دورية أكاديمية
أعرض في EDS

[Management of immunosuppressive therapy in kidney transplant recipients with COVID19. A multicentre national study derived form the S.E.N. COVID registry.]

التفاصيل البيبلوغرافية
العنوان: [Management of immunosuppressive therapy in kidney transplant recipients with COVID19. A multicentre national study derived form the S.E.N. COVID registry.]
عنوان ترانسليتريتد: Manejo de la inmunosupresión en pacientes trasplantados de riñón con COVID19. Estudio multicéntrico nacional derivado del registro COVID de la S.E.N.
المؤلفون: López-Oliva MO; Servicio de Nefrología, Hospital U. La Paz, Madrid, Spain., Pérez-Flores I; Servicio de Nefrología, Hospital U. Clínico San Carlos, Madrid, Spain., Molina M; Servicio de Nefrología, Hospital U. Germans Trias y Pujol, Barcelona, Spain., José Aladrén M; Servicio de Nefrología, Hospital U. Miguel Servet, Zaragoza, Spain., Trujillo H; Servicio de Nefrología, Hospital U. Doce de Octubre, Madrid, Spain., Redondo-Pachón D; Servicio de Nefrología, Hospital U. del Mar, Barcelona, Spain., López V; Servicio de Nefrología, Hospital U. Carlos Haya, Málaga, Spain., Facundo C; Servicio de Nefrología, Hospital U. Fundación Puigvert, Barcelona, Spain., Villanego F; Servicio de Nefrología, Hospital U. Puerta del Mar, Cádiz, Spain., Rodríguez M; Servicio de Nefrología, Hospital U. Gregorio Marañón, Madrid, Spain., Carmen Ruiz M; Servicio de Nefrología, Hospital U. Virgen de las Nieves, Granada, Spain., Antón P; Servicio de Nefrología, Hospital U. Bellvitge, Barcelona, Spain., Rivas-Oural A; Servicio de Nefrología, Hospital U. Central de Asturias, Spain., Cabello S; Servicio de Nefrología, Hospital U. Son Espases, Palma de Mallorca, Spain., Portolés J; Servicio de Nefrología, Hospital U. Puerta de Hierro, Madrid, Spain., de la Vara L; Servicio de Nefrología, Hospital U. de Albacete, Spain., Tabernero G; Servicio de Nefrología, Hospital Clínico U. de Salamanca, Spain., Valero R; Servicio de Nefrología, Hospital U. Marqués de Valdecilla, Santander, Spain., Galeano C; Servicio de Nefrología, Hospital U. Ramón y Cajal, Madrid, Spain., Moral E; Servicio de Nefrología, Hospital U. de Ciudad Real, Spain., Ventura A; Servicio de Nefrología, Hospital U. La Fe, Valencia, Spain., Coca A; Servicio de Nefrología, Hospital Clínico U. Valladolid, Spain., Muñoz MÁ; Servicio de Nefrología, Hospital U. Virgen de la Salud, Toledo, Spain., Hernández-Gallego R; Servicio de Nefrología, Hospital U. de Badajoz, Spain., Shabaka A; Servicio de Nefrología, Hospital Fundación Alcorcón, Madrid, Spain., Ledesma G; Servicio de Nefrología, Hospital U. Infanta Sofía, Madrid, Spain., Martínez P; Servicio de Nefrología, Hospital U. Príncipe de Asturias, Madrid, Spain., Ángeles Rodríguez M; Servicio de Nefrología, Hospital U. Virgen Macarena, Sevilla, Spain., Tamajón LP; Servicio de Nefrología, Hospital U. de La Laguna, Santa Cruz de Tenerife, Spain., Cruzado L; Servicio de Nefrología, Hospital U. De Elche, Alicante, Spain., Emilio Sánchez J; Servicio de Nefrología, Hospital de Cabueñes, Asturias, Coordinador Registro COVID S.E.N, Spain., Jiménez C; Servicio de Nefrología, Hospital U. La Paz, Madrid, Spain.
المصدر: Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia [Nefrologia] 2022 Apr 30. Date of Electronic Publication: 2022 Apr 30.
Publication Model: Ahead of Print
نوع المنشور: English Abstract; Journal Article
اللغة: Spanish; Castilian
بيانات الدورية: Publisher: Elsevier Country of Publication: Spain NLM ID: 8301215 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1989-2284 (Electronic) Linking ISSN: 02116995 NLM ISO Abbreviation: Nefrologia
أسماء مطبوعة: Publication: Vol. 35, no. 2 2015- : Barcelona : Elsevier
Original Publication: Madrid : Sociedad Española De Nefrologia
مستخلص: Introduction: SARS CoV2 infection has had a major impact on renal transplant patients with a high mortality in the first months of the pandemic. Intentional reduction of immunosuppressive therapy has been postulated as one of the cornerstone in the management of the infection in the absence of targeted antiviral treatment. This has been modified according to the patient`s clinical situation and its effect on renal function or anti-HLA antibodies in the medium term has not been evaluated.
Objectives: Evaluate the management of immunosuppressive therapy made during SARS-CoV2 infection, as well as renal function and anti-HLA antibodies in kidney transplant patients 6 months after COVID19 diagnosis.
Material and Methods: Retrospective, national multicentre, retrospective study (30 centres) of kidney transplant recipients with COVID19 from 01/02/20 to 31/12/20. Clinical variables were collected from medical records and included in an anonymised database. SPSS statistical software was used for data analysis.
Results: 615 renal transplant recipients with COVID19 were included (62.6% male), with a mean age of 57.5 years.The predominant immunosuppressive treatment prior to COVID19 was triple therapy with prednisone, tacrolimus and mycophenolic acid (54.6%) followed by m-TOR inhibitor regimens (18.6%). After diagnosis of infection, mycophenolic acid was discontinued in 73.8% of patients, m-TOR inhibitor in 41.4%, tacrolimus in 10.5% and cyclosporin A in 10%. In turn, 26.9% received dexamethasone and 50.9% were started on or had their baseline prednisone dose increased.Mean creatinine before diagnosis of COVID19, at diagnosis and at 6 months was: 1.7±0.8, 2.1±1.2 and 1.8±1 mg/dl respectively (p<0.001).56.9% of the patients (N=350) were monitored for anti-HLA antibodies. 94% (N=329) had no anti-HLA changes, while 6% (N=21) had positive anti-HLA antibodies. Among the patients with donor-specific antibodies post-COVID19 (N=9), 7 patients (3.1%) had one immunosuppressant discontinued (5 patients had mycophenolic acid and 2 had tacrolimus), 1 patient had both immunosuppressants discontinued (3.4%) and 1 patient had no change in immunosuppression (1.1%), these differences were not significant.
Conclusions: The management of immunosuppressive therapy after diagnosis of COVID19 was primarily based on discontinuation of mycophenolic acid with very discrete reductions or discontinuations of calcineurin inhibitors. This immunosuppression management did not influence renal function or changes in anti-HLA antibodies 6 months after diagnosis.
(© 2022 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U.)
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فهرسة مساهمة: Keywords: Kidney transplant; SARS-CoV2; Spain; immunosuppression
تواريخ الأحداث: Date Created: 20220509 Latest Revision: 20240216
رمز التحديث: 20240217
مُعرف محوري في PubMed: PMC9055748
DOI: 10.1016/j.nefro.2022.03.008
PMID: 35528867
قاعدة البيانات: MEDLINE
الوصف
تدمد:1989-2284
DOI:10.1016/j.nefro.2022.03.008