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everolimus and transplantation

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https://www.readbyqxmd.com/read/30401391/renal-function-changes-under-everolimus-plus-cyclosporine-or-everolimus-plus-tacrolimus-after-heart-transplantation
#1
T-Y Chiang, C-I Tsao, S-S Wang
Everolimus (EVR) can be used with calcineurin inhibitors to reduce the risk of renal dysfunction, with similar immunosuppressive effect. In this study, we compared renal function after heart transplantation (HT) under EVR with cyclosporine (CSA) or tacrolimus (TAC). Between 2004 and 2014, EVR with CSA or TAC was used in 117 HT at the National Taiwan University Hospital. After HT, all patients received corticosteroid, EVR (C0 target 3-8 ng/mL) and CSA (C0 blood level 100-200 ng/mL), or TAC (Co blood level 5-10 ng/mL)...
November 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/30387865/effects-of-conversion-from-calcineurin-inhibitors-to-sirolimus-or-everolimus-on-renal-function-and-possible-mechanisms-in-liver-transplant-recipients
#2
Kai-Fan Tsai, Lung-Chih Li, Chien-Ning Hsu, Chih-Che Lin, Yu-Hung Lin, Yu-Fan Cheng, Chih-Chi Wang, Chao-Long Chen
Mammalian targets of rapamycin inhibitors (mTORIs), including sirolimus and everolimus, are used for minimizing calcineurin inhibitors after liver transplantation. However, head-to-head randomized comparisons of these 2 mTORIs are lacking. We assessed the differences in renoprotection and possible mechanisms between sirolimus and everolimus in liver transplant recipients. For this prospective cohort study, we recruited liver transplant recipients whose regimens were switched from tacrolimus to sirolimus or everolimus at a Taiwan medical center...
November 2, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/30365464/everolimus-and-long-term-clinical-outcomes-in-kidney-transplant-recipients-a-registry-based-10-year-follow-up-of-five-randomized-trials
#3
Tracey Ying, Germaine Wong, Wai H Lim, Philip Clayton, John Kanellis, Helen Pilmore, Scott Campbell, Philip J O'Connell, Graeme Russ, Steven Chadban
BACKGROUND: Data regarding the long-term efficacy of everolimus-based immunosuppression for kidney transplantation are lacking. Existing randomised controlled trials are limited by short follow-up duration which limits capacity to assess impact on graft and patient survival. METHODS: We linked individual trial participants to the Australian and New Zealand Dialysis and Transplant Registry. Using a one-step meta-analysis approach, we investigated the ten-year risk of graft loss, mortality and graft function in 349 participants from five randomised-trials of everolimus-based immunosuppression...
October 26, 2018: Transplantation
https://www.readbyqxmd.com/read/30361470/association-between-renal-dysfunction-and-major-adverse-cardiac-events-after-liver-transplantation-evidence-from-an-international-randomized-trial-of-everolimus-based-immunosuppression
#4
Faouzi Saliba, Lutz Fischer, Paolo de Simone, Peter Bernhardt, Giovanni Bader, John Fung
BACKGROUND Prospective evidence is lacking regarding the association between renal dysfunction and cardiovascular events after liver transplantation. MATERIAL AND METHODS Data were analyzed post hoc regarding renal function and major adverse cardiac events in a two-year prospective trial of de novo liver transplant recipients randomized at 30 days post-transplant to (i) everolimus [EVR]/reduced tacrolimus [EVR/rTAC] (ii) EVR with tacrolimus discontinued [TAC Elimination] or (iii) standard tacrolimus [TAC Control]...
October 26, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/30354362/effect-of-everolimus-initiation-and-calcineurin-inhibitor-elimination-on-cardiac-allograft-vasculopathy-in-de-novo-heart-transplant-recipients
#5
Satish Arora, Arne K Andreassen, Kristjan Karason, Finn Gustafsson, Hans Eiskjær, Hans Erik Bøtker, Göran Rådegran, Einar Gude, Dan Ioanes, Dag Solbu, Göran Dellgren, Thor Ueland, Pål Aukrust, Lars Gullestad
Background Cardiac allograft vasculopathy (CAV) limits survival after heart transplantation, and the effect of different immunosuppressive regimens on CAV is not fully understood. The randomized SCHEDULE trial (Scandinavian Heart Transplant Everolimus De Novo Study With Early Calcineurin Inhibitors Avoidance) evaluated whether initiation of the proliferation signal inhibitor everolimus and early cyclosporine elimination can reduce CAV development. Methods and Results The SCHEDULE trial was a multicenter Scandinavian trial, where 115 de novo heart transplantation recipients were randomized to everolimus with complete cyclosporine withdrawal 7 to 11 weeks after heart transplantation or standard cyclosporine-based immunosuppression...
