Mathew Johns S, Philips Cyriac A
Gastrointestinal, Hepatobiliary and Multi-organ Transplant Surgery, Center of Excellence in Gastrointestinal Sciences, Rajagiri Hospital, Aluva, Kerala 683112, India.
Clinical and Translational Hepatology & Monarch Liver Laboratory, The Liver Institute, Center for Excellence in Gastrointestinal Sciences, Rajagiri Hospital, Aluva, Kerala 683112, India.
J Clin Exp Hepatol. 2023 Sep-Oct;13(5):869-877. doi: 10.1016/j.jceh.2023.03.011. Epub 2023 Apr 1.
Immunosuppression optimization is central to graft function in liver transplant recipients. Post-transplantation patients develop new onset or worsening metabolic syndrome, are prone to atypical infections, and are at higher risk of developing cardiac and brain-related clinical events. In this context, liver transplant recipients are at risk of using multiple comedications alongside immunosuppressants. It is imperative for the transplant physician to understand the various drug-drug interactions that potentially reduce or promote toxicity of immunosuppression, as well as associated synergistic or antagonistic effects on extrahepatic organ systems. This comprehensive review discusses drug-drug interactions in liver transplant recipients and the impact and role of complementary and alternative medicines among individuals on immunosuppression.
免疫抑制优化对于肝移植受者的移植物功能至关重要。移植后患者会出现新发或恶化的代谢综合征,易发生非典型感染,且发生心脏和脑部相关临床事件的风险更高。在这种情况下,肝移植受者在使用免疫抑制剂的同时还存在使用多种合并用药的风险。移植医生必须了解各种药物相互作用,这些相互作用可能会降低或增加免疫抑制的毒性,以及对肝外器官系统的相关协同或拮抗作用。这篇综述讨论了肝移植受者中的药物相互作用以及补充和替代药物对个体免疫抑制的影响和作用。