المؤلفون: Trunečka P; Transplantcenter, Institute for Clinical and Experimental Medicine, Prague, Czech Republic., Klempnauer J; Department of General-, Visceral- and Transplantation Surgery, Hannover Medical School, Hannover, Germany., Bechstein WO; Department of Surgery, Goethe University Hospital and Clinics, Frankfurt, Germany., Pirenne J; Abdominal Transplant Surgery, University Hospitals Leuven, Leuven, Belgium., Bennet W; The Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden., Zhao A; Department of Abdominal Surgery, A.V. Vishnevsky Institute of Surgery, Moscow, Russian Federation., Isoniemi H; Department of Transplantation and Liver Surgery Clinic, Helsinki University Hospital, Helsinki, Finland., Rostaing L; Department of Nephrology and Organ Transplantation, Toulouse University Hospital, Toulouse, France., Settmacher U; Department of General, Visceral and Vascular Surgery, Jena University Hospital, Jena, Germany., Mönch C; Department of Surgery, Goethe University Hospital and Clinics, Frankfurt, Germany.; Department of General, Visceral and Transplantation Surgery, Westpfalz-Klinikum Hospital, Kaiserslautern, Germany., Brown M; Astellas Pharma, Medical Affairs - Global, Northbrook, IL, USA., Undre N; Astellas Pharma Europe Ltd., Chertsey, United Kingdom., Kazeem G; Astellas Pharma Europe Ltd., Chertsey, United Kingdom.; BENKAZ Consulting Ltd., Cambridge, United Kingdom., Tisone G; Transplant and Hepatobiliary Unit, Department of Surgery, University of Rome Tor Vergata, Rome, Italy.

المصدر: Annals of transplantation [Ann Transplant] 2019 Jun 04; Vol. 24, pp. 319-327. Date of Electronic Publication: 2019 Jun 04.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: International Scientific Literature, Inc Country of Publication: United States NLM ID: 9802544 Publication Model: Electronic Cited Medium: Internet ISSN: 2329-0358 (Electronic) Linking ISSN: 14259524 NLM ISO Abbreviation: Ann Transplant Subsets: MEDLINE

مواضيع طبية MeSH: Tissue Donors* , Transplant Recipients*, Immunosuppressive Agents/*therapeutic use , Kidney/*drug effects , Kidney Failure, Chronic/*surgery , Liver Transplantation/*methods , Tacrolimus/*therapeutic use, Adult ; Age Factors ; Aged ; Delayed-Action Preparations ; Female ; Graft Rejection/drug therapy ; Graft Rejection/prevention & control ; Humans ; Immunosuppressive Agents/administration & dosage ; Kidney Function Tests ; Male ; Middle Aged ; Mycophenolic Acid/administration & dosage ; Mycophenolic Acid/therapeutic use ; Tacrolimus/administration & dosage

مستخلص: BACKGROUND The DIAMOND study of de novo liver transplant patients showed that prolonged-release tacrolimus exposure in the acute post-transplant period maintained renal function over 24 weeks of treatment. To assess these findings further, we performed a post-hoc analysis in patients according to baseline kidney function, Model for End-stage Liver Disease [MELD] scores, and donor age. MATERIAL AND METHODS Patients received prolonged-release tacrolimus (initial-dose, Arm 1: 0.2 mg/kg/day, Arm 2: 0.15-0.175 mg/kg/day, Arm 3: 0.2 mg/kg/day delayed until Day 5), mycophenolate mofetil and 1 steroid bolus. Arms 2 and 3 also received basiliximab. The recommended tacrolimus target trough levels to Day 42 post-transplantation were 5-15 ng/mL in all arms. In this post-hoc analysis, change in renal outcome, based on estimated glomerular filtration rate (eGFR), Modified Diet in Renal Disease-4 (MDRD4), values from baseline to Week 24 -post-transplantation, were assessed according to baseline patient factors: eGFR (≥60 and ˂60 mL/min/1.73 m²), MELD score (˂25 and ≥25) and donor age (˂50 and ≥50 years). RESULTS Baseline characteristics were comparable (Arms 1-3: n=283, n=287, n=274, respectively). Patients with baseline renal function, eGFR ≥60 mL/min/1.73 m², experienced a decrease in eGFR in all tacrolimus treatment arms. In patients with lower baseline renal function (eGFR ˂60 mL/min/1.73 m²), an advantage for renal function was observed with both the early lower-dose and delayed higher-dose tacrolimus regimens compared with the early introduction of higher-dose tacrolimus. At Week 24, renal function was higher in the early-lower tacrolimus arm with older donors, and the delayed higher-dose tacrolimus arm with younger donors, both compared with early higher-dose tacrolimus. CONCLUSIONS Pre-transplantation factors, such as renal function and donor age, could guide the choice of prolonged-release tacrolimus regimen following liver transplantation.

