Nephropathy induced by calcineurin inhibitors in patients after heart transplantation as one of the important problems of modern transplantation

Abstract

This paper addresses the problem of calcineurin inhibitor-induced nephrotoxicity (cyclosporine A [CsA], tacrolimus) in patients after heart transplantation. Based on literature data, the authors draw attention to side effects of the drugs, which in extreme cases may lead to kidney replacement therapy. The authors outline measures that can be applied in order to reduce risk of this complication, mostly by therapy individualization, use of appropriate induction (antiinterleukin-2 receptor monoclonal antibodies) and m-TOR inhibitor replacement therapy. Studies on new drugs are also promising (e.g. voclosporin), which has low nephrotoxic potential and prevents graft rejection more effectively then CsA.