Open AccessCalcineurin Inhibitor Toxicity in Solid Organ Transplantation
Author(s) -
Andrea Karolin,
Vera Genitsch,
Daniel Sidler
Publication year - 2021
Publication title -
pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.51
H-Index - 59
eISSN - 1423-0313
pISSN - 0031-7012
DOI - 10.1159/000515933
Subject(s) - calcineurin , immunosuppression , medicine , toxicity , therapeutic window , pharmacology , transplantation , neurotoxicity , kidney transplantation , intensive care medicine
Calcineurin inhibitors (CNIs) have a substantial role in maintaining immunosuppression after solid organ transplantation (SOT). These drugs have a narrow therapeutic window, and individual doses and drug treatment monitoring are necessary. Still, a substantial proportion of patients suffer from short- or long-term calcineurin inhibitor toxicity (CNT), including kidney function impairment, hypertension, neurotoxicity, and metabolic disturbances. The authors discuss pathophysiology, clinical presentation, and histological features of CNT, with focus on renal manifestations. Furthermore, we elucidate recent and ongoing attempts to reduce the burden of CNT in SOT including CNI-sparing and CNI-free regimens.