Pharmacotherapeutic Management of Viral Infections in Post Renal Transplantation Recipients

¹Kanthaiahgari Jamuna Rani, ²Pilla Sree Surya Durga Devi*, ³Palakunta Thejasree, ⁴Boda Chaithanya Srinivas, ⁵K. Umamaheswara Rao, ⁶V. Siva Kumar
^1,3,4Pharm-D ^5th year, Krishna Teja Pharmacy College, Tirupati.
²Patient Safety Pharmacovigilance Associate, PvPI, AMC-SVIMS, SPMC (W), Tirupati.
⁵Prof. & HOD Pharmacology, SVIMS, SPMC (W), Tirupati.
⁶Senior Professor, Department of Nephrology, SVIMS, Tirupati.

A B S T R A C T
This study mainly focuses on the post-transplant opportunistic viral infections and adverse drug reactions associated with Immunosuppressant therapy and Antiviral therapy. A retrospective study was carried out in the department of Nephrology for a period of six months. Apart from the viral infections, this study also aims to address the adverse drug reactions associated with the all the drugs involved in treatment plan which include immunosuppresants therapy and anti viral therapy. The data collected from patients medical records to analyse the nature and causative organism of viral infection, frequency of attack of viral infections and the treatment given as well as ADRs associated with given treatment. Out of 88 transplanted patients, 42 patients had viral infections. CMV infection (61.53%) shows higher incidence followed by HCV (9.61%), varicella zoster (9.61%), Herpes zoster (9.61%), BK(7.69%) and HBV(1.92%). 59.37% of population of CMV infection are treated with Tab. Valganciclovir. For varicella zoster and Herpes zoster parenteral acyclovir (60%) was given. 100% recovery was observed. 58 ADRs were observed in 88 patients. Prednisolone+Tacrolimus (25.86%) showed higher incidence of ADRs. New onset of diabetes after transplantation (NODAT) (25.86%) and urinary tract infections (18.9%) were most frequent ADRs. Except NODAT rests of all the ADRs are recovered in our study.  Patients should be monitored throughout the post-transplant treatment period for opportunistic infections like viral infections. A proper monitoring of given treatment (Immunosuppressant therapy and anti-viral therapy) through the treatment period can reduce the incidence of preventable ADRs such that the term patient safety is the utmost priority can be justified.
Keywords: Renal transplantation, viral infections, cytomegalo virus, Hepatitis C virus.