Immunosuppression in pediatric liver transplant recipients: Unique aspects
Pediatric liver transplantation has experienced improved outcomes over the last 50 years. This can be attributed in part to establishing optimal use of immunosuppressive agents to achieve a balance between minimizing the risks of allograft rejection and infection. The management of immunosuppression...
Gespeichert in:
| Veröffentlicht in: | Liver transplantation 2017-02, Vol.23 (2), p.244-256 |
|---|---|
| Hauptverfasser: | , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 256 |
|---|---|
| container_issue | 2 |
| container_start_page | 244 |
| container_title | Liver transplantation |
| container_volume | 23 |
| creator | Miloh, Tamir Barton, Andrea Wheeler, Justin Pham, Yen Hewitt, Winston Keegan, Tara Sanchez, Christine Bulut, Pinar Goss, John |
| description | Pediatric liver transplantation has experienced improved outcomes over the last 50 years. This can be attributed in part to establishing optimal use of immunosuppressive agents to achieve a balance between minimizing the risks of allograft rejection and infection. The management of immunosuppression in children is generally more complex and can be challenging when compared with the use of these agents in adult liver transplant patients. Physiologic differences in children alter the pharmacokinetics of immunosuppressive agents, which affects absorption, distribution, metabolism, and drug excretion. Children also have a longer expected period of exposure to immunosuppression, which can impact growth, risk of infection (bacterial, viral, and fungal), carcinogenesis, and likelihood of nonadherence. This review discusses immunosuppressive options for pediatric liver transplant recipients and the unique issues that must be addressed when managing this population. Further advances in the field of tolerance and accommodation are needed to relieve the acute and cumulative burden of chronic immunosuppression in children. Liver Transplantation 23 244–256 2017 AASLD |
| doi_str_mv | 10.1002/lt.24677 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_1860883774</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4306565951</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4157-3d96f34a2b95bdb3498dc92c1dcfce4b3db7128e0403a79f9c8e6ac6cf8fc3fb3</originalsourceid><addsrcrecordid>eNp1kM1LwzAYh4Mobk7Bv0AKXrx05qtN6k2GH5OBl-0c0jSBjC6NSarsv7fauZun9z08PD94ALhGcI4gxPdtmmNaMnYCpqjALC8pI6fHvywm4CLGLYQIFRU8BxPMOKO4gFPwttztetfF3vugY7Sdy6zLvG6sTMGqrLWfOmQpSBd9K13KglbWW-1SfMg2zn70OpPRa5XiJTgzso366nBnYPP8tF685qv3l-XicZUrigqWk6YqDaES11VRNzWhFW9UhRVqlFGa1qSpGcJcQwqJZJWpFNelVKUy3ChiajIDt6PXh26Yj0lsuz64YVIgXkLOCWN0oO5GSoUuxqCN8MHuZNgLBMVPNNEm8RttQG8Owr7e6eYI_lUagHwEvmyr9_-KxGo9Cr8B4kp26w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1860883774</pqid></control><display><type>article</type><title>Immunosuppression in pediatric liver transplant recipients: Unique aspects</title><source>Wiley-Blackwell Journals</source><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Miloh, Tamir ; Barton, Andrea ; Wheeler, Justin ; Pham, Yen ; Hewitt, Winston ; Keegan, Tara ; Sanchez, Christine ; Bulut, Pinar ; Goss, John</creator><creatorcontrib>Miloh, Tamir ; Barton, Andrea ; Wheeler, Justin ; Pham, Yen ; Hewitt, Winston ; Keegan, Tara ; Sanchez, Christine ; Bulut, Pinar ; Goss, John</creatorcontrib><description>Pediatric liver transplantation has experienced improved outcomes over the last 50 years. This can be attributed in part to establishing optimal use of immunosuppressive agents to achieve a balance between minimizing the risks of allograft rejection and infection. The management of immunosuppression in children is generally more complex and can be challenging when compared with the use of these agents in adult liver transplant patients. Physiologic differences in children alter the pharmacokinetics of immunosuppressive agents, which affects