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Operational tolerance: Past lessons and future prospects: Liver Transplant Tolerance by Josh Levitsky is a Medicine article available to read on EtoBox.
What is Operational tolerance: Past lessons and future prospects: Liver Transplant Tolerance about?
Every liver transplant (LT) center has had patients who either self-discontinue immunosuppressive (IS) therapy or are deliberately withdrawn due to a research protocol or clinical concern (ie, lymphoproliferative disorder [LPD], overwhelming infection). This is understandable because maintenance IS therapy, particularly calcineurin inhibitors (CNI), is associated with significant cost, side effects, and considerable long-term morbidity and mortality. Detrimental effects of IS therapy include increased risk of cardiovascular disease, metabolic syndrome, bone loss, opportunistic and community-acquired infections, and malignancy. In fact, LT recipients have among the highest rates of chronic kidney disease and associated mortality among all nonkidney solid organ recipients. This mortality is only ameliorated by undergoing a curative kidney transplant, usurping costs and valuable organ resources. The search for improved treatment algorithms includes trial and error CNI dose minimization, the use of alternative IS agents (antimetabolites, mammalian target of rapamycin [mTOR] inhibitors), or even complete CNI withdrawal. Yet those who are successful in achieving such operational toleranc
Who reads Operational tolerance: Past lessons and future prospects: Liver Transplant Tolerance?
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- Author
- Josh Levitsky
- Publisher
- Ovid Technologies (Wolters Kluwer Health)
- Published
- 2011
- Language
- EN
- Field
- Medicine (Health Sciences)