Immunosuppressive therapy for renal transplantation in adults
National Institute for Clinical Excellence
Record ID 32004000798
English
Authors' objectives:
To provide guidance on the use of immunosuppressive therapy for renal transplantation in adults.
Authors' recommendations:
Guidance 1.1 Basiliximab or daclizumab, used as part of a calcineurin-inhibitor-based immunosuppressive regimen, are recommended as options for induction therapy in the prophylaxis of acute organ rejection in adults undergoing renal transplantation. The induction therapy (basiliximab or daclizumab) with the lowest acquisition cost should be used.
1.2 Tacrolimus is an alternative to ciclosporin when a calcineurin inhibitor is indicated as part of an initial or a maintenance immunosuppressive regimen in renal transplantation for adults. The initial choice of tacrolimus or ciclosporin should be based on the relative importance of their side-effect profiles for individual people.
1.3 Mycophenolate mofetil is recommended for adults as an option as part of an immunosuppressive regimen only: - where there is proven intolerance to calcineurin inhibitors, particularly nephrotoxicity leading to risk of chronic allograft dysfunction, or - in situations where there is a very high risk of nephrotoxicity necessitating minimisation or avoidance of a calcineurin inhibitor.
1.4 Sirolimus is recommended for adults as an option as part of an immunosuppressive regimen only in cases of proven intolerance to calcineurin inhibitors (including nephrotoxicity) necessitating complete withdrawal of these treatments.
1.5 These recommendations contain advice that may result in some medicines being prescribed outside the terms of their marketing authorisation. Clinicians prescribing these drugs should ensure that patients are aware of this, and that they consent to their use in such circumstances.
Authors' methods:
Systematic review
Details
Project Status:
Completed
URL for project:
http://www.nice.org.uk/page.aspx?o=221103
Year Published:
2004
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
England, United Kingdom
MeSH Terms
- Graft Rejection
- Immunosuppressive Agents
- Kidney Transplantation
Contact
Organisation Name:
National Institute for Clinical Excellence
Contact Address:
MidCity Place, 71 High Holborn, London WC1V 6NA, UK. Tel: +44 020 7067 5800; Fax: +44 020 7067 5801
Contact Name:
nice@nice.nhs.uk
Contact Email:
nice@nice.nhs.uk
Copyright:
National Institute for Clinical Excellence (NICE)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.