A common practice in my country when a patient with immunosuppresive treatment (glomerulopathy, kidney transplant) has an infection ussually the baseline immunosuppressive treatment is changed, sometimes suspension of MMF and tacrolimus and substitution for steroids only , however I haven't found any guideline that suggest how to do it.
In our transplant center we will hold the MMF, keep steroids, and shoot for the lower end of our accepted ranges for Tacrolimus. A general guide we use for post transplant Tacrolimus ranges are: month 0-3 (8-12 ng/ml), month 3-6 (6-10ng/ml), and > 6 months (4-8ng/ml).
Hello,
In our transplant center, we generally will hold (in particular) the antimetabolite (imuran or mycophenolate) during episodes of infection requiring hospitalization. There are no trials that I am aware of to inform us on this practice, but is done as a matter of common practice. I would imagine that this would be a very difficult study to randomize for practical reasons and so this recommendation might forever be based on 'expert opinion'.
Dr. Jordan Weinstein
In our transplant center, we generally will hold (in particular) the antimetabolite (imuran or mycophenolate) during episodes of infection requiring hospitalization. There are no trials that I am aware of to inform us on this practice, but is done as a matter of common practice. I would imagine that this would be a very difficult study to randomize for practical reasons and so this recommendation might forever be based on 'expert opinion'.
Dr. Jordan Weinstein
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