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Lung transplantation tacrolimus

Brandon E Cohen, Igor Krivitskiy, Sarah Bui, Kevin Forrester, Jeffrey Kahn, Richard Barbers, Binh Ngo
BACKGROUND: Organ transplantation is a significant risk factor for the development of skin cancer. The impact of skin type, immunosuppressive regimens, and photosensitizing agents requires further study. OBJECTIVE: The objective of this study was to compare skin cancer development between Caucasian and non-Caucasian transplant recipients at the University of Southern California. METHODS: We performed a retrospective chart review of lung and liver transplantations to determine the incidence of post-transplant skin cancer...
November 23, 2018: Clinical Drug Investigation
Ryan G Short, Tina D Tailor
History A 31-year-old woman with a history of bilateral orthotopic lung transplantation performed 10 months earlier for cystic fibrosis presented for a routine follow-up appointment, with her chief symptom being a cough. The cough started approximately 1 month prior to this appointment and was minimally productive of clear to yellow phlegm. In addition to her cough, she reported increased sinus congestion and a sensation of "something in her upper chest." She denied shortness of breath, wheezing, hemoptysis, or cigarette smoking...
December 2018: Radiology
Y Matsuda, S Eba, F Hoshi, H Oishi, T Sado, M Noda, A Sakurada, T Watanabe, H Niikawa, M Akiba, Y Okada
BACKGROUND: Calcineurin inhibitors are a commonly used immunosuppressive drug and over 80% of lung transplant (LTx) recipients use tacrolimus. Sustained-release tacrolimus (SRT) was developed as a once-daily formulation, resulting in slower release and reduction in peak concentration compared with twice-daily immediate-release tacrolimus (IRT). Previous reports indicate that SRT may carry fewer side effects than IRT; however, the impact of SRT in bronchiolitis obliterans syndrome (BOS) after LTx is unclear...
November 2018: Transplantation Proceedings
H Suzuki, Y Matsuda, M Noda, H Oishi, T Watanabe, T Sado, M Yamada, T Tamada, Y Okada
BACKGROUND AND OBJECTIVES: To treat organ transplant patients with mycobacterial infection, physicians need to pay attention to interaction between drugs used against mycobacteria and immunosuppressants. The purpose of this report is to describe the clinical features of and treatment for mycobacterial infection in lung transplant (LTx) recipients. METHODS: To investigate the incidence, treatment, and outcome for mycobacterial infection, we retrospectively reviewed 100 LTx recipients in our program since 2000...
November 2018: Transplantation Proceedings
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
Yu-Cheng Chiu, Meng-Hsing Ho, Teng-Wei Chen, Chung-Bao Hsieh, Hsiu-Lung Fan
Drug-drug interactions between azoles and calcineurin inhibitors can cause issues for organ transplant specialists. Clinical practice guidelines for the treatment of solid-organ transplant recipients with invasive aspergillosis infection are lacking. Here, we present a patient who developed pulmonary aspergillosis after liver transplant. The patient had prolonged treatment with echinocandin that was not effective. A drug-drug interaction between azoles and tacrolimus caused issues for the clinical physician...
October 24, 2018: Experimental and Clinical Transplantation
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
Shaun Ong, Robert D Levy, John Yee, Nilu Partovi, Andrew Churg, Philippe Roméo, Jean Chalaoui, Roland Nador, Alissa Wright, Hélène Manganas, Christopher J Ryerson
BACKGROUND: Until recently, lung transplantation was not considered in patients with human immunodeficiency virus (HIV). HIV seropositive patients with suppressed viral loads can now expect long-term survival with the advent of highly active antiretroviral therapies (HAART); however, HIV remains a relative contraindication to lung transplantation. We describe, to our knowledge, the first HIV seropositive lung transplant recipient in Canada. We also review the literature of previously reported cases of solid-organ transplantation in patients with HIV with a focus on immunosuppression considerations...
