scholarly journals POST-TRANSPLANT FUNCTIONAL STATUS TRAJECTORY AMONG ADULT KIDNEY TRANSPLANT RECIPIENTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S793-S793
Author(s):  
Nadia M Chu ◽  
Zhan Shi ◽  
Christine Haugen ◽  
Dorry Segev ◽  
Mara McAdams-DeMarco
Keyword(s):  
Functional Status ◽  
Kidney Transplant ◽  
Mixed Effects Models ◽  
Karnofsky Performance Scale ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Adult Kidney ◽  
The Mean ◽  
Separate Cohort ◽  
Performance Scale

Abstract Frailty and disabilities are highly prevalent among kidney transplant (KT) recipients, but are not routinely measured in KT recipients. The Karnofsky Performance Scale (KPS) is a clinically perceived measure used to evaluate patient’s ability to manage daily activities, but little is known about its post-KT trajectories and its relationship to frailty and disability in KT recipients. We leveraged a cohort of 159,992 adult KT recipients from SRTR (1/2005-6/2018) and a cohort of 1,106 adult KT recipients from a prospective cohort study on aging and KT with recorded KPS (range 10%-100% integers). In each separate cohort, we used mixed effects models to assess differences in trajectories of KPS post-KT. In 159,992 KT recipients in SRTR, the mean unadjusted KPS score was 88.34% (95%CI: 88.28%, 88.40%) and declined at a rate of -0.59%/year (95%CI: -0.61%, -0.57%) post-KT, such that by 2-years post-KT the average was 87.00% (95%CI: 86.94%, 87.05%). Age at KT was associated with steeper decline in KPS (p0.05). KPS is a measure of functional status distinct from frailty, ADL, IADL, and SPPB at KT admission that declines with older age post-KT. Older KT recipients should be monitored closely for declines in physical function, and potentially undergo prehabilitation to improve functional status post-KT.

Evaluation of Filgrastim Therapy in Kidney Transplant Recipients

2017 ◽  
Vol 27 (4) ◽  
pp. 360-364 ◽  
Author(s):  
Teresa Poon ◽  
Christina M. Guerra
Keyword(s):  
Kidney Transplant ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Duration Of Treatment ◽  
Adult Kidney ◽  
Serious Infections ◽  
The Mean ◽  
Short Courses

Context: Neutropenia is associated with a high risk of serious infections in kidney transplant recipients. There are no sufficient studies of using granulocyte colony-stimulating factors, such as filgrastim, in renal transplant recipients to establish a clear, specified role of this off-label indication. Using filgrastim in these patients may increase the risk of rejection by overstimulating the immune system. Objective: To evaluate the use of filgrastim in adult kidney transplant recipients presenting with neutropenia. Patients and Design: Data were obtained from a medication utilization report of filgrastim in kidney transplant recipients at our center from September 2012 to August 2015. Main Outcome Measure(s) and Results: There were 28 cases of neutropenia that were treated with a range of 1 to 5 doses of filgrastim 300 or 480 μg, with a mean of 1.79 doses. The mean total dose of filgrastim administered per episode of neutropenia was 632 μg (8.6 μg/kg). Overall, 87.5% of the cases achieved a white blood cell count of at least 3 × 109 cells/L within 7 days of hospital discharge. There were no cases of infection or acute rejection following treatment. Conclusions: The use of filgrastim in kidney transplant recipients demonstrated success in reversing neutropenia. Short courses of therapy were required with minimal adverse events. Patients who required readmission were successfully re-treated. Additional studies are required to determine the most effective dose and duration of treatment.

Extracorporeal photopheresis for the treatment of graft rejection in 33 adult kidney transplant recipients

2019 ◽  
Vol 58 (4) ◽  
pp. 515-524
Author(s):  
Mathilde Tamain ◽  
Johnny Sayegh ◽  
Arnaud Lionet ◽  
Philippe Grimbert ◽  
Carole Philipponnet ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Graft Rejection ◽  
Extracorporeal Photopheresis ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Adult Kidney

scholarly journals Pharmacokinetics, Pharmacodynamics, and Immunogenicity of Belatacept in Adult Kidney Transplant Recipients

2013 ◽  
Vol 34 (2) ◽  
pp. 117-126 ◽  
Author(s):  
Jinshan Shen ◽  
Robert Townsend ◽  
Xiaoli You ◽  
Yun Shen ◽  
Ping Zhan ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Adult Kidney

An Exploratory Correlational Study in the Use of Mobile Technology Among Adult Kidney Transplant Recipients

2018 ◽  
Vol 28 (4) ◽  
pp. 368-375 ◽  
Author(s):  
Tara O’Brien ◽  
Cynthia L. Russell ◽  
Alai Tan ◽  
Mallory Washington ◽  
Donna Hathaway
Keyword(s):  
Kidney Transplant ◽  
Mobile Technology ◽  
Mobile Apps ◽  
Self Management ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Cross Sectional ◽  
Adult Kidney ◽  
Access Patterns ◽  
Management Of Care

