Our investigators seek to better understand the dose-concentration-response and adverse-events relationships of immunosuppressive drugs in pediatric patients receiving organ transplants. Immune suppressing therapies have led to unprecedented short-term patient and graft survival, but long-term survival rates remain suboptimal. Our ongoing research, funded through the National Institutes of Health and other sources, seeks to identify pharmacokinetic, pharmacodynamic and pharmacogenetic factors to explain differences in adverse events and clinical response in transplant patients. Our work includes studying the age-dependent disposition of mycophenolic acid in pediatric renal transplant recipients and children with lupus using newly discovered genetic polymorphisms. Our data will help develop web-based “dashboards” and dosing algorithms to allow personalized dose tailoring.
We also have finalized an important study in morbidly obese adolescents identifying pharmacokinetic, pharmacodynamic and pharmacogenetic factors that will allow personalized propofol anesthesia during bariatric surgery. As part of our personalized pain initiative, we work with colleagues in the Department of Anesthesia on novel pharmacological approaches that use the patient’s drug metabolizing genotype and phenotype to manage pain with morphine and related drugs, reduce adverse events and avoid clinically significant drug/drug interactions.