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https://www.readbyqxmd.com/read/29786042/early-immunosuppressive-exposure-of-enteric-coated-mycophenolate-sodium-plus-tacrolimus-associated-with-acute-rejection-in-expanded-criteria-donor-kidney-transplantation
#1
Chen-Guang Ding, Li-Zi Jiao, Feng Han, He-Li Xiang, Pu-Xun Tian, Xiao-Ming Ding, Xiao-Ming Pan, Xiao-Hui Tian, Yang Li, Jin Zheng, Wu-Jun Xue
Background: Immunosuppressive agents are still inefficient in preventing biopsy-proven acute rejection (BPAR) after expanded criteria donor (ECD) kidney transplantation. The aim of this study was to investigate the relationships between early immunosuppressive exposure and the development of BPAR. Methods: We performed a retrospective study of 58 recipients of ECD kidney transplantation treated with enteric-coated-mycophenolate sodium, tacrolimus (Tac), and prednisone...
June 5, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29731387/challenges-of-immunosuppressive-and-antitrypanosomal-drug-therapy-after-heart-transplantation-in-patients-with-chronic-chagas-disease-a-systematic-review-of-clinical-recommendations
#2
REVIEW
Silas Santana Nogueira, Amanda Aparecida Felizardo, Ivo Santana Caldas, Reggiani Vilela Gonçalves, Rômulo Dias Novaes
BACKGROUND: Although contraindicated for decades, heart transplantation (HT) has finally become a feasible therapeutic option for the treatment of Chagasic patients with end-stage heart failure. Part of the success in achieving acceptable survival rates after HT is due to the enhancement of the pharmacological management of allograft rejection and reactivation of Trypanosoma cruzi infection. METHODS: By using the framework of a systematic review, we investigated if Chagasic patients who have undergone a HT are treated with similar immunosuppressive and antitrypanosomal regimens in endemic and non-endemic countries and exhibits similar T...
April 17, 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29731069/bk-virus-infection-in-thai-kidney-transplant-recipients-a-single-center-experience
#3
P Skulratanasak, J Mahamongkhonsawata, M Chayakulkeereeb, N Larpparisutha, N Premasathiana, A Vongwiwatana
INTRODUCTION: BK virus-associated nephropathy (BKVAN) is a significant cause of allograft dysfunction and failure in kidney transplant recipients. Early detection and proper adjustment of immunosuppression is the best method for treatment of this condition and to improve long-term allograft outcome. Here, we reported the prevalence and risk factors of BK virus (BKV) infection in our population. METHODS: We retrospectively reviewed kidney transplant recipients at Siriraj Hospital between January 2012 and December 2015 who had been investigated using real-time polymerase chain reaction BK viral load...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29713132/high-tacrolimus-intra-patient-variability-is-associated-with-graft-rejection-and-de-novo-donor-specific-antibodies-occurrence-after-liver-transplantation
#4
Arnaud Del Bello, Nicolas Congy-Jolivet, Marie Danjoux, Fabrice Muscari, Laurence Lavayssière, Laure Esposito, Anne-Laure Hebral, Julie Bellière, Nassim Kamar
AIM: To investigate the role of tacrolimus intra-patient variability (IPV) in adult liver-transplant recipients. METHODS: We retrospectively assessed tacrolimus variability in a cohort of liver-transplant recipients and analyzed its effect on the occurrence of graft rejection and de novo donor-specific antibodies ( dn DSAs), as well as graft survival during the first 2 years posttransplantation. Between 02/08 and 06/2015, 116 patients that received tacrolimus plus mycophenolate mofetil (with or without steroids) were included...
April 28, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29705974/extreme-hypercalcemia-in-a-kidney-transplant-recipient
#5
Erol Demir, Cagla Karaoglan, Gulcin Yegen, Betul Sair, Halil Yazici, Aydin Turkmen, Mehmet Sukru Sever
Post-transplant hypercalcemia is a major problem in renal transplant recipients, which may negatively affect both graft and patient survival. In this paper, we present a 66-year-old male kidney transplant recipient, who was admitted to our clinic with symptoms of fever, nausea, vomiting and lethargy. Laboratory data showed good renal function; however, a serum calcium level of 22.1 mg/dL. The patient was treated by isotonic saline together with furosemide and methylprednisolone. Because of treatment resistance, subcutaneous calcitonin and ibandronate were added to the treatment protocol as well...
