive combination therapy for a refractory and resistant infection by cytomegalovirus with UL54 mutation following a hematopoietic stem cell transplant for MHC Class II deficiency.
J Infect Chemother
January 2025
Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan; Division of Immunology, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
Cytomegalovirus (CMV) infection remains one of the most common and challenging post-transplant infections. Children with inborn errors of immunity (IEI) and T-cell dysfunction are at high risk for CMV infection, which can be complicated by refractory and/or resistant cases. This case describes a Nepalese girl with MHC class II deficiency, who presented at 3 months of age with CMV and Pneumocystis jirovecii pneumonia.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!