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Updated: Jun 27, 2026
08:38
Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
Published on: November 8, 2015
Individualization of immunosuppression: concepts and rationale
Moses D Wavamunno1, Jeremy R Chapman
1Department of Renal Medicine and Transplantation, Westmead Hospital, Sydney, New South Wales, Australia.
Current Opinion in Organ Transplantation
|December 9, 2008
Summary
Individualizing immunosuppression therapy using drug monitoring and pharmacogenetics can minimize toxicity. Advances in molecular technology identify gene polymorphisms affecting drug response, optimizing long-term transplant outcomes.
Area of Science:
- Transplant medicine
- Pharmacology
- Genetics
Background:
- New immunosuppressive agents have not improved long-term transplant outcomes.
- Drug toxicity and individual pharmacokinetic variations contribute to poor outcomes.
- Individualization of immunosuppression is crucial for minimizing toxicity.
Purpose of the Study:
- To review advances in individualizing immunosuppression therapy.
- To explore therapeutic drug monitoring and pharmacogenetics/pharmacogenomics strategies.
- To minimize drug toxicity and improve transplant outcomes.
Main Methods:
- Review of current literature on immunosuppression individualization.
- Analysis of therapeutic drug monitoring (TDM) utility.
- Evaluation of pharmacogenetic and pharmacogenomic approaches.
Main Results:
- TDM is established for calcineurin inhibitors and mTOR inhibitors.
- Mycophenolate mofetil (MMF) dosage optimization via TDM is debated but shows potential with genetic polymorphisms.
- Cytochrome P450 gene polymorphisms impact tacrolimus response; donor genotype may influence drug metabolism.
Conclusions:
- TDM is the primary method for individualizing immunotherapy.
- Molecular technologies identify gene polymorphisms affecting drug metabolism, transport, and targets.
- Prospective studies are needed to integrate genotype testing into immunosuppression management.
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