scholarly journals Evaluation of the tacrolimus II microparticle enzyme immunoassay (MEIA II) in liver and renal transplant recipients

1998 ◽  
Vol 44 (9) ◽  
pp. 1942-1946 ◽  
Author(s):  
Jan L Cogill ◽  
Paul J Taylor ◽  
Ian S Westley ◽  
Raymond G Morris ◽  
Stephen V Lynch ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Renal Transplant Patient ◽  
Transplant Patient ◽  
Therapeutic Drug ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Significant Difference ◽  
Microparticle Enzyme Immunoassay ◽  
Clinically Significant ◽  
Comparison Data

Abstract We evaluated the MEIA II with blood samples with added tacrolimus (3.0, 5.0, 11.0, and 22.0 μg/L). The assay had acceptable recoveries (99–103%) and intraday imprecision (<16.0%) across the range of concentrations studied, except for the recoveries at 3.0 μg/L (86.3%) and 5.0 μg/L (80.7%). Comparison of liver (n = 116) and renal (n = 113) patient samples measured by MEIA II against HPLC-tandem mass spectrometry (HPLC-MS/MS) found a mean overestimation of 15.6%. From these comparison data it can be calculated that at values of 5 and 20 μg/L in liver or renal transplant patient samples, measured by HPLC-MS/MS, MEIA II will have the corresponding range estimates of 3.6–7.9 μg/L and 20.9–25.4 μg/L, respectively. No clinically significant difference in results, in terms of overestimation or correlation, was observed between the two transplant groups studied. The MEIA II is an improvement on the previous MEIA I and is suitable for the therapeutic drug monitoring of tacrolimus where HPLC-MS/MS is unavailable.

scholarly journals Fecal microbiota transplantation as an effective treatment for carbapenem-resistant Klebsiella pneumoniae infection in a renal transplant patient

2020 ◽  
Author(s):  
Junpeng Wang ◽  
Xin Li ◽  
Xiaoqiang Wu ◽  
Zhiwei Wang ◽  
Xuan Wu ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Renal Transplant ◽  
Klebsiella Pneumoniae ◽  
Renal Transplant Patient ◽  
Transplant Patient ◽  
Fecal Microbiota Transplantation ◽  
Fecal Microbiota ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Carbapenem Resistant

Abstract Background: In renal transplant recipients, carbapenem-resistant Klebsiella pneumoniae (CRKP) infection is common, and usually associated with severe clinical outcomes due to a lack of effective therapeutics.Case presentation: A 37-year-old female had a CRKP infection one month after the kidney transplantation. Since the effect of the antibiotic therapy was limited, fecal microbiota transplantation (FMT) was performed. FMT resulted in increased richness and diversity of gut microbiota and reduced relative abundance of Klebsiella. After FMT, the infection of the patient caused by CRKP was well controlled without inducing adverse effects.Conclusion: This study demonstrated the therapeutic effect of FMT on CRKP infection, and may shine some light on the treatment of the infections caused by CRKP for the patients after transplantation.

Topical imiquimod cream 5% for resistant perianal warts in a renal transplant patient

2002 ◽  
Vol 13 (7) ◽  
pp. 501-503 ◽  
Author(s):  
S L Gayed
Keyword(s):  
Renal Transplant ◽  
Effective Treatment ◽  
Renal Transplant Patient ◽  
Transplant Patient ◽  
Genital Warts ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Imiquimod Cream ◽  
Patient Subgroup ◽  
Genitourinary Medicine

Renal transplant recipients represent a patient subgroup for whom the effective treatment of genital warts poses a significant problem in genitourinary medicine. This case demonstrates the safe and effective treatment of resistant perianal warts in a male renal transplant recipient using imiquimod.

Topical imiquimod cream 5% for resistant perianal warts in a renal transplant patient

2002 ◽  
Vol 13 (5) ◽  
pp. 349-351 ◽  
Author(s):  
S L Gayed
Keyword(s):  
Renal Transplant ◽  
Effective Treatment ◽  
Renal Transplant Patient ◽  
Transplant Patient ◽  
Genital Warts ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Imiquimod Cream ◽  
Patient Subgroup ◽  
Genitourinary Medicine

Renal transplant recipients represent a patient subgroup for whom the effective treatment of genital warts poses a significant problem in genitourinary medicine. This case demonstrates the safe and effective treatment of resistant perianal warts in a male renal transplant recipient using imiquimod.

scholarly journals IVIG Associated Aseptic Meningitis in a Renal Transplant Patient

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Tamara Wanigasekera ◽  
Rachel J. Grainger ◽  
Donal J. Sexton ◽  
Colm Magee
Keyword(s):  
Adverse Effect ◽  
Renal Transplant ◽  
Aseptic Meningitis ◽  
Renal Transplant Patient ◽  
Transplant Patient ◽  
Ivig Therapy ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Antibody Mediated Rejection

