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首页> 外文期刊>Medical Case Studies >Tacrolimus adverse events in transplant recipients with diarrhoea or calcium channel blockers: Systematic review
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Tacrolimus adverse events in transplant recipients with diarrhoea or calcium channel blockers: Systematic review

机译：系统性评价：腹泻或钙通道阻滞剂的移植受者中他克莫司的不良反应

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摘要

Tacrolimus is widely used for solid-organ transplant immunosuppression.?Adverse events can happen?in recipients with?diarrhoea or calcium channel blockers (CCBs) co-administration. We?undertook a systematic review on adverse events in recipients?treated with Tacrolimus for whom a raised tacrolimus trough level (≥10 ng/ml) was reported, in a situation of diarrhoea or CCB co-administration.?From 312 identified studies, 16 were included, representing 65 patients. Sixty-one (94%) patients were suffering from diarrhoea, 3 (5%) received concomitant CCBs, and one (2%) presented with both; 46 (71%) were adults, 45 (69%) were kidney transplant recipients. Only 9 (14%) suffered from clinical symptoms: nephrotoxicity was reported in 9%, and required dialysis in 2%, neurotoxicity in 7%, multi-organ failure in 4%, and transient liver dysfunction in 2%. One patient was found to carry polymorphisms on CYP450 and P-glycoprotein, both involved in the tacrolimus metabolism and influenced by diarrhoea and CCB administration.?Although, the risk of adverse events related to raised tacrolimus through blood level in situations of diarrhea or CCB administration is well-known and can be severe, published data is still scarce. The determination of the exact frequency of such events and the risk factors involved, such as pharmacogenetic background, would require observational cohort studies.
机译：他克莫司被广泛用于实体器官移植的免疫抑制。腹泻或钙通道阻滞剂（CCBs）共同给药的接受者可能发生不良事件。我们对腹泻或CCB并用的情况下接受他克莫司治疗的受试者的他克莫司谷水平升高（≥10 ng / ml）进行了系统的回顾研究。从312项确定的研究中，有16项包括65名患者。腹泻的患者有61名（94％），同时接受了CCB的患者有3名（5％），并且有两种同时出现的CCBs（1％）。成人有46名（71％），肾移植受者有45名（69％）。只有9名（14％）患有临床症状：肾毒性为9％，需要透析的为2％，神经毒性为7％，多器官功能衰竭为4％，短暂性肝功能障碍为2％。发现一名患者的CYP450和P-糖蛋白具有多态性，均与他克莫司的代谢有关，并受腹泻和CCB的影响。？是众所周知的并且可能很严重，已发布的数据仍然很少。确定此类事件的确切频率以及所涉及的危险因素（例如遗传背景）将需要进行观察性队列研究。

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