Immunosuppression under Trial

Immunosuppression in solid organ transplantation is currently experiencing a worldwide revival since new drugs are now available and others are under development. In order to contribute to the design of future strategies, a critical approach of surrogate endpoints is given and long-term side effects are analysed, together with the impact of non-compliance, quality-of-life and economical parameters. In this book, international specialists have set up the scientific rationale and provided new bases for further immunosuppressive strategies.

Inhalt
1: Setting the stages in clinical trials.- 1. Current results as reference for future improvements in immunosuppression.- 2. Rationale of clinical trials from the physician.- 3. Minimal standards for reporting clinical trial results in transplantation.- 4. Methodological approach of clinical trials for renal transplantation.- 2: Is acute rejection an appropriate surrogate marker?.- 5. Surrogate end-points for clinical trials in renal transplantation.- 6. Is acute rejection an appropriate surrogate marker for clinical trials in liver transplantation?.- 7. The success of clinical immunosuppressive trials in heart transplantation: the early detection of acute rejection.- 3: Towards long-term end-points.- 8. Factors influencing long-term allograft survival.- 4: Can we minimize the long-term side effects?.- 9. Patients' appraisal of side effects in quality of life assessments of immunosuppressive regimens.- 10. Cardiovascular complications after renal transplantation.- 11. Strategies to minimize nephrotoxicity associated with calcineurin inhibitors.- 12. Diabetogenic effect of immunosuppressive drugs.- 13. Can we minimize long-term side effects of immunosuppressive drugs on lipid metabolism?.- 14. Can we minimize the long-term side effects of immunosuppressive drugs in pediatric patients?.- 5: Strategies.- 15. Induction therapy.- 16. Effect of long-term immunosuppression in kidney-graft recipients on cancer incidence: randomised comparison of two cyclosporin regimens.- 17. Immunosuppression in composite tissue transplantation.- 18. The search for immunosuppressive synergy.- 19. Economic analysis of immunosuppression in transplantation: a review of recent studies in liver and kidney transplantation.- 6: Clinical trials for at-risk situations.- 20. Questions raised by theexclusion of 'at risk' conditions from current trials in organ transplantation.- Name index.