absorption, distribution, metabolism, and drug excretion. Children also have a longer expected period of exposure to immunosuppression, which can impact growth, risk of infection (bacterial, viral, and fungal), carcinogenesis, and likelihood of nonadherence. This review discusses immunosuppressive options for pediatric liver transplant recipients and the unique issues that must be addressed when managing this population. Further advances in the field of tolerance and accommodation are needed to relieve the acute and cumulative burden of chronic immunosuppression in children. Liver Transplantation 23 244–256 2017 AASLD</description><identifier>ISSN: 1527-6465</identifier><identifier>EISSN: 1527-6473</identifier><identifier>DOI: 10.1002/lt.24677</identifier><identifier>PMID: 27874250</identifier><identifier>CODEN: LITRFO</identifier><language>eng</language><publisher>United States: Wolters Kluwer Health, Inc</publisher><subject>Adolescent ; Adult ; Age Factors ; Child ; Communicable Diseases - epidemiology ; Communicable Diseases - etiology ; Communicable Diseases - immunology ; Counseling ; End Stage Liver Disease - mortality ; End Stage Liver Disease - surgery ; Graft Rejection - immunology ; Graft Rejection - prevention & control ; Graft Survival - immunology ; Humans ; Immune Tolerance ; Immunosuppression - adverse effects ; Immunosuppression - methods ; Immunosuppressive Agents - pharmacology ; Immunosuppressive Agents - therapeutic use ; Liver ; Liver - immunology ; Liver Transplantation - adverse effects ; Patient Compliance - psychology ; Patient Transfer ; Pediatrics ; Transplant Recipients - psychology ; Transplants & implants ; Treatment Outcome</subject><ispartof>Liver transplantation, 2017-02, Vol.23 (2), p.244-256</ispartof><rights>2016 by the American Association for the Study of Liver Diseases.</rights><rights>2017 by the American Association for the Study of Liver Diseases.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4157-3d96f34a2b95bdb3498dc92c1dcfce4b3db7128e0403a79f9c8e6ac6cf8fc3fb3</citedby><cites>FETCH-LOGICAL-c4157-3d96f34a2b95bdb3498dc92c1dcfce4b3db7128e0403a79f9c8e6ac6cf8fc3fb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flt.24677$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flt.24677$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27874250$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Miloh, Tamir</creatorcontrib><creatorcontrib>Barton, Andrea</creatorcontrib><creatorcontrib>Wheeler, Justin</creatorcontrib><creatorcontrib>Pham, Yen</creatorcontrib><creatorcontrib>Hewitt, Winston</creatorcontrib><creatorcontrib>Keegan, Tara</creatorcontrib><creatorcontrib>Sanchez, Christine</creatorcontrib><creatorcontrib>Bulut, Pinar</creatorcontrib><creatorcontrib>Goss, John</creatorcontrib><title>Immunosuppression in pediatric liver transplant recipients: Unique aspects</title><title>Liver transplantation</title><addtitle>Liver Transpl</addtitle><description>Pediatric liver transplantation has experienced improved outcomes over the last 50 years. This can be attributed in part to establishing optimal use of immunosuppressive agents to achieve a balance between minimizing the risks of allograft rejection and infection. The management of immunosuppression in children is generally more complex and can be challenging when compared with the use of these agents in adult liver transplant patients. Physiologic differences in children alter the pharmacokinetics of immunosuppressive agents, which affects absorption, distribution, metabolism, and drug excretion. Children also have a longer expected period of exposure to immunosuppression, which can impact growth, risk of infection (bacterial, viral, and fungal), carcinogenesis, and likelihood of nonadherence. This review discusses immunosuppressive options for pediatric liver transplant recipients and the unique issues that must be addressed when managing this population. Further advances in the field