المؤلفون: Czyżewski Ł; Department of Nephrology Nursing, Medical University of Warsaw, Warsaw, Poland., Wyzgał J; Department of Nephrology Nursing, Medical University of Warsaw, Warsaw, Poland., Czyżewska E; Department of Laboratory Diagnostics, Medical University of Warsaw, Warsaw, Poland., Sańko-Resmer J; Department of Nephrology Nursing, Medical University of Warsaw, Warsaw, Poland., Szarpak Ł; Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland.

المصدر: Annals of transplantation [Ann Transplant] 2017 Apr 04; Vol. 22, pp. 187-198. Date of Electronic Publication: 2017 Apr 04.

نوع المنشور: Journal Article; Observational Study

بيانات الدورية: Publisher: International Scientific Literature, Inc Country of Publication: United States NLM ID: 9802544 Publication Model: Electronic Cited Medium: Internet ISSN: 2329-0358 (Electronic) Linking ISSN: 14259524 NLM ISO Abbreviation: Ann Transplant Subsets: MEDLINE

مواضيع طبية MeSH: Kidney Transplantation* , Transplant Recipients*, Body Composition/*physiology , Hemodynamics/*physiology , Kidney/*physiopathology , Kidney Failure, Chronic/*surgery, Adult ; Aged ; Blood Pressure/physiology ; Cross-Sectional Studies ; Female ; Humans ; Kidney Failure, Chronic/physiopathology ; Male ; Middle Aged

مستخلص: BACKGROUND Cardiovascular disease (CVD) has been associated with decreased graft survival and increased complications in renal transplant recipients (RTRs). The objectives of this study were to explore the relationship between body composition and hemodynamic parameters (cardiac index [CI] and systemic vascular resistance index [SVRI]) in RTRs. MATERIAL AND METHODS The study included 80 RTRs (mean age: 51±8 yrs) who had been admitted to our Nephrology and Transplantology Clinic at 0.5 to 28 years after KTx. The control groups consisted of the 40 patients receiving hemodialysis and 20 health-care professionals. A Cardioscreen 1000 monitor (Messtechnik, Ilmenau, Germany) was used to perform non-invasive hemodynamic measurements. Body composition was studied using a Tanita BC 418 body composition analyzer (Tanita Corp., Tokyo, Japan). Clinical and laboratory data were also analyzed. RESULTS One-way ANOVA confirmed statistically significant differences between RTRs, HD patients, and the control group in CI (2.8±0.3 vs. 3.1±0.7 vs. 3.5±0.6 L/min/m2, P<0.001, respectively) and SVRI (2619±492 vs. 2307±701 vs. 2012±452 d·s/cm-5/m², P<0.001, respectively). In RTRs with functioning AVF, our study revealed significantly higher CI (2.9±0.3 vs. 2.7±0.4 L/min/m², P=0.004) and significantly lower SVRI (2497±286 vs. 2729±605 d·s/cm-5/m², P=0.035). CONCLUSIONS In conclusion, our data indicate that cardiovascular manifestations in the RTRs group are mainly related to decreased CI and HR in addition to increased SVRI with high arterial blood pressure.

