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Keywords timing of initiation of calcin...

timing of initiation of calcineurin inhibitors

https://read.qxmd.com/read/36593877/cardiovascular-risk-following-conversion-to-belatacept-from-a-calcineurin-inhibitor-in-kidney-transplant-recipients-a-randomized-clinical-trial
#21
JOURNAL ARTICLE
Obbo W Bredewold, Joe Chan, My Svensson, Annette Bruchfeld, Johan W de Fijter, Hans Furuland, Josep M Grinyo, Anders Hartmann, Hallvard Holdaas, Olof Hellberg, Alan Jardine, Lars Mjörnstedt, Karin Skov, Knut T Smerud, Inga Soveri, Søren S Sørensen, Anton-Jan van Zonneveld, Bengt Fellström
RATIONALE & OBJECTIVE: In kidney transplant recipients (KTRs), a belatacept-based immunosuppressive regimen is associated with beneficial effects on cardiovascular (CV) risk factors compared with calcineurin inhibitor (CNI)-based regimens. Our objective was to compare the calculated CV risk between belatacept and CNI (predominantly tacrolimus) treatments using a validated model developed for KTRs. STUDY DESIGN: Prospective, randomized, open-label, parallel-group, investigator-initiated, international multicenter trial...
January 2023: Kidney medicine
https://read.qxmd.com/read/36591982/approach-to-acute-kidney-injury-following-paediatric-kidney-transplant
#22
REVIEW
Abigail Atlas-Lazar, Daniella Levy-Erez
PURPOSE OF REVIEW: In a child with evidence of acute kidney injury (AKI) following renal transplantation, it is important to quickly and accurately diagnose the cause to enable timely initiation of therapeutic interventions. The following article will discuss the differential diagnosis of acute graft dysfunction in paediatric kidney transplant recipients. This review will systematically guide the clinician through the common and less common causes and provide updates on current treatments...
April 1, 2023: Current Opinion in Pediatrics
https://read.qxmd.com/read/36508646/mammalian-target-of-rapamycin-inhibitors-and-kidney-function-after-thoracic-transplantation-a-systematic-review-and-recommendations-for-management-of-lung-transplant-recipients
#23
JOURNAL ARTICLE
Katja Schmucki, Patrick Hofmann, Thomas Fehr, Ilhan Inci, Malcolm Kohler, Macé M Schuurmans
BACKGROUND: Chronic kidney disease (CKD) after lung transplantation is common and limits the survival of transplant recipients. The calcineurin inhibitors (CNI), cyclosporine A, and tacrolimus being the cornerstone of immunosuppression are key mediators of nephrotoxicity. The mammalian target of rapamycin (mTOR) inhibitors, sirolimus and everolimus, are increasingly used in combination with reduced CNI dosage after lung transplantation. METHODS: This systematic review examined the efficacy and safety of mTOR inhibitors after lung transplantation and explored their effect on kidney function...
January 1, 2023: Transplantation
https://read.qxmd.com/read/36481797/calcineurin-inhibitors-impact-on-cardiovascular-and-renal-function-a-descriptive-study-in-lung-transplant-recipients-from-the-north-of-spain
#24
JOURNAL ARTICLE
Rita Nogueiras-Álvarez, Víctor Manuel Mora-Cuesta, José Manuel Cifrián-Martínez, María Ángeles de Cos-Cossío, María Del Mar García-Sáiz
Patients undergoing lung transplantation (LTx) need administration of immunosuppressive therapy following the procedure to prevent graft rejection. However, these drugs are not exempt from potential risks. The development of cardiovascular risk factors and impaired renal function in the post-transplantation period are conditions that may be favoured by the use of calcineurin inhibitor (CNI) drugs which could have repercussions on the quality of life and the post-transplantation evolution. To evaluate the cardiovascular and renal toxicity following the administration of CNI as maintenance immunosuppression in lung transplant recipients (LTRs) we reviewed a total number of 165 patients undergoing LTx between 01/01/2015 and 08/12/2018...
