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Clinical Chemistry 42: 1316-1321, 1996;
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Clinical Chemistry, Vol 42, 1316-1321, Copyright © 1996 by American Association for Clinical Chemistry

Toxic effects of immunosuppressive drugs: mechanisms and strategies for controlling them

LM Shaw, B Kaplan and D Kaufman
Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia 19104-4283, USA. les- shaw@path la.med.upenn.edu

Since cyclosporine (CsA) was introduced into clinical practice in late 1983 to prevent rejection in transplant patients, there has been an almost explosive growth in the number and types of transplants and the number of transplant centers, an increase in the life expectancy of the transplanted organ, and substantial decreases in rates of acute rejection and life-threatening infections. Despite these successes, major improvements in immunosuppressive therapy are needed, especially a reduction in toxic side effects and a rigorous definition of the relation between drug concentration and clinical effects. Such improvements may be achievable with the incorporation of new drugs such as tacrolimus and mycophenolate mofetil into immunosuppression protocols and the development of rigorously defined therapeutic drug- monitoring programs.


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