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Erschienen in: Die Nephrologie 3/2022

27.12.2021 | Nierentransplantation | Leitthema

Immunmonitoring nach pädiatrischer Nierentransplantation jenseits des klassischen (pharmakokinetischen) Monitorings

verfasst von: PD Dr. med. Thurid Ahlenstiel-Grunow

Erschienen in: Die Nephrologie | Ausgabe 3/2022

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Zusammenfassung

Nach Nierentransplantation ist eine immunsuppressive Therapie erforderlich, um akute und chronische Abstoßungen zu vermeiden. Die immunsuppressive Medikation verursacht jedoch ein erhöhtes Risiko für virale und bakterielle Infektionen und ist mit einer Vielzahl unerwünschter Arzneimittelwirkungen verbunden. Zur Optimierung der immunsuppressiven Therapie ist eine an den individuellen Bedarf angepasste Dosierung entscheidend, um Über- und Unterimmunsuppression zu vermeiden sowie unerwünschte Arzneimittelnebenwirkungen zu reduzieren. In der Routine erfolgt die Steuerung der Immunsuppressiva meist anhand des Talspiegelmonitorings im Blut, das zwar die Pharmakokinetik, jedoch nicht die Pharmakodynamik widerspiegelt. Es fehlen diagnostische und prognostische Marker zur Beurteilung der individuellen Intensität der Immunsuppression, was im Kindesalter angesichts des erhöhten Infektionsrisikos von besonderer Bedeutung ist. Jenseits des klassischen Talspiegelmonitorings werden derzeit verschiedene Immunmonitoringverfahren zur Bestimmung der Immunabwehr bzw. des Grades der Immunsuppression evaluiert. Ziel des Immunmonitorings in Ergänzung zum klassischen Talspiegelmonitoring ist die Personalisierung der immunsuppressiven Therapie im Sinne eines „effect-related drug monitoring“.
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Metadaten
Titel
Immunmonitoring nach pädiatrischer Nierentransplantation jenseits des klassischen (pharmakokinetischen) Monitorings
verfasst von
PD Dr. med. Thurid Ahlenstiel-Grunow
Publikationsdatum
27.12.2021
Verlag
Springer Medizin
Erschienen in
Die Nephrologie / Ausgabe 3/2022
Print ISSN: 2731-7463
Elektronische ISSN: 2731-7471
DOI
https://doi.org/10.1007/s11560-021-00558-3

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