December 8, 2022: Scientific Reports
https://read.qxmd.com/read/36397270/basiliximab-as-maintenance-immunosuppression-in-heart-transplant-recipients-a-single-pediatric-center-experience
#25
JOURNAL ARTICLE
Teaghan T Chen, Megan M Greene, Melanie D Everitt, Kathleen E Simpson
BACKGROUND: Pediatric heart transplant recipients are at risk for complications from prolonged exposure to immunosuppressive drugs, pharmacokinetic challenges in maintaining consistent immunosuppression, and medication non-adherence. Basiliximab (BAS), an interleukin-2 receptor antagonist, is used for induction therapy across many pediatric heart transplant centers, but use as maintenance immunosuppression has not been well described. METHODS: This was a retrospective, single pediatric center cohort study of heart transplant recipients who received BAS for maintenance immunosuppression (defined as >2 monthly doses) from January 1, 2011, to December 31, 2021...
November 17, 2022: Pediatric Transplantation
https://read.qxmd.com/read/36287318/visual-evoked-potentials-as-a-method-for-the-prospective-assessment-of-tacrolimus-neurotoxicity-in-patients-after-kidney-transplantation
#26
JOURNAL ARTICLE
Sebastian Sirek, Aureliusz Kolonko, Dorota Pojda-Wilczek
INTRODUCTION: Neurotoxicity, including optic nerve injury, is one of the most common adverse effects of tacrolimus, the principal calcineurin inhibitor used after kidney transplantation (KTx). The electrophysiologic measurements of both pattern visual evoked potentials (PVEP) and flash visual evoked potentials (FVEP) are valuable when drug-induced optic neuropathy is suspected. OBJECTIVES: To determine whether VEP measurement is a sensitive and repeatable method for monitoring tacrolimus neurotoxicity...
December 2022: Documenta Ophthalmologica. Advances in Ophthalmology
https://read.qxmd.com/read/36268438/evolving-liver-transplantation-in-pakistan-future-challenges
#27
JOURNAL ARTICLE
Abdul Wahab Dogar, Kaleem Ullah, Sidhant Ochani, Hafiz Bilal Ahmad
Liver transplantation is a life-saving procedure that started in the early 60s. Initially, it struggled with multiple failed attempts but later it progressed and emerged as a gold standard procedure for liver failure secondary to various etiologies. In the first two decades, it faced various challenges like peri and post-operative care management, the quality of graft, optimal immunosuppressant use, and recipient selection criteria. Because of these challenges, the 1-year survival remained below 30% initially...
October 2022: Annals of Medicine and Surgery
https://read.qxmd.com/read/36164194/ct-039-health-related-quality-of-life-following-allogeneic-hematopoietic-stem-cell-transplantation-with-omidubicel-versus-standard-umbilical-cord-blood
#28
RANDOMIZED CONTROLLED TRIAL
Chenyu Lin, Gautam Sajeev, Patrick Stiff, Claudio Brunstein, Corey Cutler, Guillermo Sanz, Caroline Lindemans, Andrew Rezvani, Rabi Hanna, Liang Piu Koh, Richard Maziarz, William Hwang, Yan Song, Qing Liu, Rocio Manghani, Smitha Sivaraman, James Signorovitch, Einat Galamidi-Cohen, Mitchell Horwitz, Anthony Sung
CONTEXT: Omidubicel is an ex vivo expanded stem cell product derived from umbilical cord blood (UCB) for allogeneic hematopoietic stem cell transplantation (allo-HSCT). A multicenter phase III trial demonstrated faster engraftment and fewer infections with omidubicel versus standard UCB. OBJECTIVE: To compare patient-reported health-related quality of life (HRQL) between omidubicel and UCB. DESIGN: Patients with hematologic malignancies undergoing allo-HSCT were randomized 1:1 to omidubicel or UCB between 2017-2020...