April 28, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29689561/urate-lowering-agents-in-asymptomatic-hyperuricemia-role-of-urine-sediment-analysis-and-musculoskeletal-ultrasound
#6
Davide Viggiano, Giuseppe Gigliotti, Gianfranco Vallone, Anna Giammarino, Michelangelo Nigro, Giovambattista Capasso
Current urate-lowering therapy (ULT) includes three direct acting drugs (allopurinol, febuxostat, Rasburicase) and at least four 'indirect' drugs with other important targets (canagliflozin, losartan, fenofibrate and sevelamer). Moreover, the alcalinization of urines using bicarbonate can be used to dissolve urate crystals and the clinician may discontinue several drugs are known to increase serum levels of uric acid, such as diuretics, aspirin, cyclosporine, theophylline, mycophenolate and ACE inhibitors. While there is a consensus to start ULT in cases of symptomatic hyperuricemia (gout, urate-nephrolithiasis), the very frequent conditions of asymptomatic hyperuricemia remains a major conundrum...
April 19, 2018: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29676018/conversion-from-tacrolimus-mycophenolate-mofetil-to-tacrolimus-mtor-immunosuppression-after-kidney-pancreas-transplantation-reduces-the-incidence-of-both-bk-and-cmv-viremia
#7
Richard J Knight, Edward A Graviss, Duc T Nguyen, Samantha A Kuten, Samir J Patel, Lillian Gaber, A Osama Gaber
BACKGROUND: We sought to determine if conversion from tacrolimus/mycophenolate mofetil (TAC-MMF) to tacrolimus/mTOR inhibitor (TAC-mTOR) immunosuppression would reduce the incidences of BK and CMV viremia after kidney/pancreas (KP) transplantation. METHODS: In this single center review, the TAC-mTOR cohort (n=39) was converted at one month post-transplant to an mTOR inhibitor and reduced dose tacrolimus. Outcomes were compared to a cohort of KP recipients (n=40) maintained on TAC-MMF...
April 19, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29670764/corticosteroid-weaning-in-stable-heart-transplant-patients-guidance-by-serum-cortisol-level
#8
David A Baran, Cheryl Rosenfeld, Mark J Zucker
Background: Despite earlier studies describing the feasibility of steroid weaning in heart transplant patients, the majority of patients are maintained on steroid therapy for life. We examined a strategy based on a single morning serum cortisol measurement. Methods: We assigned stable posttransplant patients, who were maintained on tacrolimus, mycophenolate mofetil, and corticosteroids, into one of two groups based on a screening morning cortisol level. Patients with a cortisol < 8 micrograms/deciliter were assigned to a "maintenance" group and the others were assigned to the weaning group and steroids were tapered off over 4-6 weeks...
2018: Journal of Transplantation
https://www.readbyqxmd.com/read/29669532/pulmonary-lymphangioleimyomatosis-and-systemic-lupus-erythematosus-in-a-menopausal-woman
#9
Hong Hong, Ruiheng Yang, Xiuzhen Li, Mengjun Wang, Zhongchao Ma
BACKGROUND: Pulmonary lymphangioleimyomatosis (PLAM) is a rare disease involving lung. PLAM primarily affects young women, a characteristic it shares with systemic lupus erythematosus (SLE). Estrogen has long been assumed to play an important role both in PLAM and SLE. We report a menopausal woman, who was found to have PLAM 1 year after she was diagnosed with SLE. Her chest radiograph was normal in the early phase of SLE. CASE PRESENTATION: A 52-year-old Chinese woman was referred to our hospital in August 2014 because of swelling in both legs...
April 18, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29662050/does-vitamin-d-affect-chronic-renal-allograft-function-in-pediatric-transplant-patients
#10
Brooke Wile, Elisa Yoo, Ana Catalina Alvarez Elias, Lakshmimathy Subramanian, Kathryn Eager, Ajay Parkesh Sharma, Guido Filler
BACKGROUND Correction of hypovitaminosis D is simple, but it is unclear whether it is associated with an accelerated decline of renal allograft function in pediatric renal transplantation patients. This retrospective single center cohort study aimed at analyzing the effect of vitamin D and covariates on the slope of 1/creatinine after the first year. MATERIAL AND METHODS After ethics committee approval, 37 (14 male) pediatric renal transplant recipients on mycophenolate mofetil, who were followed between 2006 and 2014, were included in this study...
