scholarly journals The impact of tacrolimus exposure on extrarenal adverse effects in adult renal transplant recipients

2019 ◽  
Vol 85 (3) ◽  
pp. 516-529 ◽  
Author(s):  
Olivia Campagne ◽  
Donald E. Mager ◽  
Daniel Brazeau ◽  
Rocco C. Venuto ◽  
Kathleen M. Tornatore
2021 ◽  
Vol 11 (5) ◽  
pp. 68
Author(s):  
Mervat Mamdouh Abu Zead ◽  
Lamia Mohamed Nabil Ismail ◽  
Sahier Omar El-khashab

Immunosuppressant therapies are considered vital for the long-term survival of kidney grafts, however it can significantly modify patients’ HRQOL because of their adverse effects and the complex medication schedule they represent. Aims: (1) To explore symptom experiences and symptom distress with adverse effects of immunosuppressive therapies, (2) To assess the impact of symptoms experience and symptoms distress on health-related quality of life among renal transplant recipient, and (3) To correlate them with gender. One hundred Renal transplant recipients were interviewed using the End-Stage Renal Disease Symptom Checklist Transplantation Module (ESRDSCL-TM). Results: Most of the renal transplant participants reported best and good quality of life, however, there were a statistically significant differences by gender. Women reported low satisfaction in quality of life comparing with men. In relation to the most frequent distressing symptoms in men and women, the study revealed that women reported higher levels in majority of the given symptoms distress such as back pain, increased hair growth and mood swings. Moreover, women perceived higher means levels with respect to increased appetite while men reported more distress for the items as increased appetite, mood swings, decreased interest in sex, depression, and sleeplessness. Conclusion: Renal transplant recipients had good quality of life with immunosuppressive therapies, but intensive assessment of patients after transplantation should be done to identify their needs. Moreover, consideration should be taken with regards gender variations thus help planning to get better quality of life, as a relatively normal lifestyle is re-established.


2009 ◽  
Vol 1 ◽  
pp. CMT.S2218 ◽  
Author(s):  
Nathan Newbold ◽  
Brianna Riley ◽  
Karen Hardinger

Mycophenolic acid inhibits an enzyme, inosine monophosphate dehydrogenase (IMPDH), blocking purine synthesis of lymphocytes and therefore functioning as an effective immunosuppressive agent in transplantation. Currently, there are two available forms of mycophenolic acid (MPA) available; mycophenolate mofetil (MMF) and enteric-coated, delayed-release mycophenolate sodium (EC-MPS). Both products are approved for prophylaxis of organ rejection in renal transplant recipients. The use of MPA may be associated with adverse gastrointestinal effects which can lead to a reduction of the dose or discontinuation of therapy. Enteric-coated MPS was developed to reduce the upper gastrointestinal side effects due to its delayed release in the small intestines. Similar systemic MPA exposure is provided by oral administration of MMF 1000 mg daily and EC-MPS 720 mg, which contain near equimolar MPA content. Clinical trials in renal transplant recipients have demonstrated that EC-MPS is therapeutically equivalent to MMF when used at the time of transplantation and when used for conversion for gastrointestinal complications. The available literature regarding the incidence and severity of gastrointestinal adverse effects and the impact on quality of life remains controversial. Prospective, randomized trials of the available MPA formulations are warranted to further explore the gastrointestinal adverse effect profiles.


2018 ◽  
Vol 33 (5) ◽  
pp. 897-910 ◽  
Author(s):  
Britta Höcker ◽  
Martin Aguilar ◽  
Paul Schnitzler ◽  
Lars Pape ◽  
Martin Bald ◽  
...  

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Susanne Rieger ◽  
Dirk Bethe ◽  
Angela Bagorda ◽  
Dorothea Treiber ◽  
Jörg Beimler ◽  
...  

AbstractA successful transition of renal transplant recipients from pediatric to adult care requires a structured, need-adapted and multidisciplinary approach to preserve renal graft function during this critical period of life. In this article we present our clinical protocol for transition from pediatric to adult care, which we developed on the basis of the International Society of Nephrology (ISN)/International Pediatric Nephrology Association (IPNA) consensus guidelines influenced by our own experience. This transition program was established in our center in July 2017. The entire transition process is structured and accompanied by a transition key worker (social worker). From 12 years of age we train pediatric renal transplant recipients in medical knowledge, self-management skills and networking with self-help groups. The training is adapted to the individual patient‘s intellectual ability, lasts about 10 years and takes place with increasing intensity. Repeatedly we perform standardized informational interviews and check patient’s knowledge of transplant-related topics. Psychosocial and educational issues are evaluated concomitantly. The actual transfer takes place in a pediatric-adult-transition clinic. Relevant medical and psychosocial aspects are discussed and the future treatment regimen is established. The date of transfer is adapted to the individual patient’s need; it varies between 18 and 24 years of age. In periods of increased risk for non-adherence the transfer is postponed to intensify the efforts for training and assistance. After transfer a standardized evaluation of each individual patient takes place focusing on medical and psychosocial issues and on satisfaction with the transition process. Collection of these data is still in progress and will be analyzed systematically at a later stage in order to evaluate the impact of this new transition program on the stability of transplant function. That analysis might serve as a basis for negotiations about refunding with health insurance companies.


2008 ◽  
Vol 86 (4) ◽  
pp. 564-570 ◽  
Author(s):  
Jason Moore ◽  
Xiang He ◽  
Paul Cockwell ◽  
Mark A. Little ◽  
Atholl Johnston ◽  
...  

2020 ◽  
Vol 318 (1) ◽  
pp. F76-F85
Author(s):  
Patrick J. Highton ◽  
Alice E. M. White ◽  
Daniel G. D. Nixon ◽  
Thomas J. Wilkinson ◽  
Jill Neale ◽  
...  

Renal transplant recipients (RTRs) and patients with nondialysis chronic kidney disease display elevated circulating microparticle (MP) counts, while RTRs display immunosuppression-induced infection susceptibility. The impact of aerobic exercise on circulating immune cells and MPs is unknown in RTRs. Fifteen RTRs [age: 52.8 ± 14.5 yr, estimated glomerular filtration rate (eGFR): 51.7 ± 19.8 mL·min−1·1.73 m−2 (mean ± SD)] and 16 patients with nondialysis chronic kidney disease (age: 54.8 ± 16.3 yr, eGFR: 61.9 ± 21.0 mL·min−1·1.73 m−2, acting as a uremic control group), and 16 healthy control participants (age: 52.2 ± 16.2 yr, eGFR: 85.6 ± 6.1 mL·min−1·1.73 m−2) completed 20 min of walking at 60–70% peak O2 consumption. Venous blood samples were taken preexercise, postexercise, and 1 h postexercise. Leukocytes and MPs were assessed using flow cytometry. Exercise increased classical ( P = 0.001) and nonclassical ( P = 0.002) monocyte subset proportions but decreased the intermediate subset ( P < 0.001) in all groups. Exercise also decreased the percentage of platelet-derived MPs that expressed tissue factor in all groups ( P = 0.01), although no other exercise-dependent effects were observed. The exercise-induced reduction in intermediate monocyte percentage suggests an anti-inflammatory effect, although this requires further investigation. The reduction in the percentage of tissue factor-positive platelet-derived MPs suggests reduced prothrombotic potential, although further functional assays are required. Exercise did not cause aberrant immune cell activation, suggesting its safety from an immunological standpoint (ISRCTN38935454).


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