October 2022: Clinical Lymphoma, Myeloma & Leukemia
https://read.qxmd.com/read/36086937/letermovir-for-cytomegalovirus-prophylaxis-in-high-risk-heart-transplant-recipients
#29
JOURNAL ARTICLE
Stephanie Golob, Jaya Batra, Ersilia M DeFilippis, Matan Uriel, Matt Carey, Maureen Gaine, Angelo Mabasa, Justin Fried, Jayant Raikelkar, Susan Restaino, Sun Hi Lee, Farhana Latif, Melana Yuzefpolskaya, Paolo C Colombo, Jason Choe, David Majure, Douglas Jennings, Marcus R Pereira, Kevin Clerkin, Gabriel Sayer, Nir Uriel
Letermovir is a novel agent for the prevention of cytomegalovirus (CMV) infection and disease that, unlike traditional CMV DNA polymerase inhibitors, does not carry the risk of myelosuppression. The purpose of this study was to evaluate the safety, efficacy, and clinical application of letermovir for CMV prophylaxis in heart transplant (HT) recipients. Between November 1, 2019, and October 1, 2021, at a single, tertiary care hospital, 17 HT recipients were initiated on letermovir due to leukopenia while on valganciclovir...
December 2022: Clinical Transplantation
https://read.qxmd.com/read/36060621/safety-efficacy-and-relapse-of-nirmatrelvir-ritonavir-in-kidney-transplant-recipients-infected-with-sars-cov-2
#30
JOURNAL ARTICLE
Arnaud Devresse, Sébastien Briol, Julien De Greef, Florian Lemaitre, Lidvine Boland, Vincent Haufroid, Anais Scohy, Benoit Kabamba, Jean Cyr Yombi, Leila Belkhir, Tom Darius, Antoine Buemi, Kristell De Potter, Rebecca Mantegazza, Bertrand Bearzatto, Eric Goffin, Nada Kanaan
Introduction: Nirmatrelvir-ritonavir (NR) has demonstrated its efficacy to decrease the risk of progression to severe COVID-19 in high-risk patients. However, evidence in infected kidney transplant recipients (KTRs) is lacking. Moreover, NR has significant and potentially harmful interactions with calcineurin inhibitors (CNIs). Methods: In this single-center retrospective study, we included all KTRs treated with NR from April 28th to June 3th , 2022. A standard management strategy of CNIs dose adaptation (discontinuation of tacrolimus 12 hours before the start of NR and administration of 20% the cyclosporine dose) and laboratory follow-up was applied...
August 28, 2022: KI Reports
https://read.qxmd.com/read/36047901/outcomes-of-de-novo-belatacept-based-immunosuppression-regimen-and-avoidance-of-calcineurin-inhibitors-in-recipients-of-kidney-allografts-at-higher-risk-for-underutilization
#31
JOURNAL ARTICLE
Ankita Patel, Tara Shertel, Michael Wynd, Vikram Wadhera, David Serur, Benjamin Schleich, Yuriy Yushkov, Michael Goldstein
To describe an experience using a protocol using de novo belatacept (DNB) based maintenance immunosuppression in the setting of lymphocyte depletion. A retrospective, observational study was performed on 37 kidney transplant recipients treated with the DNB protocol, which was defined as belatacept initiated within 7 days after a kidney transplant with steroids and mycophenolate with anti-thymocyte globulin (ATG) induction without concomitant calcineurin inhibitors (CNIs). Patients who received a deceased donor kidney meeting one or more of the following criteria: anticipated cold ischemia time (CIT) greater than 24 h, donation after cardiac death, donor acute kidney injury, and a Kidney Donor Profile Index (KDPI) >85% during the study period were included...
November 2022: Nephrology
https://read.qxmd.com/read/35876081/bronchiolitis-obliterans-organising-pneumonia-secondary-to-tacrolimus-toxicity-in-a-pediatric-cardiac-transplant-recipient
#32
JOURNAL ARTICLE
Farida Karim, Amrit Misra, Swati Sehgal
BACKGROUND: Bronchiolitis obliterans organising pneumonia is a rare complication associated with calcineurin inhibitors and mammalian target of rapamycin inhibitors. While bronchiolitis obliterans organising pneumonia in adult transplant patients has been reported, it has not been well described in pediatric transplant patients. CASE DESCRIPTION: We present a case of a 19-month-old male patient with dilated cardiomyopathy who underwent orthotropic heart transplantation at 14 months of life for heart failure refractory to medical therapy...
