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https://www.readbyqxmd.com/read/29344227/sirolimus-treatment-for-cirrhosis-or-hepatocellular-carcinoma-patients-accompanied-by-psoriasis-after-liver-transplantation-a-single-center-experience
#1
Lin Zhou, Guo-Sheng Du, Li-Chao Pan, Yong-Gen Zheng, Zhi-Jia Liu, Hai-Da Shi, Shao-Zhen Yang, Xian-Jie Shi, Meng Xuan, Li-Kui Feng, Zhi-Dong Zhu
There is currently no consensus on the most suitable therapeutic approach for psoriasis (PS) co-existing with posthepatic cirrhosis (PCs) and hepatocellular carcinoma (HCC) following liver transplantation (LT). The present study provides an analysis of the therapeutic experience of such patients. Five LT recipients (two with PC and three with HCC) with accompanying PS were included. The induction program consisted of methylprednisolone plus basiliximab treatment. The initial postoperative treatment scheme consisted of tacrolimus (FK506) plus mycophenolate mofetil (MMF) and hormone; the latter was withdrawn 1 week after LT...
December 2017: Oncology Letters
https://www.readbyqxmd.com/read/29303612/the-effect-of-induction-therapy-on-established-cmv-specific-t-cell-immunity-in-living-donor-kidney-transplantation
#2
L Stranavova, P Hruba, E Girmanova, I Tycova, A Slavcev, J Fronek, J Slatinska, P Reinke, H-D Volk, O Viklicky
Cytomegalovirus (CMV) infection influences both short and long term outcomes in immunosuppressed organ transplant recipients. The aim of this study was to evaluate the effect of different induction immunosuppression regimens on CMV specific T cell response in patients with already established CMV immunity. In 24 seropositive living donor kidney recipients, the frequency of CMV specific T cells was determined by ELISPOT (Enzyme-Linked ImmunoSpot) assay prior and 6 months after transplantation. Recipients' peripheral blood mononuclear cells were stimulated with immediate-early (IE1) and phosphoprotein 65 (pp65) CMV-derived peptide pools and the number of cells producing interferon gamma (IFN-gamma) was assessed...
January 5, 2018: Physiological Research
https://www.readbyqxmd.com/read/29281761/outcomes-of-kidney-transplantations-in-children-weighing-15-kilograms-or-less-a-retrospective-cohort-study
#3
Benedetta Chiodini, Jean Herman, Ksenija Lolin, Brigitte Adams, Elise Hennaut, Pierre Lingier, Dimitri Mikhalski, Thierry Schurmans, Noël Knops, Karl M Wissing, Daniel Abramowicz, Khalid Ismaili
Kidney transplantation (KT) is often delayed in small children because of fear of post-operative complications. We report early and long-term outcomes in children transplanted at ≤15 kg in the two largest Belgian pediatric transplant centers. Outcomes before (period1) and since the introduction of basiliximab and mycophenolate-mofetil in 2000 (period2) were compared. Seventy-t wo KTs were realized between 1978 and 2016: 38 in period1 and 34 in period2. Organs came from deceased donors in 48 (67%) cases. Surgical complications occurred in 25 KTs (35%) with no significant difference between the two periods...
December 27, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29274236/successful-steroid-withdrawal-guided-by-surveillance-biopsies-a-single-center-experience
#4
Caroline Wehmeier, Patricia Hirt-Minkowski, Patrizia Amico, Argyrios Georgalis, Helmut Hopfer, Jürg Steiger, Michael Dickenmann, Stefan Schaub
Steroid withdrawal following renal transplantation is challenging and widely debated. This retrospective study aimed at investigating the frequency and determinants of successful steroid withdrawal guided by surveillance biopsies. We analysed 156 pre-transplant DSA-negative renal transplants receiving basiliximab induction and maintenance immunosuppression with tacrolimus-mycophenolate-steroids. The absence of rejection in surveillance biopsies at 3 or 6 months post-transplant initiated steroid withdrawal, which was monitored by subsequent indication and/or surveillance biopsies...
December 23, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29259387/simultaneous-liver-pancreas-duodenum-and-kidney-transplantation-in-a-patient-with-hepatitis-b-cirrhosis-uremia-and-insulin-dependent-diabetes-mellitus
#5
Jiang Li, Qing-Jun Guo, Jin-Zhen Cai, Cheng Pan, Zhong-Yang Shen, Wen-Tao Jiang
Simultaneous liver, pancreas-duodenum, and kidney transplantation has been rarely reported in the literature. Here we present a new and more efficient en bloc technique that combines classic orthotopic liver and pancreas-duodenum transplantation and heterotopic kidney transplantation for a male patient aged 44 years who had hepatitis B related cirrhosis, renal failure, and insulin dependent diabetes mellitus (IDDM). A quadruple immunosuppressive regimen including induction with basiliximab and maintenance therapy with tacrolimus, mycophenolate mofetil, and steroids was used in the early stage post-transplant...
