INCREASED RISK OF GRAFT LOSS IN MYCOPHENOLATE MOFETIL (MMF) AND TACROLIMUS (TACRO)-TREATED RENAL TRANSPLANT RECIPIENTS (RTRʼS) WITH ACUTE REJECTION

ASAIO Journal ◽  
2001 ◽  
Vol 47 (2) ◽  
pp. 141
Author(s):  
Mariana Markell ◽  
Moro Salifu ◽  
Dhiren Haria ◽  
Harrison King ◽  
Dale Distant ◽  
...  
Keyword(s):  
Mycophenolate Mofetil ◽  
Renal Transplant ◽  
Acute Rejection ◽  
Graft Loss ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Increased Risk

scholarly journals Comparison of the Emit Immunoassay with HPLC for Therapeutic Drug Monitoring of Mycophenolic Acid in Pediatric Renal-Transplant Recipients on Mycophenolate Mofetil Therapy

2002 ◽  
Vol 48 (3) ◽  
pp. 517-525 ◽  
Author(s):  
Lutz T Weber ◽  
Maria Shipkova ◽  
Victor W Armstrong ◽  
Natalie Wagner ◽  
Ekkehard Schütz ◽  
...  
Keyword(s):  
Mycophenolate Mofetil ◽  
Renal Transplant ◽  
Acute Rejection ◽  
Mycophenolic Acid ◽  
Therapeutic Drug ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Increased Risk ◽  
Pediatric Renal Transplant ◽  
Pediatric Renal Transplant Recipients

Abstract Background: HPLC is currently the preferred method for accurate measurement of mycophenolic acid (MPA). This study was designed to validate the Emit compared with HPLC in relation to clinical outcome measurements. Methods: Pediatric renal-transplant recipients (n = 50) on an immunosuppressive triple regimen consisting of cyclosporin A, prednisone, and mycophenolate mofetil (600 mg/m2 twice per day) were investigated in an open-label prospective study. Pharmacokinetic profiles over 12 h were obtained at 1 week, 3 weeks, 3 months, and 6 months posttransplant. Plasma MPA was measured by both reversed-phase HPLC and the Emit immunoassay. Results: There was an association between the risk of acute rejection episodes and low area under the curve values from t0 to t12h (AUC0–12) for MPA (MPA-AUC0–12) or predose concentrations of MPA derived from both HPLC and Emit measurements. According to ROC analysis, an AUC value of 33.8 mg · h/L for MPA from t0 to t12h (MPA-AUC0–12) determined by HPLC had a diagnostic sensitivity of 80% and a diagnostic specificity of 57%. The corresponding value of the Emit was 36.1 mg · h/L. For the predose concentration (MPA-c12), a concentration of 1.2 mg/L determined by HPLC and 1.4 mg/L determined by Emit gave a sensitivity of 80% and a specificity of 60%, respectively. There was no association of any pharmacokinetic variables derived from total MPA measurements with an increased risk of side effects related to mycophenolate mofetil. Conclusions: The Emit assay appears to have a comparable diagnostic efficacy to HPLC for assessing the risk of acute rejection in pediatric renal-transplant recipients. However, because of the cross-reactivity of the antibody used in the Emit assay with the active MPA acyl glucuronide metabolite, the decision thresholds for the Emit were higher than those calculated from HPLC measurements.

The relative risk of overall graft loss and acute rejection among African American renal transplant recipients is attenuated with advancing age

2010 ◽  
Vol 25 (5) ◽  
pp. 721-730 ◽  
Author(s):  
Jesse D. Schold ◽  
Titte R. Srinivas ◽  
William E. Braun ◽  
Daniel A. Shoskes ◽  
Saul Nurko ◽  
...  
Keyword(s):  
African American ◽  
Relative Risk ◽  
Renal Transplant ◽  
Acute Rejection ◽  
Graft Loss ◽  
Renal Transplant Recipients ◽  
Transplant Recipients

scholarly journals EFFECT OF LEPTIN CONCENTRATIONS AND LEPTIN RECEPTOR GENE POLYMORPHISMS ON THE OUTCOME OF RENAL TRANSPLANTATION

2021 ◽  
Author(s):  
Guadalup García-Pino ◽  
Enrique Luna ◽  
Sonia Mota-Zamorano ◽  
Luz María González ◽  
María Ángeles Tormo ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Renal Transplant ◽  
Acute Rejection ◽  
Clinical Outcomes ◽  
Leptin Receptor ◽  
Renal Transplant Recipients ◽  
Inverse Association ◽  
Transplant Recipients ◽  
Lepr Gene ◽  
Increased Risk

IntroductionLeptin is a pro-inflammatory adipocytokine implicated in cardiovascular disease, insulin resistance, obesity and chronic kidney disease.Material and methodsIn a cohort of 236 renal transplant recipients, we aimed to determine whether circulating leptin concentrations and/or three polymorphisms in the leptin receptor (LEPR) gene, namely rs1137100, rs1137101 and rs1805094, were related to clinical outcomes in renal transplantation. Plasma leptin concentrations were measured by ELISA. Genetic variants were determined by conventional real-time PCR assays and statistical associations with clinical outcomes were obtained by logistic regression modelling.ResultsPatients with elevated leptin levels were at higher risk of acute rejection [OR=1.03 (1.01–1.05), p=0.03] and displayed worse renal clearance (p=0.001) than patients with lower levels. Leptin levels were not significantly affected by any of the three LEPR SNPs. The rs1137101 G variant showed an inverse association with the risk of delayed graft function (DGF) [OR=0.42 (0.22-0.81), p=0.009], whilst the homozygous rs1805094 CC genotype was associated with increased risk of acute rejection [OR=11.38 (2.15-60.16), p=0.004]. A statistically significant association was also observed between the rs1137100 GG genotype and better renal function [mean difference vs. AA/AG =20.20 (4.91-35.49) ml/min, p=0.010].ConclusionsOur results show that both leptin plasma concentrations and polymorphisms in the LEPR gene may affect clinical outcomes in renal transplant recipients, suggesting that the determination of these parameters could be useful in predicting post-transplant adverse events.

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