July 25, 2022: Cardiology in the Young
https://read.qxmd.com/read/35814514/postreperfusion-liver-biopsy-as-predictor-of-early-graft-dysfunction-and-survival-after-orthotopic-liver-transplantation
#33
JOURNAL ARTICLE
Esteban Fuentes-Valenzuela, Javier Tejedor-Tejada, Félix García-Pajares, Beatriz M Rubiales, Rodrigo Nájera-Muñoz, Carlos Maroto-Martín, Laura Sánchez-Delgado, Carmen Alonso-Martín, Carolina A Álvarez, Gloria Sánchez-Antolín
BACKGROUND: Postreperfusion liver biopsy (PRB) can assess the degree of ischemia/reperfusion injury (IRI) after orthotopic liver transplantation (OLT). The influence of IRI on graft outcomes and overall survival is controversial. AIM: To determine the correlation between the severity of IRI in PRB and overall graft and patient survival and, secondarily, to identify factors on PRB that predict poor graft outcomes. METHODS: This is a retrospective analysis of all patients who underwent OLT using donation after brain death (DBD) with PRB...
2022: Journal of Clinical and Experimental Hepatology
https://read.qxmd.com/read/35756950/induction-and-maintenance-immunosuppression-in-lung-transplantation
#34
REVIEW
Bronwyn Small, Jenny Au, Heidi Brink, Ishani Shah, Heather Strah
Immunosuppression for lung transplant recipients is a critical part of post-transplant care, to prevent acute and chronic rejection. Treatment protocols consist of induction and maintenance immunotherapy. Induction agents provide an immediate state of immunosuppression following transplantation and over time, and their use has become more commonplace. Several agents are available for clinical use, including anti-thymocyte globulin, alemtuzumab, and basiliximab, the latter being most commonly employed. Each induction agent has unique side effects and caveats to their use, of which we must be aware...
July 2022: Indian Journal of Thoracic and Cardiovascular Surgery
https://read.qxmd.com/read/35750283/low-intensity-immunosuppressive-therapy-for-chronic-graft-versus-host-disease
#35
JOURNAL ARTICLE
Kazuki Yoshimura, Shun-Ichi Kimura, Hideki Nakasone, Yuhei Nakamura, Masakatsu Kawamura, Shunto Kawamura, Junko Takeshita, Nozomu Yoshino, Yukiko Misaki, Shimpei Matsumi, Ayumi Gomyo, Aki Tanihara, Yosuke Okada, Masaharu Tamaki, Machiko Kusuda, Kazuaki Kameda, Hidenori Wada, Shinichi Kako, Yoshinobu Kanda
In general, an initial systemic treatment for chronic graft-versus-host disease (cGVHD) is 0.5 to 1 mg/kg of prednisolone (PSL). However, patients without high-risk features are sometimes treated with calcineurin inhibitors (CI) or PSL at lower doses. Therefore, we retrospectively evaluated patients with cGVHD who were treated with low-intensity immunosuppressive therapy (IST), defined as CI with or without PSL at less than 0.25 mg/kg. The primary outcome was failure-free survival (FFS), and we evaluated current FFS (cFFS) considering the state transition between low-intensity IST and high-intensity IST defined as the administration of more than 0...
June 22, 2022: Transplantation and cellular therapy
https://read.qxmd.com/read/35743353/influence-of-immunosuppressive-regimen-on-diffusivity-and-oxygenation-of-kidney-transplants-analysis-of-functional-mri-data-from-the-randomized-zeus-trial
#36
JOURNAL ARTICLE
Laila-Yasmin Mani, Jasna Cotting, Bruno Vogt, Ute Eisenberger, Peter Vermathen
The ZEUS study was a multi-center randomized controlled trial investigating the effect of early conversion from a ciclosporin-based to an everolimus-based regimen on graft function twelve months post-transplantation. In this investigator-initiated sub-study, functional magnetic resonance imaging (fMRI) of kidney grafts was prospectively performed to non-invasively assess differences in graft oxygenation, diffusion and perfusion between groups and time-points using diffusion-weighted imaging (DWI) and blood oxygen level-dependent (BOLD)-MRI...