of tolerance and accommodation are needed to relieve the acute and cumulative burden of chronic immunosuppression in children. Liver Transplantation 23 244–256 2017 AASLD</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age Factors</subject><subject>Child</subject><subject>Communicable Diseases - epidemiology</subject><subject>Communicable Diseases - etiology</subject><subject>Communicable Diseases - immunology</subject><subject>Counseling</subject><subject>End Stage Liver Disease - mortality</subject><subject>End Stage Liver Disease - surgery</subject><subject>Graft Rejection - immunology</subject><subject>Graft Rejection - prevention & control</subject><subject>Graft Survival - immunology</subject><subject>Humans</subject><subject>Immune Tolerance</subject><subject>Immunosuppression - adverse effects</subject><subject>Immunosuppression - methods</subject><subject>Immunosuppressive Agents - pharmacology</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>Liver</subject><subject>Liver - immunology</subject><subject>Liver Transplantation - adverse effects</subject><subject>Patient Compliance - psychology</subject><subject>Patient Transfer</subject><subject>Pediatrics</subject><subject>Transplant Recipients - psychology</subject><subject>Transplants & implants</subject><subject>Treatment Outcome</subject><issn>1527-6465</issn><issn>1527-6473</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kM1LwzAYh4Mobk7Bv0AKXrx05qtN6k2GH5OBl-0c0jSBjC6NSarsv7fauZun9z08PD94ALhGcI4gxPdtmmNaMnYCpqjALC8pI6fHvywm4CLGLYQIFRU8BxPMOKO4gFPwttztetfF3vugY7Sdy6zLvG6sTMGqrLWfOmQpSBd9K13KglbWW-1SfMg2zn70OpPRa5XiJTgzso366nBnYPP8tF685qv3l-XicZUrigqWk6YqDaES11VRNzWhFW9UhRVqlFGa1qSpGcJcQwqJZJWpFNelVKUy3ChiajIDt6PXh26Yj0lsuz64YVIgXkLOCWN0oO5GSoUuxqCN8MHuZNgLBMVPNNEm8RttQG8Owr7e6eYI_lUagHwEvmyr9_-KxGo9Cr8B4kp26w</recordid><startdate>201702</startdate><enddate>201702</enddate><creator>Miloh, Tamir</creator><creator>Barton, Andrea</creator><creator>Wheeler, Justin</creator><creator>Pham, Yen</creator><creator>Hewitt, Winston</creator><creator>Keegan, Tara</creator><creator>Sanchez, Christine</creator><creator>Bulut, Pinar</creator><creator>Goss, John</creator><general>Wolters Kluwer Health, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope></search><sort><creationdate>201702</creationdate><title>Immunosuppression in pediatric liver transplant recipients: Unique aspects</title><author>Miloh, Tamir ; Barton, Andrea ; Wheeler, Justin ; Pham, Yen ; Hewitt, Winston ; Keegan, Tara ; Sanchez, Christine ; Bulut, Pinar ; Goss, John</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4157-3d96f34a2b95bdb3498dc92c1dcfce4b3db7128e0403a79f9c8e6ac6cf8fc3fb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age Factors</topic><topic>Child</topic><topic>Communicable Diseases - epidemiology</topic><topic>Communicable Diseases - etiology</topic><topic>Communicable Diseases - immunology</topic><topic>Counseling</topic><topic>End Stage Liver Disease - mortality</topic><topic>End Stage Liver Disease - surgery</topic><topic>Graft Rejection - immunology</topic><topic>Graft Rejection - prevention & control</topic><topic>Graft Survival - immunology</topic><topic>Humans</topic><topic>Immune Tolerance</topic><topic>Immunosuppression - adverse effects</topic><topic>Immunosuppression - methods</topic><topic>Immunosuppressive Agents - pharmacology</topic><topic>Immunosuppressive Agents - therapeutic use</topic><topic>Liver</topic><topic>Liver - immunology</topic><topic>Liver Transplantation - adverse effects</topic><topic>Patient Compliance - psychology</topic><topic>Patient Transfer</topic><topic>Pediatrics</topic><topic>Transplant Recipients - psychology</topic><topic>Transplants & implants</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Miloh, Tamir</creatorcontrib><creatorcontrib>Barton, Andrea</creatorcontrib><creatorcontrib>Wheeler, Justin</creatorcontrib><creatorcontrib>Pham, Yen</creatorcontrib><creatorcontrib>Hewitt, Winston</creatorcontrib><creatorcontrib>Keegan, Tara</creatorcontrib><creatorcontrib>Sanchez, Christine</creatorcontrib><creatorcontrib>Bulut, Pinar</creatorcontrib><creatorcontrib>Goss, John</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><jtitle>Liver transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Miloh, Tamir</au><au>Barton, Andrea</au><au>Wheeler, Justin</au><au>Pham, Yen</au><au>Hewitt, Winston</au><au>Keegan, Tara</au><au>Sanchez, Christine</au><au>Bulut, Pinar</au><au>Goss, John</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Immunosuppression in pediatric liver transplant recipients: Unique aspects</atitle><jtitle>Liver transplantation</jtitle><addtitle>Liver Transpl</addtitle><date>2017-02</date><risdate>2017</risdate><volume>23</volume><issue>2</issue><spage>244</spage><epage>256</epage><pages>244-256</pages><issn>1527-6465</issn><eissn>1527-6473</eissn><coden>LITRFO</coden><abstract>Pediatric liver transplantation has experienced improved outcomes over the last 50 years. This can be attributed in part to establishing optimal use of immunosuppressive agents to achieve a balance between minimizing the risks of allograft rejection and infection. The management of immunosuppression in children is generally more complex and can be challenging when compared with the use of these agents in adult liver transplant patients. Physiologic differences in children alter the pharmacokinetics of immunosuppressive agents, which affects absorption, distribution, metabolism, and drug excretion. Children also have a longer expected period of exposure to immunosuppression, which can impact growth, risk of infection (bacterial, viral, and fungal), carcinogenesis, and likelihood of nonadherence. This review discusses immunosuppressive options for pediatric liver transplant recipients and the unique issues that must be addressed when managing this population. Further advances in the field of tolerance and accommodation are needed to relieve the acute and cumulative burden of chronic immunosuppression in children. Liver Transplantation 23 244–256 2017 AASLD</abstract><cop>United States</cop><pub>Wolters Kluwer Health, Inc</pub><pmid>27874250</pmid><doi>10.1002/lt.24677</doi><tpages>13</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1527-6465 |
| ispartof | Liver transplantation, 2017-02, Vol.23 (2), p.244-256 |
| issn | 1527-6465 1527-6473 |
| language | eng |
| recordid | cdi_proquest_journals_1860883774 |
| source | Wiley-Blackwell Journals; MEDLINE; Alma/SFX Local Collection |
| subjects | Adolescent Adult Age Factors Child Communicable Diseases - epidemiology Communicable Diseases - etiology Communicable Diseases - immunology Counseling End Stage Liver Disease - mortality End Stage Liver Disease - surgery Graft Rejection - immunology Graft Rejection - prevention & control Graft Survival - immunology Humans Immune Tolerance Immunosuppression - adverse effects Immunosuppression - methods Immunosuppressive Agents - pharmacology Immunosuppressive Agents - therapeutic use Liver Liver - immunology Liver Transplantation - adverse effects Patient Compliance - psychology Patient Transfer Pediatrics Transplant Recipients - psychology Transplants & implants Treatment Outcome |
| title | Immunosuppression in pediatric liver transplant recipients: Unique aspects |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-14T18%3A36%3A23IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Immunosuppression%20in%20pediatric%20liver%20transplant%20recipients:%20Unique%20aspects&rft.jtitle=Liver%20transplantation&rft.au=Miloh,%20Tamir&rft.date=2017-02&rft.volume=23&rft.issue=2&rft.spage=244&rft.epage=256&rft.pages=244-256&rft.issn=1527-6465&rft.eissn=1527-6473&rft.coden=LITRFO&rft_id=info:doi/10.1002/lt.24677&rft_dat=%3Cproquest_cross%3E4306565951%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1860883774&rft_id=info:pmid/27874250&rfr_iscdi=true |