Maintenance Therapy Immunosuppressive Agents in Post-Liver Transplant Recipients
Keywords:
immunosuppressive agents, liver transplant recipients, medication adherenceAbstract
Liver disease is one of the pivotal public health problems in Thailand. Patients with end-stage liver disease from various causes, such as cirrhosis caused by the hepatitis B virus, the hepatitis C virus, or alcoholic liver disease, as well as hepatocellular carcinoma and patients with acute liver failure have a high mortality rate if not treated timely and appropriately. Liver transplantation is a life-saving surgery for patients with end-stage liver disease. It is the current gold standard treatment. A liver transplant is surgery to replace a diseased liver with a healthy liver from a donor. The first successful liver transplant was performed in 1967, but initial results were not as successful as expected. Therefore, surgical techniques have been developed, and the organ preservation process has improved, including the development of effective immunosuppressive agents. As a result, liver transplantation is successful in terms of patient survival and graft survival, and liver transplant recipients need to receive lifelong immunosuppressive therapy to prevent graft rejection, along with co-medications. Therefore, adherence to immunosuppressive agents must be a concern for excellent long-term outcomes. However, long-term adverse effects of immunosuppressive agents, such as nephrotoxicity, opportunistic infections, and metabolic disorders, can occur that become a major concern and must be continuously monitored.
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