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Liver transplantation tacrolimus nephrotox

Nephrotoxicity Tacrolimus can cause nephrotoxicity, particularly when used in high doses. Nephrotoxicity has been noted in approximately 52% of kidney transplantation patients and in 33% to 40% of liver transplantation patients receiving the drug. [Pg.1936]

Long-term follow-up (mean of 93 months) of tacroU-mus-based immunosuppression has been reported in 121 adult patients with liver transplants (10). Infections were the most common causes of deaths (17 patients out of 42), and half of them occurred during the first year after transplantation. Cardiovascular events (seven patients) or de novo malignancies (three patients) were also important causes of death. End-stage renal disease related to tacrolimus nephrotoxicity was noted in two patients who required renal transplantation At 7 years, other important adverse effects included hyperkalemia (30%) or... [Pg.3280]

Overah, the reported incidence of tacrolimus-associated nephrotoxicity varies from 18 to 42% in liver transplant patients among 128 patients who had early and late episodes of renal allograft dysfunction (1-156 weeks after transplantation) requiring biopsy, tacrohmus nephrotoxicity was estimated to account for only 17% of cases... [Pg.3284]

Tacrolimus causes acute reversible renal dysfunction in renal [661-663,667], hver [290,664-666,679,680], heart [681-683] and pulmonary [684, 685] transplant recipients and in patients with immunologically mediated diseases [686]. Tacrolimus-induced GFR and RBF decrease is associated with an important increase in renal vascular resistance, both in humans and rodents [63,679,687-692]. Calcium channel blockers improved renal function in TAC-treated liver transplant recipients [693] and in animal models of TAC nephrotoxicity [689,694-6%]. Tacrohmus acute nephrotoxicity, similar to CSA, shows normal renal histology or non-specific changes such as isometric cytoplasmic vacuolation in tubular epithelial cells, microcalcification, giant mitochondria and lysosomes, and necrosis and early hyahnosis of individual smooth muscle cells in the afferent arterioles, which revert with drug reduction or discontinuation [697-699]. [Pg.646]

Hawwa AF, Elmay JC (2011) Impact of ATP binding cassette subfamily B member 1 pharmacogenetics on tacrolimus-associated nephrotoxicity and dosage requirement in pediatric patients with liver transplant. Expert Opin Drug Saf 10 9-22... [Pg.682]

Jain A, Reyes J, Kashyap R, Rohal S, Abu-Elmagd K, Starzl T, Fung J. What have we learned about primary liver transplantation under tacrolimus immunosuppression Long-term follow-up of the first 1000 patients. Ann Surg 1999 230 441-448. Ryffel B, Weber E, Mihatsch MJ. Nephrotoxicity of immunosuppressants in rats comparison of macrolides with cyclosporin. Exp Nephrol 1994 2 324-333. [Pg.458]

A study in 18 liver transplant and 7 kidney-pancreas transplant patients taking tacrolimus and sirolimus found no difference in the pharmacokinetics of either drug and no nephrotoxicity when the drugs were taken either... [Pg.1084]

Hawwa AF, McKieman PJ, Shields M, Millership JS, Collier McElnay JC. Influence of ABCBl polymorphisms and haplotypes on tacrolimus nephrotoxicity and dosage requirements in children with liver transplant. Br J Clin Pharmacol 2009 68(3) 413-21. [Pg.836]

A 58-year-old man with acute liver failure received tacrolimus (3 mg b.i.d) 8 days after liver transplantation [61 ]. On day 11 after transplantation, A. fumigatus was cultured from broncho-alveolar lavage and voriconazole started. At the same time tacrolimus dose was reduced to 30% to avoid toxicity. Oral voriconazole was started on day 21 to avoid nephrotoxicity, which... [Pg.388]

Cyclosporine and tacrolimus are calcineurin inhibitors that are administered as part of immunosuppressive regimens in kidney, liver, heart, lung, and bone marrow transplant recipients. In addition, they are used in autoimmune disorders such as psoriasis and multiple sclerosis. The pathophysiologic mechanism for ARF is renal vascular vasoconstriction.41 It often occurs within the first 6 to 12 months of treatment, and can be reversible with dose reduction or drug discontinuation. Risk factors include high dose, elevated trough blood concentrations, increased age, and concomitant therapy with other nephrotoxic drugs.41 Cyclosporine and tacrolimus are extensively metabolized by... [Pg.370]


See other pages where Liver transplantation tacrolimus nephrotox is mentioned: [Pg.431]    [Pg.432]    [Pg.432]    [Pg.1082]    [Pg.1083]    [Pg.822]    [Pg.429]    [Pg.680]    [Pg.1620]    [Pg.20]   
See also in sourсe #XX -- [ Pg.646 , Pg.649 ]

See also in sourсe #XX -- [ Pg.431 , Pg.433 ]




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