October 16, 2018: BMC Pulmonary Medicine
Dimitri Gassmann, Stefan Weiler, Joachim C Mertens, Cäcilia S Reiner, Bart Vrugt, Mirjam Nägeli, Joanna Mangana, Beat Müllhaupt, Fabienne Jenni, Benjamin Misselwitz
Background: Orthotopic liver transplantation (OLT) is a potential curative treatment in patients with hepatocellular carcinoma (HCC); however, treatment options for recurrent HCC after OLT are limited. Immune checkpoint inhibitors, such as nivolumab, an inhibitor of programmed cell death protein 1, have been successfully used for metastatic HCC but data on safety of nivolumab following solid organ transplantation are limited. Methods: We report a 53-year-old woman with HCC who was treated with OLT...
August 2018: Transplantation Direct
C Ferrándiz-Pulido, M T Martin-Gomez, T Repiso, C Juárez, B Ferrer, I López-Lerma, G Aparicio, C González-Cruz, F Moreso, A Román, V García-Patos
BACKGROUND: The incidence of cutaneous infections by dematiaceous fungi is rising in our environment due to the high number of solid organ transplant recipients (SOTR). OBJECTIVE: To review our experience in the management of cutaneous phaeohyphomycoses in a Spanish reference center for dermatological care of SOTR. METHODS: Retrospective clinical, histopathological and microbiological review of all SOTR diagnosed of a phaeohyphomycosis in a 7-year period...
September 19, 2018: Mycoses
J Wojarski, M Ochman, M Latos, P Biniszkiewicz, W Karolak, E Woźniak-Grygiel, M Maruszewski, M Urlik, W Mędrala, Z Kułaczkowska, K Pyrc, S Żegleń
BACKGROUND: The aim of the study was to assess the frequency of infections caused by Pneumocystis jiroveci, Chlamydophila pneumoniae, Legionella pneumophila, and Mycoplasma pneumoniae among lung transplant recipients in the context of immunosuppression. METHODS: The study group consisted of 94 patients (37 women and 57 men; mean age 42.03 years) transplanted between 2009 and 2016 at the Silesia Center for Heart Diseases (SCCS). Immunosuppressive treatment (induction and maintenance therapy) was assessed...
September 2018: Transplantation Proceedings
Florentine Garaix, Marc Stern, François-Xavier Lamy, Laurence Dubel, Nassim Kamar
BACKGROUND Different pharmaceutical forms of oral tacrolimus allow tailored administration. The granular formulation facilitates accurate dose adjustment of tacrolimus according to patient characteristics, such as weight, or potential concomitant drug interactions. Currently, there are no data describing the use of tacrolimus granules in transplant recipients in France. MATERIAL AND METHODS OPTIMOD was a 6-month prospective, observational multicenter study that aimed to describe patient characteristics and conditions of use of tacrolimus granules...
August 10, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Marlina Mansour, Lucas Hill, Janice Kerr
BACKGROUND: The direct acting antivirals (DAAs) for treatment of hepatitis C virus (HCV) infection have sustained virologic response (SVR) rates of greater than 90% in most patients. However, data evaluating DAA use in transplant patients are limited. The goal of this study was to evaluate the effectiveness and safety of HCV treatment in this high-risk population. METHODOLOGY: This single-center retrospective study included liver, kidney, lung, and/or heart transplant patients who were treated for HCV infection with DAAs...
August 6, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Claudie Laprise, Elizabeth K Cahoon, Charles F Lynch, Amy R Kahn, Glenn Copeland, Lou Gonsalves, Margaret M Madeleine, Ruth M Pfeiffer, Eric A Engels
Solid organ transplant recipients have an increased risk of lip cancer, but the reasons are uncertain. Using data from the Transplant Cancer Match Study, we describe the epidemiology of lip cancer among 261 500 transplant recipients in the United States. Two hundred thirty-one lip cancers were identified, corresponding to elevated risks for both invasive and in situ lip cancers (standardized incidence ratios of 15.3 and 26.2, respectively). Invasive lip cancer incidence was associated with male sex (adjusted incidence rate ratio [aIRR] 2...
August 3, 2018: American Journal of Transplantation
Ryan G Short, Tina D Tailor
History A 31-year-old woman with a history of bilateral orthotopic lung transplantation performed 10 months earlier for cystic fibrosis presented for a routine follow-up appointment, with her chief symptom being a cough. The cough started approximately 1 month prior to this appointment and was minimally productive of clear to yellow phlegm. In addition to her cough, she reported increased sinus congestion and a sensation of "something in her upper chest." She denied shortness of breath, wheezing, hemoptysis, or cigarette smoking...
