The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians · 2009
Two-year follow-up of the pharmacokinetics of immunosuppressive drugs in a neonate who underwent heart transplantation.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Regazzi Mario, Perotti Gianfranco, Pellegrini Carlo, Molinaro Maria Delfina, Tzialla Chryssoula, Cabano Rita, D'Armini Andrea Maria, Stronati Mauro, Viganò Mario
Аннотация
The pharmacokinetic properties of immunosuppressive drugs are quite different in newborns than in adults and few studies describe the pharmacokinetics of these drugs in pediatric heart transplant recipients. We report on the two-year follow up of a neonate who underwent heart transplantation for Hypoplastic Left Heart Syndrome on day of life 9. Two different immunosuppressive regimens were used: cyclosporine, azathioprine and prednisone in the early postoperative period, followed by the routine tacrolimus and mycophenolate mofetil combination plus prednisone from post-transplant day 22. Our findings demonstrate marked variability in immunosuppressive pharmacokinetic profiles early post-transplant. Frequent monitoring of drug levels is required to ensure that they remain within the therapeutic range. After the first 2-3 months post-transplant, changes in immunosuppressive drug levels are less marked and correlate more with the administered dosage.