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Lung transplantation tacrolimus

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...
June 19, 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
Albert Z Muranda, Ludolf Greeff, Mike M Sathekge, Thabo Lengano, Victor O L Karusseit
BACKGROUND: Cryptococcosis is an important opportunistic infection of organ transplant recipients. It is the third most common fungal infection of transplant patients and occurs especially in kidney recipients. Cryptococcus neoformans is a ubiquitous fungus which infects humans by inhalation of spores. C. gattii has more recently been recognised as a pathogen. Infection commonly is disseminated affecting mainly the central nervous system and the lungs. Cryptococcoma, a localised form of the disease, has been described in various organs...
April 23, 2018: BMC Nephrology
G Schmalz, L Berisha, H Wendorff, F Widmer, A Marcinkowski, H Teschler, U Sommerwerck, R Haak, O Kollmar, D Ziebolz
BACKGROUND: Aim of this study was to investigate the association of the time under immunosuppression and different immunosuppressive medication on periodontal parameters and selected periodontal pathogenic bacteria of immunosuppressed patients after solid organ transplantation (SOT). MATERIAL AND METHODS: 169 Patients after SOT (lung, liver or kidney) were included and divided into subgroups according their time under (0-1, 1-3, 3-6, 6-10 and >10 years) and form of immunosuppression (Tacrolimus, Cyclosporine, Mycophenolate, Glucocorticoids, Sirolimus and monotherapy vs...
May 1, 2018: Medicina Oral, Patología Oral y Cirugía Bucal
John R Greenland, Tiffany Chong, Angelia S Wang, Emily Martinez, Pavan Shrestha, Jasleen Kukreja, Steven R Hays, Jeffrey A Golden, Jonathan P Singer, Qizhi Tang
Lung transplant immunosuppression regimens generally include the calcineurin inhibitor tacrolimus. We hypothesized that mean residual expression (MRE) of calcineurin-dependent genes assesses rejection and infection risk better than does tacrolimus trough. We prospectively followed 44 lung allograft recipients at 2 to 18 months posttransplant and measured changes in whole blood interleukin-2, interferon-γ, and granulocyte-macrophage colony-stimulating factor gene expression following a tacrolimus dose. Posttransplant duration, immunosuppressive medication levels, and bronchoscopic rejection and infection assessments were compared with MRE by using generalized-estimating equation-adjusted models...
April 19, 2018: American Journal of Transplantation
Rickard Nordén, Jesper Magnusson, Anna Lundin, Ka-Wei Tang, Staffan Nilsson, Magnus Lindh, Lars-Magnus Andersson, Gerdt C Riise, Johan Westin
Background: Major hurdles for survival after lung transplantation are rejections and infectious complications. Adequate methods for monitoring immune suppression status are lacking. Here, we evaluated quantification of torque teno virus (TTV) and Epstein-Barr virus (EBV) as biomarkers for defining the net state of immunosuppression in lung-transplanted patients. Methods: This prospective single-center study included 98 patients followed for 2 years after transplantation...
April 2018: Open Forum Infectious Diseases
Chengcheng Fu, Jia Chen, Yang Xu, Depei Wu
PURPOSE: The purpose of this retrospective study was to analyze the dose adjustment of immunosuppressants (cyclosporine, tacrolimus and sirolimus) for the patients with allogeneic hematopoietic stem cell and solid-organ (heart/lung) transplantation during co-administration of posaconazole. METHODS: MEDLINE, EMBASE and Cochrane Library were searched from January 1, 2000 to June 30, 2017 for clinical reports of patients who received allogeneic hematopoietic stem cell and organ transplantation and were co-administered posaconazole and immunosuppressants (cyclosporine, tacrolimus or sirolimus)...
March 27, 2018: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
Janka Franeková, Josef Cindr, Petra Lavríková, Jitka Komrsková, Peter Sečník, Věra Lánská, Antonín Jabor
BACKGROUND: Cancer prevention is essential after transplantation (Tx). The use of HE4 and Risk of Ovarian Malignancy Algorithm (ROMA) is recommended as a tool for selective ovarian cancer screening; however, creatinine is a known confounder. This study assessed the reliability of HE4, CA125, and ROMA after Tx. METHODS: We matched a total of 202 women without gynecological malignancies and 236 men by age and serum creatinine. Each pair consisted of a patient after Tx (kidney, liver, heart, and pancreas) and a diseased but non-Tx consecutive patient...
