Department of Pharmacotherapy and Pharmacy Services, University Health, San Antonio, Texas, USA.
Pharmacotherapy Education and Research Center, University of Texas Health San Antonio, San Antonio, Texas, USA.
Pharmacotherapy. 2022 Aug;42(8):594-598. doi: 10.1002/phar.2718.
Advances in maintenance immunosuppression over the past three decades have improved solid organ transplantation outcomes dramatically. Uninterrupted access to immunosuppression is paramount to minimize rejection and maintain allograft and patient survival. Agents used vary based on transplanted organ, center-specific protocol, provider expertise, insurance formularies, ability to cover co-pays, recipient characteristics and tolerability. Published data reflects this heterogeneity. Despite these obstacles, the information about maintenance immunosuppression use cross pollinates between organ groups with standard of care agents often being used off-label, making medication access a challenge for many transplant recipients. A multidisciplinary panel of American transplant clinicians was formed to review published literature on maintenance immunosuppression with the goal to formulate consensus recommendations for their use in specific organ groups. These consensus recommendations are intended to provide transplant clinicians with a summary of literature on maintenance immunosuppression in the modern era, and to support transplant team members working to secure medication access for patients.
在过去的三十年中，维持性免疫抑制的进步极大地改善了实体器官移植的结果。不间断地获得免疫抑制是至关重要的，以最大限度地减少排斥反应，并维持移植物和患者的生存。所使用的药物因移植器官、中心特定方案、提供者专业知识、保险处方、支付能力、受者特征和耐受性而异。已发表的数据反映了这种异质性。尽管存在这些障碍，但关于维持性免疫抑制使用的信息在器官组之间交叉传播，标准治疗药物经常被超适应证使用，这使得许多移植受者难以获得药物。一个由美国移植临床医生组成的多学科小组对维持性免疫抑制的已发表文献进行了审查，目的是制定在特定器官组中使用这些药物的共识建议。这些共识建议旨在为移植临床医生提供关于现代维持性免疫抑制文献的摘要，并支持移植团队成员努力为患者获得药物。
