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Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
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Cyclosporine: a review.

Dustin Tedesco1, Lukas Haragsim

  • 1Division of Nephrology and Hypertension, University of Oklahoma Health Sciences Center, 920 S. L. Young Blvd, WP 2250 Oklahoma City, OK 73104, USA.

Journal of Transplantation
|January 21, 2012
PubMed
Summary
This summary is machine-generated.

Cyclosporine has advanced transplant medicine but shows limited long-term renal allograft survival and causes nephrotoxicity. Research now focuses on minimizing or avoiding calcineurin inhibitors to improve patient outcomes.

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Area of Science:

  • Nephrology
  • Immunology
  • Transplant Medicine

Background:

  • Cyclosporine, introduced in the late 1970s, significantly advanced transplant medicine.
  • While improving acute rejection and early graft survival, long-term renal allograft survival data is less conclusive.
  • Nephrotoxicity, both acute and chronic, is a significant concern associated with cyclosporine use.

Purpose of the Study:

  • To review the mechanism of action of cyclosporine.
  • To examine the pathophysiologic and histologic features of cyclosporine-induced nephrotoxicity.
  • To explore recent studies aiming to minimize or avoid calcineurin inhibitors.

Main Methods:

  • Literature review of cyclosporine's clinical use and effects.
  • Analysis of studies on cyclosporine's mechanism of action.
  • Examination of research on cyclosporine-induced nephrotoxicity and alternative protocols.

Main Results:

  • Cyclosporine has demonstrated efficacy in preventing acute rejection but exhibits dose-dependent nephrotoxicity.
  • Chronic nephrotoxicity is an irreversible complication, impacting long-term graft function.
  • Emerging strategies aim to reduce reliance on calcineurin inhibitors.

Conclusions:

  • Cyclosporine remains a cornerstone in transplant medicine but necessitates careful monitoring due to nephrotoxicity.
  • Understanding the mechanisms of cyclosporine-induced kidney damage is crucial for developing safer immunosuppressive regimens.
  • Future research focuses on novel protocols to mitigate cyclosporine's adverse effects and enhance long-term transplant outcomes.