Evaluating non-adherence to immunosuppressant medications in pediatric liver transplant recipients.

Détails

ID Serval
serval:BIB_B90BC883C487
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Evaluating non-adherence to immunosuppressant medications in pediatric liver transplant recipients.
Périodique
Pediatric Transplantation
Auteur⸱e⸱s
Stuber M.L., Shemesh E., Seacord D., Washington J., Hellemann G., McDiarmid S.
ISSN
1399-3046[electronic], 1397-3142[linking]
Statut éditorial
Publié
Date de publication
2008
Volume
12
Numéro
3
Pages
284-288
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
Non-adherence with recommended immunosuppressant medications is common post-pediatric liver transplant and is the most important reason for organ rejection in long-term survivors. However, there is currently no validated, standard method to measure adherence, with a well-defined threshold, making it extremely difficult to evaluate interventions to improve adherence. Previous studies have suggested that the degree of fluctuation of medication blood levels over time can provide an idea about how regularly the medication is being taken. The present study, conducted at UCLA medical center, sought to identify a specific threshold value of the s.d. of individual tacrolimus blood levels in pediatric liver transplant recipients which would be associated with rejection episodes in these patients. A threshold of 3.0 has been identified in other studies, and was supported by the analysis of retrospective data from 96 subjects. However, further analysis found that a s.d. of 2.5 appeared to have a better fit with the data. These findings suggest the utility of monitoring the s.d. of routine tacrolimus blood levels in pediatric liver transplant recipients for detecting non-adherence to immunosuppressant medication prior to clinical rejection, allowing earlier interventions.
Mots-clé
Adolescent, Child, Child, Preschool, Female, Graft Rejection, Humans, Immunosuppressive Agents/therapeutic use, Infant, Infant, Newborn, Liver Transplantation/methods, Male, Patient Compliance, Pediatrics/methods, Retrospective Studies, Tacrolimus/therapeutic use
Pubmed
Web of science
Création de la notice
02/03/2010 16:04
Dernière modification de la notice
20/08/2019 15:27
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