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Immunosuppression in pediatric liver transplant recipients: Unique aspects
- Source :
- Liver Transplantation. 23:244-256
- Publication Year :
- 2017
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2017.
-
Abstract
- Pediatric liver transplantation has experienced improved outcomes over the last 50 years. This can be attributed in part to establishing optimal use of immunosuppressive agents to achieve a balance between minimizing the risks of allograft rejection and infection. The management of immunosuppression in children is generally more complex and can be challenging when compared with the use of these agents in adult liver transplant patients. Physiologic differences in children alter the pharmacokinetics of immunosuppressive agents, which affects absorption, distribution, metabolism, and drug excretion. Children also have a longer expected period of exposure to immunosuppression, which can impact growth, risk of infection (bacterial, viral, and fungal), carcinogenesis, and likelihood of nonadherence. This review discusses immunosuppressive options for pediatric liver transplant recipients and the unique issues that must be addressed when managing this population. Further advances in the field of tolerance and accommodation are needed to relieve the acute and cumulative burden of chronic immunosuppression in children. Liver Transplantation 23 244-256 2017 AASLD.
- Subjects :
- Adult
Counseling
Graft Rejection
Patient Transfer
medicine.medical_specialty
Adolescent
medicine.medical_treatment
Population
030230 surgery
Liver transplantation
Communicable Diseases
Immune tolerance
End Stage Liver Disease
03 medical and health sciences
0302 clinical medicine
Pharmacokinetics
Immune Tolerance
medicine
Humans
Distribution (pharmacology)
Child
education
Intensive care medicine
Immunosuppression Therapy
Transplantation
education.field_of_study
Hepatology
business.industry
Graft Survival
Age Factors
Immunosuppression
Transplant Recipients
Tacrolimus
Liver Transplantation
Calcineurin
Treatment Outcome
Liver
Immunology
Patient Compliance
030211 gastroenterology & hepatology
Surgery
business
Immunosuppressive Agents
Subjects
Details
- ISSN :
- 15276473 and 15276465
- Volume :
- 23
- Database :
- OpenAIRE
- Journal :
- Liver Transplantation
- Accession number :
- edsair.doi.dedup.....a661f736eb9191e91a4401bf83f3670b