December 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29226570/campath-calcineurin-inhibitor-reduction-and-chronic-allograft-nephropathy-the-3c-study-results-of-a-randomized-controlled-clinical-trial
#6
Richard Haynes, Lisa Blackwell, Natalie Staplin, William G Herrington, Jonathan Emberson, Parminder K Judge, Benjamin C Storey, Martin J Landray, Paul N Harden, Colin Baigent, Peter Friend
Calcineurin inhibitors (CNI e.g. tacrolimus) reduce short-term kidney transplant failure, but chronic nephrotoxicity may contribute to late transplant loss. Elective conversion to inhibitors of the mammalian target of rapamycin pathway (mTOR e.g. sirolimus) might avoid long-term CNI renal damage and improve outcomes. The 3C Study was a pragmatic randomized controlled trial comprising sequential randomizations between alemtuzumab and basiliximab induction therapy (at the time of surgery) and between tacrolimus and sirolimus maintenance therapy at 6-months post-transplant...
December 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29198694/reversible-cerebral-vasoconstriction-syndrome-after-heart-transplantation-a-case-report
#7
Y Kumai, O Seguchi, T Sato, K Wada, M Shiozawa, C Yokota, K Kuroda, S Nakajima, T Sato, M Yanase, Y Matsumoto, S Fukushima, T Fujita, J Kobayashi, N Fukushima
BACKGROUND: Reversible cerebral vasoconstriction syndrome (RCVS) is a transient cerebrovascular disorder putatively caused by some immunosuppressive agents. CASE REPORT: We recently encountered a 47-year-old female patient diagnosed with dilated cardiomyopathy who developed RCVS after heart transplantation. A triple-drug regimen consisting of tacrolimus, mycophenolate mofetil, and a corticosteroid was started after surgery. On postoperative day (POD) 11, the patient developed a severe headache, although computed tomography of the head demonstrated no signs of hemorrhage or infarction...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29136299/malignancy-in-renal-transplant-recipients-exposed-to-cyclophosphamide-prior-to-transplantation-for-the-treatment-of-native-glomerular-disease
#8
Margaret R Jorgenson, Jillian L Descourouez, Tripti Singh, Brad C Astor, Sarah E Panzer
STUDY OBJECTIVE: To evaluate the risk of posttransplantation malignancy in renal transplant recipients exposed to pretransplantation cyclophosphamide for the treatment of glomerular nephropathy (GN). DESIGN: Retrospective cohort study. SETTING: Tertiary academic medical center. PATIENTS: Six hundred adult renal transplant recipients were transplanted between 1993 and 2014; 54 patients were exposed to pretransplantation cyclophosphamide for treatment of GN (GN-CYC group), and 546 patients with polycystic kidney disease were not exposed to pretransplantation cyclophosphamide (PKD group)...
November 14, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29068092/high-dose-mizoribine-combined-with-calcineurin-inhibitor-cyclosporine-or-tacrolimus-basiliximab-and-corticosteroids-for-renal-transplantation-a-japanese-multicenter-study
#9
Tsukasa Nishioka, Norio Yoshimura, Hidetaka Ushigome, Yoshihiko Watarai, Kenji Nishimura, Kiyokazu Akioka, Nobuyuki Nakamura, Mutsushi Kawakita, Kenji Yuzawa, Tatsuya Nakatani
OBJECTIVE: To evaluate the utility and safety of high-dose mizoribine combination therapy using cyclosporine and tacrolimus as calcineurin inhibitors in patients undergoing kidney transplant. METHODS: The present study enrolled 156 patients who received kidney transplants in 18 institutions between 2009 and 2013. ABO-incompatible and/or pre-sensitized recipients were excluded. Immunosuppression used cyclosporine (88) or tacrolimus (68) as a calcineurin inhibitor, and the dosage was adjusted based on blood concentrations...