The management of antibody-mediated rejection in renal transplant recipients involves plasmapheresis with IVIG. Aseptic meningitis is a rare adverse effect of IVIG therapy and is a diagnosis of exclusion. We report a case of a renal transplant patient who developed IVIG associated aseptic meningitis in the context of management of antibody-mediated rejection, four years after transplantation.

scholarly journals Improved renal allograft survival for pre-emptive paediatric renal transplant recipients in the UK

2021 ◽  
pp. archdischild-2020-321277
Author(s):  
Matko Marlais ◽  
Kate Martin ◽  
Stephen D Marks
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Transplant ◽  
Renal Allograft ◽  
Cox Regression ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Allograft Survival ◽  
Significant Difference ◽  
Donor Type ◽  
The Uk

BackgroundThe aim of this study was to investigate whether being on dialysis at the time of renal transplantation affected renal allograft survival in paediatric renal transplant recipients (pRTRs).MethodsRetrospective study of UK Transplant Registry (National Health Service Blood and Transplant) data on all children (aged <18 years) receiving a kidney-only transplant from 1 January 2000 to 31 December 2015. Kaplan-Meier estimates of patient and renal allograft survival calculated and Cox regression modelling accounting for donor type. The relationship between time on dialysis and renal allograft survival was examined.Results2038 pRTRs were analysed: 607 (30%) were pre-emptively transplanted, 789 (39%) and 642 (32%) on peritoneal dialysis and haemodialysis, respectively, at the time of transplantation. Five-year renal allograft survival was significantly better in the pre-emptively transplanted group (90.6%) compared with those on peritoneal dialysis and haemodialysis (86.4% and 85.7%, respectively; p=0.02). After accounting for donor type, there was a significantly lower hazard of 5-year renal allograft failure in pre-emptively transplanted children (HR 0.742, p=0.05). Time spent on dialysis pre-transplant negatively correlated with renal allograft survival (p=0.002). There was no significant difference in 5-year renal allograft survival between children who were on dialysis for less than 6 months and children transplanted pre-emptively (87.5% vs 90.5%, p=0.25).ConclusionsPre-emptively transplanted children have improved 5-year renal allograft survival, compared with children on dialysis at the time of transplantation. Although increased time spent on dialysis correlated with poorer renal allograft survival, there was no evidence that short periods of dialysis pre-transplant affected renal allograft survival.

P1763TUBERCULOSIS IN RENAL TRANSPLANT RECEPIENTS - DO RITUXIMAB AND OTHER IMMUNOSUPRESSION HAVE A ROLE?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Anupma Kaul ◽  
Dharmendra Bhaduria ◽  
Narayan Prasad ◽  
Amit Gupta
Keyword(s):  
Renal Transplantation ◽  
Renal Transplant ◽  
Immunosuppressive Agents ◽  
Induction Agent ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Transplant Patients ◽  
Significant Difference ◽  
High Prevalence ◽  
Mean Time

Abstract Background and Aims Rituximab is an anti CD 20 agent used widely in renal transplant recipients. Its use is associated with various infections;however, its association with Tuberculosis (TB) is not well established and has not been studied in post renal transplantation patients. Method This is a single centre, retrospective analysis of 56 renal transplant recipients who received rituximab for various reasons and 287 post renal transplant patients who did not receive rituximab during the study period from January 2013 to June 2017. The association between use of rituximab and incidence of TB was studied. Other factors associated with tuberculosis were also investigated. Results Baseline characteristics were similar in both the groups. Mean time for occurrence of TB was 18.4 + 10.6 months after renal transplantation. Rituximab use was not significantly associated with tuberculosis or any other infection. Higher number of rejection episodes (60% vs 32.72%, p=0.029) was the only factor associated with greater incidence of TB. However, no specific type of rejection was associated with tuberculosis. Use of plasmapheresis in post transplant period for treatment of humoral rejections was associated with significantly higher incidence of TB (33.33% vs 13.41%, p=0.031), however when pre- transplant plasmapheresis was also considered, there was no significant difference. The choice of induction agent was not associated with higher incidence of TB. Conclusion Use of rituximab is not associated with higher incidence of TB when compared to other immunosuppressive agents. Routine screening and prophylaxis may not be advisable especially in a country like India with high prevalence of TB; as it will further delay transplantation and may adversely affect the outcome of the patients.

scholarly journals COVID-19 in Renal Transplant Patient Presenting With Active Typical Symptoms and Resolved Atypical Symptoms