August 2018: Radiology
Helena Sintes, Berta Sáez-Giménez, Cristina Berastegui, Manuel López-Meseguer, Víctor Monforte, Carlos Bravo, Jaume Vima, Susana Gómez-Ollés, Antonio Roman
BACKGROUND: The aim of this study was to compare the pharmacokinetic profile, tolerability, and safety of a novel once-daily extended-release formulation of tacrolimus (LCPT) with that of once-daily prolonged-release tacrolimus (ODT) in stable adult lung transplant (LT) recipients. METHODS: Phase II, open-label, single-arm, single-center, prospective pilot pharmacokinetic study. Study population comprised 20 stable LTR receiving ODT, mean age 55.9 (r: 38-67) years, 13 (65%) men...
June 29, 2018: Transplantation
Ian J Saldanha, Oluwaseun Akinyede, Karen A Robinson
BACKGROUND: For people with cystic fibrosis and advanced pulmonary damage, lung transplantation is an available and viable option. However, graft rejection is an important potential consequence after lung transplantation. Immunosuppressive therapy is needed to prevent episodes of graft rejection and thus subsequently reduce morbidity and mortality in this population. There are a number of classes of immunosuppressive drugs which act on different components of the immune system. There is considerable variability in the use of immunosuppressive agents after lung transplantation in cystic fibrosis...
June 18, 2018: Cochrane Database of Systematic Reviews
Daniel R Calabrese, Rebecca Florez, Katherine Dewey, Christine Hui, Dara Torgerson, Tiffany Chong, Hilary Faust, Raja Rajalingam, Steven R Hays, Jeffrey A Golden, Jasleen Kukreja, Jonathan P Singer, John R Greenland
Most lung transplantation immunosuppression regimens include tacrolimus. Single nucleotide polymorphisms (SNPs) in genes important to tacrolimus bioavailability and clearance (ABCB1, CYP3A4, and CYP3A5) are associated with differences in tacrolimus pharmacokinetics. We hypothesized that polymorphisms in these genes would impact immunosuppression-related outcomes. We categorized ABCB1, CYP3A4, and CYP3A5 SNPs for 321 lung allograft recipients. Genotype effects on time to therapeutic tacrolimus level, interactions with antifungal medications, concentration to dose (C0 /D), acute kidney injury, and rejection were assessed using linear models adjusted for subject characteristics and repeat measures...
August 2018: Clinical Transplantation
Hironosuke Watanabe, Tomoshi Tsuchiya, Koichiro Shimoyama, Akira Shimizu, Sadanori Akita, Hiroshi Yukawa, Yoshinobu Baba, Takeshi Nagayasu
BACKGROUND: Immunosuppression following lung transplantation is a key aspect to the graft's survival. However, the well-known complications that are caused by immunosuppressive regimens present an opportunity to study ways to minimize the usage of these drugs. Recently, a promising discovery has been made pertaining to the immunomodulatory effects of adipose tissue-derived mesenchymal stem cells (ADMSCs) through their secretion of hepatocyte growth factor. In the hopes of mitigating the adverse effects of standard immunosuppressive regimens, our study aims to investigate the effects of ADMSCs on the immune response utilizing a rat lung transplantation model...
July 2018: Journal of Surgical Research
Paul N Banks, Ashraf Omar, Rajat Walia, Sarabjit Bhalla, Yun Chong, Sofya Tokman
Background: Lung transplant recipients are treated with a 3-drug immunosuppressive regimen that consists of a calcineurin inhibitor, an antiproliferative agent, and a corticosteroid. Calcineurin inhibitors are the backbone of this regimen, and tacrolimus is used more often than cyclosporine, because tacrolimus is the more potent of the two agents. Tacrolimus-induced hyponatremia has been described among kidney transplant recipients, but not among lung transplant recipients. Methods: We conducted a retrospective chart review of patients who underwent lung transplant at our institution and went on to develop severe hyponatremia...
April 2018: Transplantation Direct
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