April 17, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29661455/management-of-juvenile-idiopathic-arthritis-in-abo-incompatible-kidney-transplantation-a-case-report
#11
S Ishikawa, M Tasaki, T Kuroda, D Kobayashi, K Saito, Y Nakagawa, M Ikeda, K Takahashi, Y Tomita
Biologic agents are a beneficial therapy for juvenile idiopathic arthritis (JIA). However, there is a lack of evidence with regard to management of these agents for JIA patients who undergo kidney transplantation (KTx). A 36-year-old woman with JIA who was treated with tocilizumab targeting interleukin-6 (IL-6) receptor underwent ABO-incompatible kidney transplantation (ABOi KTx). To prevent over-immunosuppression, tocilizumab was discontinued before ABOi KTx. Rituximab, tacrolimus, mycophenolate mofetil, everolimus, and methylprednisolone were used for immunosuppression...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29644994/autoimmune-hepatitis
#12
REVIEW
Giorgina Mieli-Vergani, Diego Vergani, Albert J Czaja, Michael P Manns, Edward L Krawitt, John M Vierling, Ansgar W Lohse, Aldo J Montano-Loza
Autoimmune hepatitis (AIH) is a severe liver disease that affects children and adults worldwide. The diagnosis of AIH relies on increased serum transaminase and immunoglobulin G levels, presence of autoantibodies and interface hepatitis on liver histology. AIH arises in genetically predisposed individuals when a trigger, such as exposure to a virus, leads to a T cell-mediated autoimmune response directed against liver autoantigens; this immune response is permitted by inadequate regulatory immune control leading to a loss of tolerance...
April 12, 2018: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/29616329/proliferative-glomerulonephritis-with-monoclonal-igg-deposits-in-children-and-young-adults
#13
Guolan Xing, Robert Gillespie, Badreldin Bedri, Albert Quan, Pingchuan Zhang, Xin J Zhou
BACKGROUND: Proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID) has been recognized as a distinct entity in recent years. To the best of our knowledge, all patients with PGNMID reported thus far were older than 20 years of age. We now report five cases of PGNMID in patients under 20 years of age. METHODS: The clinical database was searched for patients with native kidney biopsies from 9/2011 to 8/2017, and cases with a diagnosis of PGNMID were retrieved...
April 3, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29611341/outcome-and-predictors-of-renal-survival-in-patients-with-lupus-nephritis-comparison-between-cyclophosphamide-and-mycophenolate-mofetil
#14
Young Bin Joo, Young Mo Kang, Hyoun-Ah Kim, Chang-Hee Suh, Tae-Jong Kim, Yong-Wook Park, Jisoo Lee, Joo-Hyun Lee, Dae Hyun Yoo, Sang-Cheol Bae, Hye-Soon Lee, So-Young Bang
AIM: To compare renal outcomes between cyclophosphamide (CYC) and mycophenolate mofetil (MMF), and attempt to identify a predictor of renal survival. METHODS: A total of 99 patients with class III-V lupus nephritis (LN) and treated with CYC or MMF were enrolled. The remission rate and predictors of poor renal outcomes in LN were assessed. RESULTS: The mean age at LN diagnosis was 31.7 years. The baseline characteristics of the two groups were similar except for the chronicity index (3...
April 2, 2018: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/29610699/hemorrhagic-tamponade-as-initial-manifestation-of-systemic-lupus-with-subsequent-refractory-and-progressive-lupus-myocarditis-resulting-in-cardiomyopathy-and-mitral-regurgitation
#15
Nicole Marijanovich, Alexandra Halalau
Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease with a wide range of clinical and serological manifestations. Cardiac disease among patients with SLE is common and can involve the pericardium, myocardium, valves, conduction system, and coronary arteries. We are reporting a case of SLE in a young woman that is unique is unique in that initial symptoms consisted of pericarditis and hemorrhagic tamponade which remained progressive and resistant to aggressive immunosuppressive treatment and led to severe cardiomyopathy (ejection fraction of 25%) and severe (+4) mitral regurgitation...