September 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/30348935/everolimus-use-for-intolerance-or-failure-of-baseline-immunosuppression-in-adult-heart-and-lung-transplantation
#6
Shelby E Kelsh, Reda Girgis, Michael Dickinson, Jennifer K McDermott
BACKGROUND Everolimus can be utilized after heart or lung transplantation to reduce calcineurin inhibitor associated nephrotoxicity, due to cell cycle inhibitor adverse effects, and as adjunct therapy for rejection, cardiac allograft vasculopathy, and bronchiolitis obliterans syndrome. MATERIAL AND METHODS A single-center, retrospective cohort study was conducted including 51 adult heart transplant patients (n=32) and lung transplant patients (n=19) started on everolimus due to immunosuppressive therapy intolerance or failure, between 2010 and 2017...
October 23, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/30337516/clinical-outcomes-of-tuberculosis-in-recipients-after-living-donor-liver-transplantation
#7
Noruel Gerard A Salvador, Sin-Yong Wee, Chih-Che Lin, Chao-Chien Wu, Hung-I Lu, Ting-Lung Lin, Wei-Feng Lee, Yi-Chia Chan, Li-Man Lin, Chao-Long Chen
BACKGROUND This study aimed to determine clinical outcomes using various drugs during tuberculosis (TB) treatment among living donor liver transplant (LDLT) recipients with TB and to assess the impact of performing LDLT in patients with active TB at the time of LDLT. MATERIAL AND METHODS Out of 1313 LDLT performed from June 1994 to May 2016, 26 (2%) adult patients diagnosed with active TB were included in this study. Active TB was diagnosed using either TB culture, PCR, and/or tissue biopsy. RESULTS The median age was 56 years and the male/female ratio was 1...
October 19, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/30328142/waldenstr%C3%A3-m-macroglobulinemia-2018-update-on-diagnosis-risk-stratification-and-management
#8
Morie A Gertz
DISEASE OVERVIEW: Waldenström macroglobulinemia (WM) is a lymphoplasmacytic lymphoma with immunoglobulin M (IgM) monoclonal protein. Clinical features include anemia, thrombocytopenia, hepatosplenomegaly, lymphadenopathy, and rarely hyperviscosity. DIAGNOSIS: Presence of IgM monoclonal protein associated with ≥10% clonal lymphoplasmacytic cells in bone marrow confirms the diagnosis. The L265P mutation in MYD88 is detectable in >90% of patients and is found in the majority of IgM monoclonal gammopathy of undetermined significance patients...
October 17, 2018: American Journal of Hematology
https://www.readbyqxmd.com/read/30319636/early-everolimus-initiation-fails-to-counteract-the-cytotoxic-response-mediated-by-cd8-t-and-nk-cells-in-heart-transplant-patients
#9
Beatriz Díaz-Molina, Paula Diaz-Bulnes, Reyes Carvajal Palao, Maria José Bernardo, Ramón M Rodriguez, Viviana Corte-Iglesias, Cesar Moris de la Tassa, Jose Luis Lambert, Beatriz Suarez-Alvarez
The positive long-term effects of conversion to everolimus (EVL) after heart transplantation (HT) have been evaluated in several studies. However, the timing of EVL initiation, the best way to combine it with other immunosuppressive treatments, and the impact of these combinations on the immune response are poorly understood aspects. Here, we analyzed the immune phenotype and function of HT patients ( n = 56) at short and long terms (prospective and retrospective cohorts), taking into account the time of EVL initiation: early (3 months post-transplant, EVL-E group) or late (>1 year post-transplant, EVL-L group) compared with mycophenolate mofetil treatment (MMF group)...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/30318104/everolimus-rescue-treatment-for-chronic-rejection-after-pediatric-living-donor-liver-transplantation-2-case-reports
#10
T Ueno, S Hiwatashi, R Saka, H Yamanaka, Y Takama, Y Tazuke, K Bessho, H Okuyama
Chronic rejection (CR) remains a challenging complication after liver transplantation. Everolimus, which is a mammalian target of rapamycin inhibitor, has an anti-fibrosis effect. We report here the effect of everolimus on CR. Case 1 was a 7-year-old girl who underwent living donor liver transplantation (LDLT) shortly after developing fulminant hepatitis at 10 months of age. Liver function tests (LFTs) did not improve after transplantation despite treatment with tacrolimus + mycophenolate mofetil (MMF). Antithymoglobulin (ATG) and steroid pulse therapy were also ineffective...
