Immunosuppressive therapy and post‐transplantation diarrhea

Abstract

Gastrointestinal complications, including diarrhea, are among the anticipated adverse events secondary to immunosuppression. The reported overall rate of diarrhea may be affected by drug‐specific effects, dose—response effects, interactions with other medications, drug formulation, the length of study follow‐up, reporting bias and population characteristics such as ethnicity and baseline disease, including transplant organ type. The true incidence of diarrhea is often difficult to assess from the numerous published clinical trials. A number of deficiencies, including self‐reporting, interstudy comparisons, lack of blinding, concomitant medications and a general lack of standardization and quantification of diarrhea may greatly obscure comparisons among the different immunosuppressive medications. This review considers each of these factors in assessing the overall incidence of post‐transplantation diarrhea for the various immunosuppressive medications currently in use.