Introduction: Rapidly growing use of mobile technology provides a platform for self-management of care support for those with chronic conditions. Few studies have explored the characteristics or access patterns of kidney transplant recipients who use mHealth applications (apps) for self-management of care. Research Questions: The primary aim of this study was to describe demographics, use, barriers, and perceptions of mobile apps for self-management of care among adult kidney transplants recipients. The secondary aim was to compare blood urea nitrogen, glomerular filtration rate, and number of hospitalizations among mHealth app users, other app users, and non-app users. Methods: A cross-sectional design was used to administer the Mobile Application Use among Kidney Transplant Recipients Questionnaire. Descriptive statistics, χ2 statistics, and analysis of variance were used for the primary aim and linear regression was used for the secondary aim. Results: The sample included mostly African American males (n = 123, 75.5%) with a mean age of 50 (13.2) years. Knowledge was the greatest barrier reported by the non-app users (mHealth app users 9%, other app users 12%, non-app users, 49%, P < .001). Significantly fewer hospitalizations were found in the mHealth app users compared to other app users (regression coefficient b = −1.2, standard error [SE] = 0.5) and non-app users ( b = −0.9, SE = 0.6), adjusting for patient demographic and clinical characteristics. Discussion: Findings suggest a relationship may exist between mHealth app use and a decrease in the number of hospitalizations following kidney transplantation.

scholarly journals P1762THE EFFECT OF IMMUNOSUPPRESSIVE THERAPY ON THE CLINICAL FOLLOW-UP OF BK VIRUS IN KIDNEY TRANSPLANT RECIPIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Gulay Yilmaz ◽  
Volkan Polatkan ◽  
Ebru Ozdemir ◽  
Turker Erturk ◽  
Emel Tatli ◽  
...  
Keyword(s):  
Immunosuppressive Therapy ◽  
Kidney Transplant ◽  
Antiviral Treatment ◽  
Immunosuppressive Treatment ◽  
Bk Virus ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Group I ◽  
The Mean

Abstract Background and Aims BK virus nephropathy occurs in up to 10% of kidney transplant recipients and can result in graft loss. The reactivation of BK virus is largely asymptomatic, and routine surveillance especially in the first 12-24 months after transplant is necessary for early recognition and intervention. Reduced immunosuppression and antiviral treatment in the early stages may be effective in stopping BK virus replication. This study is designed to investigate the effect of management in immunosuppressive therapy on BK virus titers and graft functions in our kidney transplant group. Method A total of 370 kidney transplant recipients between the ages of 18-69 years and receiving a triple immunosuppressive therapy (Tacrolimus+Mycophenoloic Acid+Prednisolone) were included in the study. Demographic characteristics, BK virus titers, serum creatinine and immunosuppressive drug (Tacrolimus, Everolimus) levels were measured at regular intervals in the first 24 months. Among these patients 43 of them were found to have BK virus positivity. At the time of the detection of BK virus positivity, patients were divided into three groups regarding the change in the immunosuppressive protocols: Group I: Tacrolimus + Everolimus + Prednisolone, Group II: Everolimus + Prednisolone, Group III: Tacrolimus + Prednisolone. BK virus titers and graft functions of all three groups were compared with each other. SPSS 15 for Windows was used for statistical analysis. Results The mean age of the patients was 45.3 years, and the mean duration of transplantation was 16.3 months at the time of the BK virus positivity. During the follow-up, mean Tacrolimus levels were found to be in their highest value (14.1 ng/mL) in the posttransplant three months while BK virus titer reached the highest value (1.1x106 copies/ml) in the posttransplant seven to nine months. Increased creatinine values two months after BK virus positivity were strongly correlated (p = 0.02, p = 0.008, p = 0.05, p = 0.002 at 6th, 9th, 12th and 24th months, respectively). A significant decrease in BK virus titers was observed in all three groups due to reductions in immunosuppressive treatment protocol (p = 0.005, p = 0.003, p = 0.028, in groups I, II, III respectively). Conclusion Our study favors the benefits of the prospective screening for BK virus to identify early viral replication, permit intervention, and prevent progression to nephropathy or allograft loss. The best studied treatment for BK viremia and nephropathy is careful reduction of immunosuppression

Composite Health Outcomes in Pediatric and Young Adult Kidney Transplant Recipients

2019 ◽  
Vol 204 ◽  
pp. 196-202 ◽  
Author(s):  
Veronica A. Taylor ◽  
Cassie L. Kirby ◽  
Edward J. Nehus ◽  
Jens Goebel ◽  
David K. Hooper
Keyword(s):  
Young Adult ◽  
Health Outcomes ◽  
Kidney Transplant ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Adult Kidney
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