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Kidney transplantation: immunosuppressive therapy

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5 papers 0 to 25 followers
By P O Pediatrics, Nephrology
Mayara Ivani de Paula, José Osmar Medina Pestana, Alexandra Nicolau Ferreira, Marina Pontello Cristelli, Marcello Fabiano Franco, Wilson Ferreira Aguiar, Hélio Tedesco-Silva, Claudia Rosso Felipe
BACKGROUND: Long-term efficacy and safety of de novo use of the mammalian target of rapamycin inhibitors (mTORi) have been evaluated primarily using registry data. METHODS: This was a pooled retrospective analysis of data obtained from 10 prospective randomized trials in de novo kidney transplant recipients (n = 581) receiving calcineurin inhibitors (CNIs) combined with sirolimus (n = 329), everolimus (n = 128), or antimetabolites (n = 124). RESULTS: There were no differences in patient (84...
February 2016: Therapeutic Drug Monitoring
Xishao Xie, Yan Jiang, Xiuxiu Lai, Shilong Xiang, Zhangfei Shou, Jianghua Chen
BACKGROUND: A number of studies have provided information regarding the risks and benefits of mammalian target of rapamycin inhibitors (mTOR-I) combined with calcineurin inhibitors (CNI) versus mycophenolic acid (MPA). METHODS: Medline, Embase and the Cochrane Central Register of Controlled Trials were searched. Randomized controlled trials comparing mTOR-I to MPA as the primary immunosuppressive regimen in combination with CNI were selected and meta-analyzed. RESULTS: Eleven randomized controlled trials consisting of 4930 patients in total were included...
July 1, 2015: BMC Nephrology
Lorita M Rebellato, Karen Parker, Matthew J Everly, Kimberly P Briley, William Kendrick, Scott Kendrick, Carl E Haisch, Paul I Terasaki, Paul Bolin
The development of donor specific antibodies (DSA) post transplant has been associated with chronic rejection and graft failure. In a longitudinal study, we have shown that increases in DSA precede rejection by months, thus allowing time for intervention. We hypothesized that mycophenolic acid (MPA) dose increases may reduce and/or stabilize DSA strength and also preserve renal function. Thirty stable DSA positive kidney transplant recipients participated in this Institutional Review Board approved, exploratory, open-label, single center study to assess the efficacy of MPA dose escalation in patients with DSA...
2014: Clinical Transplants
Paolo Malvezzi, Thomas Jouve, Lionel Rostaing
CONTEXT: Preventing acute rejection (AR) after kidney transplantation is of utmost importance because an AR can have a negative impact on long-term allograft survival. EVIDENCE ACQUISITION: Directory of Open Access Journals (DOAJ), Google Scholar, PubMed, EBSCO, and Web of Science have been searched. RESULTS: At the moment this can be done by using rabbit anti-thymocyte globulins (rATGs) as an induction therapy. However, because rATGs are associated with some deleterious side-effects, such as the opportunistic infections cytomegalovirus (CMV) and de novo post-transplant cancer, it is very important they are used optimally, i...
October 2015: Journal of Nephropathology
Martin Wagner, Amy K Earley, Angela C Webster, Christopher H Schmid, Ethan M Balk, Katrin Uhlig
BACKGROUND: Modern immunosuppressive regimens after kidney transplantation usually use a combination of two or three agents of different classes to prevent rejection and maintain graft function. Most frequently, calcineurin-inhibitors (CNI) are combined with corticosteroids and a proliferation-inhibitor, either azathioprine (AZA) or mycophenolic acid (MPA). MPA has largely replaced AZA as a first line agent in primary immunosuppression, as MPA is believed to be of stronger immunosuppressive potency than AZA...
December 3, 2015: Cochrane Database of Systematic Reviews
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