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Standardisation of immunosuppressive and anti-infective drug regimens in UK Paediatric Renal transplantation: The Harmonisation Programme

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Last updated:1st May 2020

This guideline makes recommendations for immunosuppressive and anti-infective prescribing and monitoring in children and young people (CYP) receiving routine, kidney-only transplants.
Current variation in practice of immunosuppressive and anti-infective prescribing in CYP undergoing kidney transplantation impairs assessment of outcomes post transplant and may disadvantage some CYP. Different regimens employed in the UK currently include ‘steroid maintenance’ therapy comprising tacrolimus, azathioprine and prednisolone (PAT); steroid maintenance (PAT) with IL-2 receptor antagonist induction with basiliximab (PAT-B); early steroid withdrawal regimens comprising IL-2 receptor antagonist induction, tacrolimus, mycophenolate mofetil (MMF), and short course of prednisolone (the ‘TWIST’ regimen) and variations of these according to levels of immunological risk, primary disease or co-morbidities (obesity / diabetes / bone disease).

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