March 19, 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/30316397/condyloma-acuminata-of-the-urethra-in-a-male-renal-transplant-recipient-a-case-report
#11
I Hamano, S Hatakeyama, H Yamamoto, T Fujita, R Murakami, M Shimada, A Imai, T Yoneyama, T Yoneyama, Y Hashimoto, T Koie, S Narumi, H Saitoh, T Suzuki, H Tomita, C Ohyama
BACKGROUND: Condyloma acuminatum (CA) is a common sexually transmitted disease associated with human papilloma virus (HPV). CA occurring in the urethra is rare and has not been reported in male renal transplant recipients. In addition, despite immunosuppressive conditions and increased risk of HPV-related malignant neoplasms in transplant recipients, HPV testing in male transplant recipients has been uncommon. Here we report a case of urethral CA in a male deceased donor renal transplantation recipient and discuss the importance of HPV testing in male transplant recipients...
October 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/30316375/effect-of-influenza-vaccine-in-patients-with-kidney-transplant
#12
K Tsujimura, M Ota, K Chinen, K Nagayama, M Oroku, Y Shiohira, K Iseki, H Ishida, K Tanabe
BACKGROUND: Among infectious diseases, influenza is the most common cause of infection in Japan and worldwide. We aimed to evaluate the effect of influenza vaccination in kidney transplantation (KTx) recipients. METHODS: We retrospectively evaluated the records of 98 participants who underwent KTx at our institution between March 2009 and May 2016. All patients received tacrolimus or cyclosporine, mycophenolate mofetil, and methylprednisolone for maintenance immunosuppression after KTx...
October 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/30312541/circulating-delta-like-notch-ligand-1-is-correlated-with-cardiac-allograft-vasculopathy-and-suppressed-in-heart-transplant-recipients-on-everolimus-based-immunosuppression
#13
Hilde M Norum, Annika E Michelsen, Tove Lekva, Satish Arora, Kari Otterdal, Maria Belland Olsen, Xiang Yi Kong, Einar Gude, Arne K Andreassen, Dag Solbu, Kristjan Karason, Göran Dellgren, Lars Gullestad, Pål Aukrust, Thor Ueland
Cardiac allograft vasculopathy (CAV) causes heart failure after heart transplantation (HTx), but its pathogenesis is incompletely understood. Notch signaling, possibly modulated by everolimus (EVR), is essential for processes involved in CAV. We hypothesized that circulating Notch ligands would be dysregulated after HTx. We studied circulating delta-like Notch ligand 1 (DLL1) and periostin (POSTN) and CAV in de novo HTx recipients (n=70) randomized to standard or EVR-based, calcineurin inhibitor-free immunosuppression and in maintenance HTx recipients(n=41)...
October 12, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/30270311/impact-of-coronary-artery-calcification-in-the-donor-heart-on-transmitted-coronary-artery-disease-in-heart-transplant-recipients
#14
Yuki Kimura, Osamu Seguchi, Keiichiro Iwasaki, Koichi Toda, Noriko Kikuchi, Sachi Matsuda, Yuto Kumai, Kensuke Kuroda, Kyoichi Wada, Yorihiko Matsumoto, Satsuki Fukushima, Masanobu Yanase, Tomoyuki Fujita, Junjiro Kobayashi, Norihide Fukushima
BACKGROUND: Coronary artery disease (CAD) after heart transplantation (HTx) develops as a combination of donor-transmitted coronary atherosclerosis (DTCA) and cardiac allograft vasculopathy. Assessing donor CAD before procurement is important. Because coronary artery calcification (CAC) is a predictor for CAD, donor-heart CAC is usually evaluated to estimate the risk of donor CAD. The usefulness of CAC for predicting DTCA, however, is not known. Methods and Results: Sixty-four HTx recipients whose donor underwent chest computed tomography before procurement or ≤2 weeks after HTx and who underwent coronary angiography and intravascular ultrasound (IVUS) ≤3 months after HTx were enrolled...
September 29, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/30235234/systemic-immunosuppression-and-risk-of-age-related-macular-degeneration
#15
Harpal S Sandhu, Joshua Lambert, Yan Xu, Henry J Kaplan
A local immune response has been implicated in the pathogenesis of age-related macular degeneration (AMD), but it is unclear if systemic immunosuppressive/immunomodulatory therapy (IMT) protects against the onset and/or progression of AMD. We performed a retrospective cohort study using a Cox proportional hazards model of two cohorts. Cohort 1 included patients with stage V chronic kidney disease (CKD) status post kidney transplantation, on at least one IMT agent, and older than 50. Cohort 2 included patients with stage IV or V CKD who had not undergone kidney transplantation, were not on IMT, and were older than 50...
