Zsom L, Wagner L, Fülöp T. Minimization vs tailoring: Where do we stand with personalized immunosuppression during renal transplantation in 2015? World J Transplant 2015; 5(3): 73-80 [PMID: 26421259 DOI: 10.5500/wjt.v5.i3.73]
Corresponding Author of This Article
Tibor Fülöp, MD, Division of Nephrology, Department of Medicine, University of Mississippi Medical Center, 2500 North State Street, L 504, Jackson, MS 39216-4505, United States. tiborfulop.nephro@gmail.com
Research Domain of This Article
Transplantation
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Sep 24, 2015; 5(3): 73-80 Published online Sep 24, 2015. doi: 10.5500/wjt.v5.i3.73
Minimization vs tailoring: Where do we stand with personalized immunosuppression during renal transplantation in 2015?
Lajos Zsom, László Wagner, Tibor Fülöp
Lajos Zsom, Division of Transplantation, Institute of Surgery, University of Debrecen, 4032 Debrecen, Hungary
László Wagner, Department of Transplantation and Surgery, Semmelweis University, 1085 Budapest, Hungary
Tibor Fülöp, Division of Nephrology, Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216-4505, United States
Author contributions: Zsom L was first author, conceptual design, initial draft, literature review, finalizing manuscript; Wagner L contributed to clinical correlation, literature review, critical review of the manuscript; Fülöp T contributed to literature review, manuscript development and coordinating manuscript revisions, corresponding author.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Tibor Fülöp, MD, Division of Nephrology, Department of Medicine, University of Mississippi Medical Center, 2500 North State Street, L 504, Jackson, MS 39216-4505, United States. tiborfulop.nephro@gmail.com
Telephone: +1-601-9845670 Fax: +1-601-9845765
Received: January 29, 2015 Peer-review started: January 30, 2015 First decision: May 14, 2015 Revised: June 13, 2015 Accepted: July 11, 2015 Article in press: July 14, 2015 Published online: September 24, 2015 Processing time: 238 Days and 7.4 Hours
Core Tip
Core tip: When managing individual transplant recipients, awareness of potential treatment-induced complications and pre-existing comorbidities may take precedence over excessively rigid adherence to pre-existing pathways. Potential areas of improvement are: (1) a thorough assessment of immunological and metabolic risk profile of each donor recipient; (2) screening for predictors of graft loss and early signs of antibody-mediated rejection with donor-specific antibodies, protocol biopsies and proteinuria (including close follow up of adverse effects with dose adjustments or conversions as necessary); and (3) increased awareness of the possible link between poor tolerance of a given drug at a given dose and non-adherence with the prescribed regimen.