October 25, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/29018183/a-case-of-left-renal-vein-ligation-in-a-patient-with-solitary-left-kidney-undergoing-liver-transplantation-to-control-splenorenal-shunt-and-improve-portal-venous-flow
#10
Rodrigo B Martino, Eserval Rocha Júnior, Valdano Manuel, Vinicius Rocha-Santos, Luis Augusto C D'Albuquerque, Wellington Andraus
BACKGROUND Adequate portal venous flow is required for successful liver transplantation. Reduced venous flow and blood flow 'steal' by collateral vessels are a concern, and when there is a prominent splenorenal shunt present, ligation of the left renal vein has been recommended to improve portal venous blood flow. CASE REPORT A 51-year-old man who had undergone right nephrectomy in childhood required liver transplantation for liver cirrhosis and hepatocellular carcinoma due to hepatitis C virus (HCV) infection...
October 11, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28990220/low-dose-basiliximab-induction-therapy-in-heart-transplantation
#11
Veraprapas Kittipibul, Pakpoom Tantrachoti, Pat Ongcharit, Aekarach Ariyachaipanich, Sarawut Siwamogsatham, Supaporn Sritangsirikul, Kanokwan Thammanatsakul, Sarinya Puwanant
We prospectively studied efficacy and safety outcomes of two 10-mg doses of intravenous basiliximab on day 0 and day 4 for induction therapy in 17 consecutive de novo heart transplant recipients. By the 2-week assessment post-transplant, there were no deaths, graft failures, or acute cellular rejections (ACRs) ISHLT grade ≥ 2R. By the 1-year assessment post-transplant, there were 1 (6%) infectious death, no graft failure, 2 (12%) grade 2R ACRs, 6 (35%) asymptomatic CMV infections, and 4 (25%) treated infections...
October 9, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28986715/induction-therapy-of-basiliximab-versus-antithymocyte-globulin-in-renal-allograft-a-systematic-review-and-meta-analysis
#12
Kun Wang, Xianlin Xu, Min Fan
OBJECTIVE: The aim of this meta-analysis was to evaluate the efficacy of basiliximab versus antithymocyte globulin for induction therapy in renal allograft. METHODS: Medline (PubMed), Embase, Ovid, Cochrane, and the Chinese Biomedical Literature databases were searched to identify prospective randomized controlled trials that compared basiliximab with antithymocyte globulin (ATG) for induction therapy in renal transplantation. RevMan 5.1 software and Stat Manager V4...
October 6, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28923618/impact-of-induction-therapy-on-delayed-graft-function-following-kidney-transplantation-in-mated-kidneys
#13
T Butler, N Hayde
BACKGROUND: Delayed graft function (DGF) is defined as the need for dialysis within 1 week of transplantation and occurs in 20%-50% of deceased-donor kidney transplant recipients. Although recovery from DGF often occurs within a few days, many cases may take weeks to months before the transplant function begins. The delay in function increases the complexity of recipient care, makes the diagnosis of acute rejection more difficult, prolongs length of stay, and increases hospital costs...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28884915/severe-mucha-habermann-like-ulceronecrotic-skin-disease-in-t-cell-acute-lymphoblastic-leukemia-responsive-to-basiliximab-and-stem-cell-transplant
#14
Lauren A V Orenstein, Carrie C Coughlin, Andrea T Flynn, Vinodh Pillai, Markus D Boos, Gerald B Wertheim, James R Treat, David T Teachey
A 5-year-old girl with T-cell acute lymphoblastic leukemia (T-ALL) developed a progressive eruption of crusted papules and ulcerative plaques involving 80% of her body surface area with histopathology consistent with febrile ulceronecrotic Mucha-Habermann disease (FUMHD), although multiple specimens also contained clonal leukemic cells. Her skin disease was refractory to many classic treatments for FUMHD, including methotrexate, and became so severe that concern about superinfection prevented intensification of chemotherapy for her malignancy...
September 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/28873970/immunosuppressive-agents-in-adult-kidney-transplantation-in-the-national-health-service-a-model-based-economic-evaluation
#15
Tristan M Snowsill, Jason Moore, Ruben E Mujica Mota, Jaime L Peters, Tracey L Jones-Hughes, Nicola J Huxley, Helen F Coelho, Marcela Haasova, Chris Cooper, Jenny A Lowe, Jo L Varley-Campbell, Louise Crathorne, Matt J Allwood, Rob Anderson
Background: Immunosuppression is required in kidney transplantation to prevent rejection and prolong graft survival. We conducted an economic evaluation to support England's National Institute for Health and Care Excellence in developing updated guidance on the use of immunosuppression, incorporating new immunosuppressive agents, and addressing changes in pricing and the evidence base. Methods: A discrete-time state transition model was developed to simulate adult kidney transplant patients over their lifetime...