2018: PloS One
https://www.readbyqxmd.com/read/30231851/onset-and-progression-of-diabetes-in-kidney-transplant-patients-receiving-everolimus-or-cyclosporine-therapy-an-analysis-of-two-randomized-multicenter-trials
#16
Claudia Sommerer, Oliver Witzke, Frank Lehner, Wolfgang Arns, Petra Reinke, Ute Eisenberger, Bruno Vogt, Katharina Heller, Johannes Jacobi, Markus Guba, Rolf Stahl, Ingeborg A Hauser, Volker Kliem, Rudolf P Wüthrich, Anja Mühlfeld, Barbara Suwelack, Michael Duerr, Eva-Maria Paulus, Martin Zeier, Martina Porstner, Klemens Budde
BACKGROUND: Conversion from calcineurin inhibitor (CNI) therapy to a mammalian target of rapamycin (mTOR) inhibitor following kidney transplantation may help to preserve graft function. Data are sparse, however, concerning the impact of conversion on posttransplant diabetes mellitus (PTDM) or the progression of pre-existing diabetes. METHODS: PTDM and other diabetes-related parameters were assessed post hoc in two large open-label multicenter trials. Kidney transplant recipients were randomized (i) at month 4...
September 19, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/30229636/analysis-of-neoplastic-skin-complications-in-transplant-patients-experience-of-an-italian-multidisciplinary-transplant-unit
#17
Barbara Marconi, Anna Campanati, Melania Giannoni, Francesca Ricotti, Tommaso Bianchelli, Annamaria Offidani
BACKGROUND: Transplant patients need to be strictly followed, since the immunosuppressive therapies they usually receive can increase the risk of skin complications. This study aims to evaluate the prevalence of neoplastic skin complications in transplant patients. METHODS: We analyzed 256 liver or kidney transplant patients. The follow-up mean period was 7+/-3,5 years. It was also evaluated the prevalence of cutaneous neoplastic complications according to the immunosuppressive regimen received by patients as follows: cyclosporine, tacrolimus, steroids, mycophenolate mofetil or everolimus, in single, double or triple therapy...
September 18, 2018: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
https://www.readbyqxmd.com/read/30229635/kaposi-s-sarcoma-lung-metastastis-in-transplanted-patient-treatment-response-with-paclitaxel-and-everolimus
#18
Raffaele D Caposiena Caro, Angelo Coppola, Dario Didona
No abstract text is available yet for this article.
September 18, 2018: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
https://www.readbyqxmd.com/read/30211826/blood-pressure-in-de-novo-heart-transplant-recipients-treated-with-everolimus-compared-with-a-cyclosporine-based-regimen-results-from-the-randomized-schedule-trial
#19
Arne K Andreassen, Kaspar Broch, Hans Eiskjær, Kristjan Karason, Einar Gude, Dorte Mølbak, Wenche Stueflotten, Lars Gullestad
BACKGROUND: Systemic hypertension is prevalent in heart transplant recipients, and has been partially attributed to treatment with calcineurin inhibitors (CNIs). The SCHEDULE trial was the first randomized trial to study early withdrawal of CNIs in de novo heart transplant recipients, comparing an everolimus-based immunosuppressive regimen with conventional CNI-based treatment. As a prespecified secondary endpoint, blood pressure was repeatedly compared across treatment arms. METHODS: SCHEDULE was a prospective, multicenter, randomized, controlled, parallel-group, open-label trial in de novo adult heart transplant recipients, undertaken at transplant centers in Scandinavia...
September 11, 2018: Transplantation
https://www.readbyqxmd.com/read/30211023/introduction-of-everolimus-in-kidney-transplant-recipients-at-a-late-posttransplant-stage
#20
REVIEW
Junji Uchida, Tomoaki Iwai, Tatsuya Nakatani
This minireview focuses on the current knowledge about the introduction of everolimus (EVL), a mammalian target of rapamycin inhibitor, with calcineurin inhibitor (CNI) elimination or minimization in kidney transplant recipients at a late posttransplant stage. Within, we have summarized two major clinical trials, ASCERTAIN and APOLLO, and seven other retrospective or nonrandomized studies. In the open-label multicenter ASCERTAIN study, the estimated glomerular filtration rate (eGFR) at 24 mo after conversion was not significantly different between three groups-EVL with CNI elimination, CNI minimization and continued CNI unchanged-at a mean of 5...
September 10, 2018: World Journal of Transplantation
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