March 24, 2018: Journal of Clinical Laboratory Analysis
Christopher R Ensor, Carlo J Iasella, Kate M Harrigan, Matthew R Morrell, Cody A Moore, Norihisa Shigemura, Adriana Zeevi, John F McDyer, Raman Venkataramanan
Calcineurin inhibitors (CNIs) are the backbone of traditional immunosuppressive regimens for lung transplant recipients (LTR). The CNIs are both narrow therapeutic index drugs with significant interpatient and intrapatient variability that require therapeutic drug monitoring to ensure safety and effectiveness. We hypothesized that tacrolimus time-in-therapeutic range (TTR) affects acute and chronic rejection rates in LTRs. This was a single-center, observational, cross-sectional study of 292 adult LTRs. Subjects who received tacrolimus posttransplant for the first year were included...
June 2018: American Journal of Transplantation
Charles J Puza, Adela R Cardones, Paul J Mosca
Importance: The immunosuppression vital to maintaining transplanted organs comes with an increased incidence of cutaneous neoplasms. Understanding the genesis of malignant melanoma (MM) in transplant subpopulations is necessary for adequate disease surveillance. Objective: To determine the incidence and timing of presentation of MM in the cardiothoracic (heart and/or lung) transplant (CTT) population. Design, Setting, and Participants: This was a retrospective cohort study of 1164 patients who underwent a CTT from 2001 through 2016 with a median follow-up time of 4...
May 1, 2018: JAMA Dermatology
Helong Dai, Longkai Peng, Fenghua Peng, Gongbin Lan, Yu Wang, Jingjing Chen, Lei Liu, Chen Gao, Yong Guo, Chunhua Fang, Manhua Nie, Wang Long, Shaojie Yu
Pediatric kidney donors remain underutilized due to the high risk of postoperative thrombosis. To address this problem, we developed a novel en bloc kidney transplantation technique using donor thoracic aorta and the distal abdominal aorta as inflow and outflow tracts, respectively. Briefly, eight kidneys from deceased infant donors under five months old and with low body weight (1.9-4.9 kg) were transplanted en bloc into four pediatric and four adult patients. The donor's common iliac artery or external iliac artery was anastomosed to the recipient's distal external iliac artery or inferior epigastric artery, respectively, as an outflow tract...
February 15, 2018: American Journal of Transplantation
A Stanjek-Cichoracka, S Żegleń, P Ramos, B Pilawa, J Wojarski
WHAT IS KNOWN AND OBJECTIVE: The immunosuppressive drugs used in solid organ transplantation or autoimmunological processes were studied by electron paramagnetic resonance (EPR) spectroscopy to estimate their free radical scavenging activity. The interactions of immunosuppressants with free radicals were examined by an X-band (9.3 GHz) EPR spectroscopy and a model of DPPH free radicals. METHODS: The EPR spectra of DPPH and DPPH interacting with individual drugs were compared...
June 2018: Journal of Clinical Pharmacy and Therapeutics
Gerhard Schmalz, Horst Wendorff, Lisa Berisha, Anja Meisel, Florian Widmer, Anna Marcinkowski, Helmut Teschler, Urte Sommerwerck, Rainer Haak, Otto Kollmar, Dirk Ziebolz
OBJECTIVE: The aim of this study was to investigate the association of time after transplantation and different immunosuppressive medications with dental and periodontal treatment needs in patients after solid organ transplantation (SOT). METHODS: After lung, liver, or kidney transplantation, patients were included and divided into subgroups based on the time after SOT (0-1, 1-3, 3-6, 6-10, and >10 years) and immunosuppression (tacrolimus, cyclosporine, mycophenolate, glucocorticoids, sirolimus, and monotherapy vs combination)...
April 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
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