2020 ◽  
Vol 8 ◽  
pp. 232470962094930 ◽  
Author(s):  
Sreedhar Adapa ◽  
Venu Madhav Konala ◽  
Srikanth Naramala ◽  
Subba Rao Daggubati ◽  
Narayana Murty Koduri ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Renal Transplant Patient ◽  
Transplant Patient ◽  
Gastrointestinal Symptoms ◽  
Published Data ◽  
The Novel ◽  
Transplant Recipients ◽  
Atypical Symptoms ◽  
Rapid Transmission ◽  
Novel Coronavirus

The novel coronavirus disease has brought the world to standstill with high infectivity and rapid transmission. The disease caused by novel coronavirus is termed as coronavirus disease 2019 (COVID-19). We present the case of a renal transplant patient who was infected with COVID-19 through community spread and presented with fever and gastrointestinal symptoms. Transplant recipients are particularly vulnerable because of the immunosuppressed state. These patients can shed a virus for a prolonged period and can have a higher load of the virus. There have been no COVID-19 cases transmitted through organ donation. Preinfection immunological impairment can aggravate the severity of the infection. The transplant team plays a crucial role in donor and recipient evaluation and guiding the timing of the transplant. Although specific published data are lacking with regard to transplant recipients, they should follow the same precautions as the general population, like avoiding nonessential travel and practice social distancing.

Diagnosis of Polyoma Virus Infection In Renal Transplant Recipients

1999 ◽  
Vol 5 (S2) ◽  
pp. 1166-1167
Author(s):  
J. A. C. King ◽  
D. N. Howell ◽  
J. A. Tucker ◽  
R. P. Lowry
Keyword(s):  
Renal Transplant ◽  
Virus Infection ◽  
Renal Transplant Patient ◽  
Bk Virus ◽  
Polyoma Virus ◽  
Immunosuppressed Patient ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Immunosuppressed Patients ◽  
Cadaver Kidney

BK polyoma virus is a 40-45 nm DNA virus that was first identified in the urine of an immunosuppressed patient in 1971. BK virus infection often occurs in childhood and is subclinical. The majority of adults have antibodies to the virus. Asymptomatic viruria, ureteral ulceration, and ureteral stenosis have been described with infection in immunosuppressed patients. Renal graft dysfunction and interstitial nephritis have been associated with BK virus. Differentiation between rejection and infection is important. We report a case of a renal transplant patient with BK polyoma virus infection. This case illustrates the variety of methods that can be used for identification of BK polyoma virus.The patient, a 52 year old female, presented with an asymptomatic rise in serum creatinine (1.4 to 2.1 mg/dl). Her past medical history was significant for a cadaver kidney transplant two years prior for polycystic kidney disease.

scholarly journals Variation in Leukocyte Subset Concentrations Affects Calcineurin Activity Measurement: Implications for Pharmacodynamic Monitoring Strategies

2008 ◽  
Vol 54 (3) ◽  
pp. 517-524 ◽  
Author(s):  
Huub H van Rossum ◽  
Fred P H T M Romijn ◽  
Kathryn J Sellar ◽  
Nico P M Smit ◽  
Paul J M van der Boog ◽  
...  
Keyword(s):  
T Cell ◽  
Renal Transplant ◽  
Killer Cell ◽  
Therapeutic Drug ◽  
Activity Measurement ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Leukocyte Subset ◽  
Cell Counts ◽  
Monitoring Strategies

Abstract Background: In renal transplantation patients, therapeutic drug monitoring of the calcineurin (CN) inhibitor cyclosporin A (CsA) is mandatory because of the drug’s narrow therapeutic index. Pharmacodynamic monitoring of CN inhibition therapy could provide a tool to define and maintain the therapeutic efficacy of CsA therapy. We investigated the effect of variation in cell counts of leukocyte subsets on leukocyte CN activity measurement in renal transplant recipients. Methods: We measured leukocyte CN activity, whole blood CsA concentrations, and leukocyte subset cell counts in 25 renal transplant recipients. Blood was collected before graft implantation and CsA therapy, 1 day before transplantation when CsA therapy was already started, and 5 days after transplantation. Monocyte, granulocyte, CD4+ T-cell, CD8+ T-cell, B-cell, and natural killer–cell CN activities and CsA inhibition sensitivities were determined in vitro by a spectrophotometric CN assay. Results: Leukocyte CN activity was inhibited after drug intake. Inter- and intrapatient variation in leukocyte subset cell counts resulted in variation of sample composition. The mean (SD) CN activity varied among leukocyte cell subsets, ranging from 650 (230) to 166 (26) pmol/min/106 cells for monocytes and CD4+ T cells, respectively. CsA half maximal inhibitory concentration (IC50) values ranged from 15 to 78 μg/L for monocytes and B cells, respectively. Conclusion: Inter- and intraindividual leukocyte subset cell count variation can affect measured CN activity independent of CsA concentration. Cell-specific activity and drug sensitivity should be considered for sample validation to optimize method specificity when pharmacodynamic monitoring strategies are applied in a clinical setting.

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