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Iatreia

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Abstract

GUERRERO-TINOCO, Gustavo Adolfo; VILLAFANE-BERMUDEZ, Douglas Ramón  and  VELEZ-ECHEVERRI, Catalina. Immunosuppressive drugs and major complications in pediatric renal transplantation. Iatreia [online]. 2017, vol.30, n.1, pp.56-66. ISSN 0121-0793.  http://dx.doi.org/10.17533/udea.iatreia.v30n1a05.

Pediatric renal transplantation is the treatment of choice in children with chronic kidney disease. Many agents are available for immunosuppressive therapy, which are used in two different regimes: first for the induction phase, and then for maintenance. There are two strategies for reducing the risk of renal graft rejection: the first is the use of high doses of conventional immunosuppressive agents, and the second is the use in the induction phase of monoclonal or polyclonal antibodies against antigens of T cells. The two most frequently used polyclonal antibodies are horse and rabbit anti-thymocyte globulins, ATGAM and rATG, respectively. The most frequently used monoclonal antibodies are those against IL-2 receptor (basiliximab and daclizumab) and the one against antigen CD52 (alemtuzumab). Maintenance therapy is a scheme that combines the use of three conventional immunosuppressive drugs: glucocorticoids, calcineurin inhibitors, mTOR inhibitors and antiproliferatives. The following are among the major complications of renal transplantation: acute graft rejection, viral infection (cytomegalovirus and BK polyomavirus) and appearance of PTLD (posttransplant lymphoproliferative disorder).

Keywords : Immunosuppressive Agents; Pediatric; Rejection; Renal Transplantation.

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