Weber Lutz T
Pediatric Nephrology, Children's and Adolescent's Hospital, University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany,
Pediatr Nephrol. 2015 Feb;30(2):253-65. doi: 10.1007/s00467-014-2813-8. Epub 2014 Apr 25.
Finding the balance between clinical efficacy and toxicity of immunosuppressive drugs is a challenge in renal transplantation (RTx), but especially in pediatric RTx patients. Due to the expected longer life-span of pediatric transplant patients and the long-term consequences of drug-induced infectious, malignant and cardiovascular adverse effects, protocols which minimize immunosuppressive therapy make conceptual sense. In this context, therapeutic drug monitoring is a tool which provides support for the individualization of therapy. It has, however, limitations, and specific data in the pediatric cohort are comparatively sparse. There is large heterogeneity among the studies conducted to date in terms of methods, follow-up, endpoints, immunosuppressive regimens and patients. In addition, data from adult studies are not readily transferrable to the pediatric situation. This educational review gives a concise overview on aspects of therapeutic drug monitoring in pediatric RTx.
在肾移植（RTx）中，尤其是在儿科RTx患者中，找到免疫抑制药物临床疗效与毒性之间的平衡是一项挑战。由于儿科移植患者预期寿命更长，以及药物引起的感染、恶性肿瘤和心血管不良反应的长期后果，将免疫抑制治疗降至最低的方案在概念上是合理的。在这种情况下，治疗药物监测是一种为治疗个体化提供支持的工具。然而，它存在局限性，儿科队列中的具体数据相对较少。迄今为止进行的研究在方法、随访、终点、免疫抑制方案和患者方面存在很大异质性。此外，成人研究的数据不能直接应用于儿科情况。本教育综述简要概述了儿科RTx中治疗药物监测的各个方面。
