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Adverse Effects of Systemic Immunosuppression in Keratolimbal Allograft

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Title: Adverse Effects of Systemic Immunosuppression in Keratolimbal Allograft
Author(s): Krakauer, M.; Welder, J. D.; Pandya, H. K.; Nassiri, N.; Djalilian, A. R.
Subject(s): adverse effects AGE ANEMIA ARE article Chicago Comorbidity Creatinine deficiency EXPERIENCE Eye Hyperglycemia Illinois Immunosuppression Liver Liver Function Tests methods monitoring Older patient Patients POPULATION prednisone Purpose review Science stem cell STEM-CELL symptom symptoms TESTS toxicity Treatment Universities
Abstract: Purpose. Keratolimbal allograft (KLAL) is a treatment for limbal stem cell deficiency. One disadvantage is systemic immunosuppression to avoid rejection. Our purpose was to examine the adverse effects of systemic immunosuppression in KLAL. Methods. A retrospective case review of 16 patients with KLAL who received systemic immunosuppression consisting of a corticosteroid, an antimetabolite, and/or a calcineurin inhibitor was performed. Patients were monitored for signs, symptoms, or laboratory evidence of toxicity. Results. Eleven of 16 patients (68%) experienced an adverse effect. The average age of those with adverse effects was 43.5 years and without was 31.4 years. Ten of 11 patients (91%) had resolution during mean followup of 16.4 months. No serious adverse effects occurred. The most common included anemia, hyperglycemia, elevated creatinine, and elevated liver function tests. Prednisone and tacrolimus were responsible for the most adverse effects. Patients with comorbidities were more likely to experience an adverse effect (82% versus 20%, P = 0.036). Conclusions. KLAL requires prolonged systemic immunosuppression. Our data demonstrated that systemic immunosuppression did not result in serious adverse effects in our population and is relatively safe with monitoring for toxicity. In addition, we demonstrated that adverse effects are more likely in older patients with comorbidities
Issue Date: 2011-12-22
Publisher: Hindawi Publishing Corporation
Citation Info: Krakauer, M., J. D. Welder, et al. (2012). "Adverse effects of systemic immunosuppression in keratolimbal allograft." Journal of Ophthalmology 2012: 576712. DOI: 10.1155/2012/576712
Type: Article
Description: Copyright © 2012 M. Krakauer et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
ISSN: 2090-004X
Date Available in INDIGO: 2012-10-21

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