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Lung transplantation tacrolimus

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
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...
August 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
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