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M. Krakauer, H. K. Pandya, P. Bakhtiari, N. Nassiri, A. R. Djalilian; Systemic Immunosupression in Keratolimbal Allograft. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3757.
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Keratolimbal allograft is one of the few options available for limbal stem cell deficiency. One disadvantage to the procedure is the prolonged course of systemic immunosuppression that is necessary to avoid transplant rejection postoperatively. Our purpose was to examine the adverse effects of systemic immunosuppression in patients with keratolimbal allograft.
We completed a retrospective review of 16 patients with keratolimbal allograft who received systemic immunosuppression that consisted of a corticosteroid, an anti-metabolite, and/or a calcineurin inhibitor. Patients were monitored for signs, symptoms, or laboratory evidence of drug toxicity.
Ten out of 16 patients experienced adverse effects while on systemic immunosuppression. No adverse effects occurred that were serious or life-threatening. The most common adverse effects were hyperbilirubinemia, anemia, and elevated creatinine. Prednisone and tacrolimus were responsible for the greatest number of adverse effects.
Keratolimbal allograft requires a long course of systemic immunosuppression comparable to that required in renal transplant patients. In contrast to the effects seen in renal transplant patients, our data demonstrated that systemic immunosuppression did not result in serious adverse effects in our patient population. Many adverse effects self-resolved or resolved by adding or changing a medication. Close monitoring for signs, symptoms, or laboratory evidence of drug toxicity is still necessary.
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