Thai Transplant Care Practice Guideline on Immunosuppressive Therapy for Adult Kidney Transplantation
In brief
Thai guideline sets cost-conscious immunosuppression protocols for adult kidney transplants
The Thai Transplantation Society's guideline covers induction, maintenance, drug monitoring and rejection treatment for adult kidney transplant recipients, with tailored advice for resource-limited settings. It includes strategies using generic drugs and medicines that can reduce required doses, plus guidance for fasting, pregnancy and cancer. The recommendations offer a practical reference, but the abstract reports no outcome testing.
- Journal
- Nephrology (Carlton, Vic.) (Q1)
- Published
- 1 September 2026
- Study design
- Practice guideline / consensus
- Evidence level
- Level 1, High (CEBM 1c)
- Authors
- Suwasin Udomkarnjananun, Napun Sutharattanapong, Nuttasith Larpparisuth, Korntip Phonphok, Tanun Ngamvichchukorn, Peenida Skulratanasak, et al.
- PMID
- 42813300
- DOI
- 10.1111/nep.70268
Why clinicians should know about it
- Picked for Nephrology (top studies of the week, 4 October 2026): Thai transplant guideline on immunosuppressive therapy for adult kidney transplantation
Abstract
The Thai Transplantation Society developed these clinical practice guidelines to establish a comprehensive standard for immunosuppressive therapy in adult kidney transplantation. While rooted in evidence-based medicine, the objective of this document extends beyond local application, serving as a practical model for low-to-middle-income countries, particularly within the Asia-Pacific and Southeast Asian regions, where specific genetic profiles and resource limitations require tailored management strategies. This publication addresses a critical need in the field, as there has been no updated comprehensive international consensus on immunosuppression since the KDIGO Clinical Practice Guideline in 2009, over 17 years ago. These guidelines bridge this gap by synthesizing modern clinical data with practical applicability. The scope of the guidelines is extensive, covering all aspects of immunosuppression usage including induction, maintenance, therapeutic drug monitoring, and the treatment of rejection. Uniquely, this document addresses specific challenges relevant to resource-limited settings, offering protocols for cost reduction through the use of generic drugs and the co-administration of cytochrome P450 3A4 and 3A5 inhibitors to minimize dosage requirements. Furthermore, it provides distinct guidance for immunosuppression in special clinical settings, including management during periods of fasting, pregnancy, and malignancy. This guideline ultimately benefits clinicians by offering a pragmatic, updated reference that balances therapeutic efficacy with economic sustainability.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.