Evaluación de los protocolos de inmunosupresión en pacientes con trasplante renal, Hospital Regional IESS Dr. Teodoro Maldonado Carbo, 1985-2012
No hay miniatura disponible
Fecha
2013
Autores
Título de la revista
ISSN de la revista
Título del volumen
Editor
Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La mayoría de los pacientes con Enfermedad Renal Crónica (ERC) desarrollan
síntomas y requieren tratamiento de sustitución renal tales como la hemodiálisis y la
diálisis peritoneal. Sin embargo su mayor aspiración es el de ser receptores de un
trasplante renal con la esperanza de mejorar su calidad de vida. Este tipo de tratamiento
se reinicio en el Hospital del IESS en el 2004 para tratar de satisfacer dicha demanda,
utilizando esquemas estructurados de protocolo de inmunosupresión y así obtener una
menor incidencia de rechazo con mayor sobrevida del injerto que proviene en su
mayoría de donantes vivos. En este estudio tipo descriptivo, diseño no experimental,
longitudinal y retroprospectivo se evaluaron un total de 8 protocolos de
inmunosupresión utilizados en 105 pacientes con Trasplante Renal realizado entre 1985-2012 en el Servicio de Nefrología del Hospital Regional II IESS “DR. TEODORO MALDONADO CARBO”, que incluyeron el uso de los inhibidores de la calcineurina,
inhibidores de la síntesis de nucleótidos, inhibidores mTOR, cuyos resultados
demuestran que los protocolos mas utilizados fueron la combinación de
Micofelonato+ciclosporina+prednisona 46.7%, azatioprina+ciclosporina+prednisona
15.2% y ciclosporina+everolimus+prednisona 10.5%. El promedio de sobrevida del
injerto es de 2 a 10 años con un porcentaje de 73.3%, comprobándose que el
micofelonato de mofetilo estuvo presente en un 65.7% en las diferentes combinaciones,
aumentando al 77.1% después de haberlo incluido en el protocolo posterior a signos de
rechazo crónico, por lo que es uno de los fármacos que debería incluirse de forma
preferente en los esquemas de inmunosupresión para tratar de obtener mayor sobrevida
del injerto y menor incidencia de rechazo.
Most patients with chronic kidney disease (CKD) develop symptoms and require renal replacement therapy such as hemodialysis and peritoneal dialysis. However his greatest aspiration is to be recipients of a kidney transplant in hopes of improving their quality of life. This type of treatment is reset IESS Hospital in 2004 to try to meet that demand, using structured schemes immunosuppression protocol and obtain a lower incidence of rejection with increased graft survival that comes mostly from living donors. In this descriptive study, no experimental, longitudinal and retroprospectivo evaluated a total of 8 immunosuppression protocols used in 105 renal transplant patients conducted between 1985 to 2012 in the Nephrology Regional Hospital IESS II "DR. Teodoro Maldonado Carbo "which included the use of inhibitors of calcineurin inhibitors, nucleotide synthesis inhibitors, mTOR, the results show that the protocols used were the combination of cyclosporine mycophenolate + 46.7% + prednisone, azathioprine, cyclosporin + + prednisone and cyclosporine 15.2% + 10.5% + prednisone everolimus. The average graft survival is 2 to 10 years with a percentage of 73.3%, proving that mycophenolate mofetil was present in 65.7% in different combinations, increasing to 77.1% after being included in the protocol after signs Chronic rejection, and it is one of the drugs should preferentially included in the immunosuppression regimens attempt to obtain higher graft survival and reduced incidence of rejection.
Most patients with chronic kidney disease (CKD) develop symptoms and require renal replacement therapy such as hemodialysis and peritoneal dialysis. However his greatest aspiration is to be recipients of a kidney transplant in hopes of improving their quality of life. This type of treatment is reset IESS Hospital in 2004 to try to meet that demand, using structured schemes immunosuppression protocol and obtain a lower incidence of rejection with increased graft survival that comes mostly from living donors. In this descriptive study, no experimental, longitudinal and retroprospectivo evaluated a total of 8 immunosuppression protocols used in 105 renal transplant patients conducted between 1985 to 2012 in the Nephrology Regional Hospital IESS II "DR. Teodoro Maldonado Carbo "which included the use of inhibitors of calcineurin inhibitors, nucleotide synthesis inhibitors, mTOR, the results show that the protocols used were the combination of cyclosporine mycophenolate + 46.7% + prednisone, azathioprine, cyclosporin + + prednisone and cyclosporine 15.2% + 10.5% + prednisone everolimus. The average graft survival is 2 to 10 years with a percentage of 73.3%, proving that mycophenolate mofetil was present in 65.7% in different combinations, increasing to 77.1% after being included in the protocol after signs Chronic rejection, and it is one of the drugs should preferentially included in the immunosuppression regimens attempt to obtain higher graft survival and reduced incidence of rejection.
Descripción
PDF
Palabras clave
Insuficiencia renal crónica, Protocolos, Trasplante de riñón, Inmunosupresión, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador