薬物疫学と医薬品の安全性の進歩

概要

Descriptive Study of Drug Induced Liver Injury in Kidney Transplant Patients

Amina Berradia*, Mekaouche FZN, Achour N, Djoudad K, Fetati H, Toumi H

Drug induced Liver injury (DILI) is one of the most common complications after renal transplantation.

That’s why, we conducted a study wich aims to identify and describe cases of DILI that occurred after kidney transplantation at the University Hospital-establishment-Oran (UHEO).

It is a retrospective study (June 2010 to March 2017), based on renal transplant recepients (RTRs) records archived at the kidney transplant unit of the nephrology department of UHEO.

First, we have collected DILI characteristics required for the causality assessment by two methods: the naranjo et al method and the CIOMS scale.

Our study found that 23% of renal transplant recipients developped suspected DILI. The concerned patients were predominantly young men (age ≤ 32 ans). Suspected DILIs were mainly cytolytic (57%), which is comparable to the study of Hajime Takikawa et al. (55%).

According to the CIOMS method, causality was possible in 57% of cases.

The incriminated drugs were immunosuppressants, diuretiques, antimicrobials and painkillers, and they were described as hepatotoxic according to livertox database.

Moreover, DILIs were managed principally by dose reduction, momentary drug cessation or switch to another drug. Prophylactic application of Bicyclol was reported as a protective factor against DILIs at an early stage after renal transplantation. Fortunately, all DILI cases evolution in RTRs was favourable.

Close monitoring, especially therapeutic drug monitoring, should prevent severe DILIs. Also, a performant pharmacovigilance system would allow an early identification of the offending drug for a better prognosis.