2018: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/29599408/non-parathyroid-hypercalcemia-associated-with-paraffin-oil-injection-in-12-younger-male-bodybuilders
#16
Anne Sophie Koldkjær Sølling, Birgitte Tougaard, Torben Harsløf, Bente Langdahl, Helle Kongsbak Brockstedt, Keld-Erik Byg, Per Ivarsen, Ina Karstoft Ystrøm, Frank Holden Mose, Gustaf Lissel Isaksson, Morten Steen Svarer Hansen, Subagini Nagarajah, Charlotte Ejersted, Elisabeth Bendstrup, Lars Rejnmark
INTRODUCTION: Injection of paraffin oil to augment muscles size is a troubling phenomenon known to cause a foreign-body reaction with formation of granulomas. In a few case-reports, long-term side effects have been reported in terms of hypercalcemia and renal failure. METHODS: We identified a case series of 12 male bodybuilders presenting with non-parathyroid hypercalcemia who previously had injected paraffin oil to increase muscles size. RESULTS: At admission, all patients had moderate to severe hypercalcemia with suppressed PTH levels and impaired renal function...
March 29, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29579853/survival-and-evolution-of-renal-function-in-kidney-transplant-recipients-from-type-ii-asystolic-donations-a-single-center-experience
#17
N G Toapanta Gaibor, F M González-Roncero, M Cintra Cabrera, M Suñer Poblet, G Bernal Blanco, A Suarez Benjumea, M A Pérez-Valdivia, J J Egea-Guerrero, J L Rocha Castilla, M A Gentil Govantes
BACKGROUND: In recent years, stagnation in the number of kidneys from after brain-dead donors (DBD) has stimulated the use of non-heart beating donors (NHBDs). Herein we present our 5-year experience with type II Maastricht NHBDs in renal transplantation. METHODS: All patients (n = 50) in this study received type II Maastricht NHBD kidneys (March 2012 to February 2017), with a median follow-up of 33 months. RESULTS: Mean donor age was 39 ± 12 years, mean creatinine 1...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29550576/influence-of-cyp3a5-genetic-differences-in-tacrolimus-on-quantitative-interstitial-fibrosis-and-long-term-graft-function-in-kidney-transplant-recipients
#18
Naoki Komine, Shigeru Satoh, Mitsuru Saito, Kazuyuki Numakura, Takamitsu Inoue, Hiroshi Tsuruta, Shintaro Narita, Atsushi Komatsuda, Hiroshi Nanjo, Hideaki Kagaya, Takenori Niioka, Masatomo Miura, Yoko Mitobe, Tomonori Habuchi
The impact of CYP3A5 polymorphisms on clinical outcomes is controversial. The present study investigated the impact of CYP3A5 genetic differences on the development of interstitial fibrosis (IF) from 0 h to 1 year post-transplantation in biopsy sections from 96 living kidney recipients under the same target trough regimen of tacrolimus. The relationships between CYP3A5 polymorphisms and long-term graft function and death-censored graft survival were also examined. A quantitative analysis of IF was performed using computer-assisted imaging on virtual slides...
March 14, 2018: International Immunopharmacology
https://www.readbyqxmd.com/read/29548021/the-utility-of-trough-mycophenolic-acid-levels-for-the-management-of-lupus-nephritis
#19
Negiin Pourafshar, Ashkan Karimi, Xuerong Wen, Eric Sobel, Shirin Pourafshar, Nikhil Agrawal, Emma Segal, Rajesh Mohandas, Mark S Segal
Background: Monitoring of mycophenolic acid (MPA) levels may be useful for effective mycophenolate mofetil (MMF) dosing. However, whether commonly obtained trough levels are an acceptable method of surveillance remains debatable. We hypothesized that trough levels of MPA would be a poor predictor of area under the curve (AUC) for MPA. Methods: A total of 51 patients with lupus nephritis who were on MMF 1500 mg twice a day and had a 4-h AUC done were included in this study...
March 13, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29546599/idiopathic-membranous-nephropathy-in-children-treated-with-rituximab-report-of-two-cases
#20
Rossana Malatesta-Muncher, Karen W Eldin, Laurence H Beck, Mini Michael
BACKGROUND: Idiopathic membranous nephropathy is an uncommon cause of nephrotic syndrome in children and can present treatment challenges. The current treatment options of steroids and cyclophosphamide, cyclosporine, or mycophenolate require prolonged treatment durations and the associated side effects may result in nonadherence in children, especially in adolescents. CASE-DIAGNOSIS: We report two adolescent patients with idiopathic membranous nephropathy with nephrotic range proteinuria and elevated anti-phospholipase A2 receptor levels who did not achieve remission with steroids and were later treated with rituximab...
June 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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