المؤلفون: Dhiren Kumar, Y. Qazi, Akshta Pai, Anas Abou-Ismail, Joshua T. Swan, Grigoriy Shekhtman, Sham Dholakia, David Wojciechowski

المصدر: Annals of Transplantation

مصطلحات موضوعية: Graft Rejection, medicine.medical_specialty, Immunologic Surveillance, Biopsy, medicine, Humans, Dosing, Pathology, Molecular, Intensive care medicine, Kidney transplantation, Transplantation, Kidney, Review Paper, Proteinuria, medicine.diagnostic_test, business.industry, General Medicine, medicine.disease, Kidney Transplantation, Tissue Donors, Transplant Recipients, medicine.anatomical_structure, Cell-free fetal DNA, medicine.symptom, business, Cell-Free Nucleic Acids, Biomarkers

الوصف: Kidney transplant recipients require meticulous clinical and laboratory surveillance to monitor allograft health. Conventional biomarkers, including serum creatinine and proteinuria, are lagging indicators of allograft injury, often rising only after significant and potentially irreversible damage has occurred. Immunosuppressive medication levels can be followed, but their utility is largely limited to guiding dosing changes or assessing adherence. Kidney biopsy, the criterion standard for the diagnosis and characterization of injury, is invasive and thus poorly suited for frequent surveillance. Donor-derived cell-free DNA (dd-cfDNA) is a sensitive, noninvasive, leading indicator of allograft injury, which offers the opportunity for expedited intervention and can improve long-term allograft outcomes. This article describes the clinical rationale for a routine testing schedule utilizing dd-cfDNA surveillance at months 1, 2, 3, 4, 6, 9, and 12 during the first year following kidney transplantation and quarterly thereafter. These time points coincide with major immunologic transition points after transplantation and provide clinicians with molecular information to help inform decision making.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::fa2feb5a14bf166db8098211e04ad2c6
http://europepmc.org/articles/PMC8259349

المؤلفون: Shun Nishioka, Masato Fujisawa, Takahito Endo, Takeshi Ishimura, Satoshi Ogawa, Naoki Yokoyama

المصدر: Annals of Transplantation

مصطلحات موضوعية: Adult, Graft Rejection, Male, medicine.medical_specialty, Urology, Kidney, Tacrolimus, Fibrosis, Biopsy, medicine, Humans, Everolimus, PI3K/AKT/mTOR pathway, Kidney transplantation, Transplantation, Original Paper, medicine.diagnostic_test, business.industry, TOR Serine-Threonine Kinases, General Medicine, Middle Aged, medicine.disease, Allografts, Immunohistochemistry, Kidney Transplantation, Pathophysiology, Transplant Recipients, medicine.anatomical_structure, Female, business, Immunosuppressive Agents, medicine.drug

الوصف: BACKGROUND Although renoprotective effects of everolimus (EVR) in kidney transplantation (KTx) have been widely reported, its pathophysiological mechanism remains unclear. MATERIAL AND METHODS We compared changes in eGFR (ΔGFR, ml/min/1.73 m²) and the ratio of the fibrotic area in biopsy specimens (ΔFI,%) from 3 months to 3 years after KTx between the EVR+ group (EVR addition and Tac reduction early after KTx, n=32), and the EVR- group (normal Tac without EVR, n=28). We also immunohistochemically evaluated mTOR-related protein expression. RESULTS ΔGFR and ΔFI in the EVR+ vs. EVR- groups were -0.27±6.8 vs. -9.8±12.8 (p

وصف الملف: application/pdf

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::804a6f0a0886c3b403f633085d5b1db6
https://hdl.handle.net/20.500.14094/90007857

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