July 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28846737/immunosuppressant-prescription-pattern-and-trend-in-kidney-transplantation-a-multicenter-study-in-korea
#16
MULTICENTER STUDY
Ji-Yeun Chang, Jihyun Yu, Byung Ha Chung, Jaeseok Yang, Sung-Joo Kim, Chan-Duck Kim, Sang-Ho Lee, Jong Soo Lee, Joong Kyung Kim, Cheol Woong Jung, Chang Kwon Oh, Chul Woo Yang
BACKGROUND: The actual prescription pattern of immunosuppressive agents in kidney transplantation is unclear. METHODS: We investigated the pattern and trend of immunosuppressive treatment for kidney transplant patients in South Korea. A total of 636 patients at nine transplant centers were enrolled and followed for one year. We reviewed medical records and evaluated induction therapy, as well as the changing pattern and cause of maintenance therapy. RESULTS: Most patients (n = 621, 97...
2017: PloS One
https://www.readbyqxmd.com/read/28834072/a-severely-cholestatic-liver-graft-can-be-successfully-used-in-deceased-donor-liver-transplantation
#17
Seisuke Sakamoto, Kengo Sasaki, Hajime Uchida, Soichi Narumoto, Toshihiro Kitajima, Rie Irie, Akinari Fukuda, Takako Yoshioka, Mureo Kasahara
The shortage of deceased organs is still a serious issue in Japan. A proactive approach to using liver grafts from extended criteria donors (ECDs) may be one way of expanding the donor pool; however, if it is recklessly attempted, a recipient receiving such a marginal graft can be at risk of mortality due to the primary non-function or a delayed graft function. We herein report the successful outcome of a recipient receiving a severely cholestatic graft that was considered transplantable because it lacked features characteristic of a long duration of "cholestasis" according to the precise interpretation of a donor biopsy...
August 18, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28820004/drug-induced-liver-injury-in-children-clinical-observations-animal-models-and-regulatory-status
#18
Qiang Shi, Xi Yang, James J Greenhaw, Alec Thomas Salminen, Gary M Russotti, William F Salminen
Drug-induced liver injury in children (cDILI) accounts for about 1% of all reported adverse drug reactions throughout all age groups, less than 10% of all clinical DILI cases, and around 20% of all acute liver failure cases in children. The overall DILI susceptibility in children has been assumed to be lower than in adults. Nevertheless, controversial evidence is emerging about children's sensitivity to DILI, with children's relative susceptibility to DILI appearing to be highly drug-specific. The culprit drugs in cDILI are similar but not identical to DILI in adults (aDILI)...
September 2017: International Journal of Toxicology
https://www.readbyqxmd.com/read/28748879/early-clinical-manifestations-and-laboratory-findings-before-and-after-treatment-of-cytomegalovirus-infection-in-kidney-transplant-patients
#19
Wasim Ahmed Siddiqui, Issa Al Salmi, Amitabh Jha, Abbas Pakkyara, Mohammad Yasir, Faissal A M Shaheen
Cytomegalovirus (CMV) is one of the most frequently encountered opportunistic viral pathogens in kidney transplant recipients. In this study, we retrospectively reviewed all living related and unrelated kidney transplant recipients on regular follow-up from January 2006 to June 2015, who were suspected to have CMV clinically and confirmed by DNA polymerase chain reaction (PCR). CMV PCR was detected in 102 kidney transplant recipients. The median time of detection after kidney transplant was 21 months, ranging from 15 days to 84 months...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28714558/everolimus-and-reduced-calcineurin-inhibitor-therapy-in-pediatric-liver-transplant-recipients-results-from-a-multicenter-prospective-study
#20
Rainer Ganschow, Bo-Goran Ericzon, Anil Dhawan, Khalid Sharif, El-Djouher Martzloff, Barbara Rauer, Jennifer Ng, Patricia Lopez
In a 24-month, multicenter, single-arm, prospective study, 56 pediatric liver transplant patients with or without basiliximab induction were converted at 1-6 months post-transplant from standard calcineurin inhibitor (CN) therapy (± mycophenolic acid), to everolimus with reduced exposure to CNI (tacrolimus n=50, cyclosporine n=6). Steroid therapy was optional. Recruitment was stopped prematurely due to high rates of PTLD, treatment-related serious infections leading to hospitalization and premature study drug discontinuation...
November 2017: Pediatric Transplantation
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