June 8, 2022: Journal of Clinical Medicine
https://read.qxmd.com/read/35678734/pre-transplant-immune-cell-function-assay-as-a-predictor-of-early-cardiac-allograft-rejection
#37
JOURNAL ARTICLE
Samuel D Maidman, Claudia Gidea, Alex Reyentovich, Shaline Rao, Tajinderpal Saraon, Bernard S Kadosh, Navneet Narula, Julius Carillo, Deane Smith, Nader Moazami, Stuart Katz, Randal I Goldberg
INTRODUCTION: ImmuKnow, an immune cell function assay that quantifies overall immune system activity can assist in post-transplant immunosuppression adjustment. However, the utility of pre-transplant ImmuKnow results representing a patient's baseline immune system activity is unknown. This study sought to assess if pre-transplant ImmuKnow results are predictive of rejection at the time of first biopsy in our cardiac transplant population. METHODS: This is a single center, retrospective observational study of consecutive patients from January 1, 2018 to October 1, 2020 who underwent orthotopic cardiac transplantation at NYU Langone Health...
July 2022: Clinical Transplantation
https://read.qxmd.com/read/35428708/tacrolimus-in-patients-with-interstitial-pneumonia-associated-with-polymyositis-or-dermatomyositis-interim-report-of-postmarketing-surveillance-in-japan
#38
JOURNAL ARTICLE
Masataka Kuwana, Naoko Wakasugi, Toshinori Furuya, Satoshi Uno, Takafumi Suda
OBJECTIVE: The calcineurin inhibitor tacrolimus has been approved in Japan for the treatment of interstitial pneumonia (IP) in patients with polymyositis (PM) and dermatomyositis (DM). Postmarketing surveillance was initiated to examine long-term outcomes of immunosuppressive regimens containing tacrolimus in real-world settings. METHODS: Observational, prospective, postmarketing surveillance is ongoing in 179 patients with PM/ DM-associated IP initiating treatment with tacrolimus...
April 15, 2022: Journal of Rheumatology
https://read.qxmd.com/read/35372734/early-administration-of-anti-sars-cov-2-monoclonal-antibodies-prevents-severe-covid-19-in-kidney-transplant-patients
#39
JOURNAL ARTICLE
Juliette Gueguen, Charlotte Colosio, Arnaud Del Bello, Anne Scemla, Yohan N'Guyen, Claire Rouzaud, Claudia Carvalho-Schneider, Gabriela Gautier Vargas, Pierre Tremolières, A Jalal Eddine, Christophe Masset, Olivier Thaunat, Melchior Chabannes, Paulo Malvezzi, Pierre Pommerolle, Lionel Couzi, Nassim Kamar, Sophie Caillard, Philippe Gatault
Introduction: Kidney transplant recipients (KTRs) are prone to develop severe COVID-19 and are less well protected by vaccine than immunocompetent subjects. Thus, the use of neutralizing anti-SARS-CoV-2 monoclonal antibody (MoAb) to confer a passive immunity appears attractive in KTRs. Methods: We performed a French nationwide study to compare COVID-19-related hospitalization, 30-day admission to intensive care unit (ICU), and 30-day death between KTRs who received an early infusion of MoAb (MoAb group) and KTRs who did not (control group)...
June 2022: KI Reports
https://read.qxmd.com/read/35034789/no-influence-of-everolimus-on-mycophenolic-acid-area-under-the-concentration-time-curve-limited-sampling-strategy-for-mycophenolic-acid-in-japanese-kidney-transplant-recipients-treated-with-tacrolimus-mycophenolate-mofetil-steroid-and-everolimus
#40
JOURNAL ARTICLE
Takahito Endo, Takeshi Ishimura, Shun Nishioka, Naoki Yokoyama, Satoshi Ogawa, Masato Fujisawa
BACKGROUND: Despite a growing need for everolimus (EVR) to reduce calcineurin inhibitor toxicity in kidney transplantation (KTx), the influence of EVR on the pharmacokinetics of mycophenolic acid (MPA), a mycophenolate mofetil (MMF) active metabolite, is obscure, and no suitable limited sampling strategy (LSS) for MPA when EVR is concomitantly present exists. We aimed to investigate the influence of EVR on MPA pharmacokinetics in KTx. MATERIALS AND METHODS: This study complied with all principles of the Declaration of Helsinki...
January 13, 2022: Transplantation Proceedings
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