scholarly journals Drug–Drug Interaction between Tacrolimus and Vonoprazan in Kidney Transplant Recipients

2021 ◽  
Vol 10 (17) ◽  
pp. 3964
Author(s):  
Yoshiharu Suzuki ◽  
Takuya Yoshihashi ◽  
Kazuhiro Takahashi ◽  
Kinji Furuya ◽  
Nobuhiro Ohkohchi ◽  
...  
Keyword(s):  
Drug Interaction ◽  
Kidney Transplant ◽  
Genetic Polymorphisms ◽  
Blood Concentration ◽  
Initial Period ◽  
Tacrolimus Concentration ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Post Transplantation ◽  
Drug Drug Interaction

Kidney transplant recipients with tacrolimus-based immunosuppressive therapy are often treated with proton-pump inhibitors (PPIs) to prevent gastric ulcer complications. Vonoprazan, a potassium-competitive acid blocker, is a novel PPI possessing different metabolic pathways from conventional PPIs (e.g., omeprazole, lansoprazole and rabeprazole). However, no data are available on the change in blood concentration of tacrolimus after switching rabeprazole, a conventional PPI, to vonoprazan coadministration in the initial period of post-transplantation. This is a retrospective study of 18 kidney transplant recipients. The blood concentration and the concentration to dose (C/D) ratio of tacrolimus were compared before and after switching from rabeprazole to vonoprazan. Impacts of CYP2C19 and CYP3A5 genetic polymorphisms on the drug–drug interaction were also examined. The median (range) trough concentration of tacrolimus was significantly increased from 5.2 (3.6–7.4) to 8.1 (6.1–11.7) ng/mL (p < 0.0005) after switching from rabeprazole to vonoprazan. The C/D ratio of tacrolimus was also significantly increased from 38.1 (16.5–138.1) to 48.9 (26.2–207.2) (p < 0.0005). The percent changes of tacrolimus concentrations and C/D were 65.8% and 41.8%, respectively. CYP2C19 and CYP3A5 genetic polymorphisms did not affect the change in concentration and C/D ratio of tacrolimus. The present study indicates that vonoprazan coadministration increases the tacrolimus concentration regardless of CYP2C19 or CYP3A5 genetic polymorphisms. Thus, frequent monitoring of blood tacrolimus concentration is required when vonoprazan is introduced as an intensive gastric acid blocker in the early phase of post-transplantation.

scholarly journals BK Polyomavirus Micro-RNAs: Time Course and Clinical Relevance in Kidney Transplant Recipients

Viruses ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 351
Author(s):  
Baptiste Demey ◽  
Véronique Descamps ◽  
Claire Presne ◽  
Francois Helle ◽  
Catherine Francois ◽  
...  
Keyword(s):  
Viral Replication ◽  
Kidney Transplant ◽  
Clinical Relevance ◽  
Graft Loss ◽  
First Year ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Post Transplantation ◽  
Bk Polyomavirus ◽  
Micro Rnas

Background: Kidney transplant recipients (KTRs) are exposed to a high risk of BK polyomavirus (BKPyV) replication, which in turn may lead to graft loss. Although the microRNAs (miRNAs) bkv-miR-B1-3p and bkv-miR-B1-5p are produced during the viral cycle, their putative value as markers of viral replication has yet to be established. In KTRs, the clinical relevance of the changes over time in BKPyV miRNA levels has not been determined. Methods: In a retrospective study, we analyzed 186 urine samples and 120 plasma samples collected from 67 KTRs during the first year post-transplantation. Using a reproducible, standardized, quantitative RT-PCR assay, we measured the levels of bkv-miR-B1-3p and bkv-miR-B1-5p (relative to the BKPyV DNA load). Results: Detection of the two miRNAs had low diagnostic value for identifying patients with DNAemia or for predicting DNAuria during follow-up. Seven of the 14 KTRs with a sustained BKPyV infection within the first year post-transplantation showed a progressive reduction in the DNA load and then a rapid disappearance of the miRNAs. DNA and miRNA loads were stable in the other seven KTRs. Conclusions: After the DNA-based diagnosis of BKPyV infection in KTRs, bkv-miR-B1-3p and bkv-miR-B1-5p levels in the urine might be valuable markers for viral replication monitoring and thus might help physicians to avoid an excessive reduction in the immunosuppressive regimen.

SaO01618F-FDG PET/CT imaging at 3 months post transplantation excludes subclinical rejection in kidney transplant recipients

2019 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Oriane Hanssen ◽  
Laurent Weekers ◽  
Pierre Lovinfosse ◽  
Alexandre Jadoul ◽  
Alexandre Huynen ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Fdg Pet ◽  
Ct Imaging ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Post Transplantation ◽  
Pet Ct ◽  
Subclinical Rejection ◽  
Fdg Pet Ct

scholarly journals Genetic polymorphisms of Interleukin-18 are not associated with allograft function in kidney transplant recipients

2014 ◽  
Vol 37 (2) ◽  
pp. 343-349 ◽  
Author(s):  
Wenna Gleyce Araújo do Nascimento ◽  
Daiani Alves Cilião ◽  
Julieta Genre ◽  
Dikson Dibe Gondim ◽  
Renata Gomes Alves ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Genetic Polymorphisms ◽  
Transplant Recipients ◽  
Interleukin 18 ◽  
Kidney Transplant Recipients ◽  
Allograft Function

Post-Transplantation Immunoadsorption Can Be Withheld in ABO-Incompatible Kidney Transplant Recipients

2015 ◽  
Vol 19 (5) ◽  
pp. 513-517 ◽  
Author(s):  
Annelies E de Weerd ◽  
Madelon van Agteren ◽  
Jan NM Ijzermans ◽  
Willem Weimar ◽  
Michiel GH Betjes
Keyword(s):  
Kidney Transplant ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Post Transplantation

Tacrolimus Concentration‐to‐Dose Ratios in Kidney Transplant Recipients and Relationship to Clinical Outcomes

2019 ◽  
Vol 39 (8) ◽  
pp. 827-836 ◽  
Author(s):  
Felicia E. Bartlett ◽  
Clarice E. Carthon ◽  
Jennifer C. Hagopian ◽  
Timothy A. Horwedel ◽  
Spenser E. January ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Kidney Transplant ◽  
Tacrolimus Concentration ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

scholarly journals 210. Outcomes of Kidney Transplant Recipients with Donor Positive Blood Cultures

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S213-S214
Author(s):  
Petros Svoronos ◽  
Prakhar Vijayvargiya ◽  
Pradeep Vaitla ◽  
James j Wynn ◽  
Elena Beam ◽  
...  
Keyword(s):  
Blood Culture ◽  
Kidney Transplant ◽  
Demographic Data ◽  
Blood Cultures ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Donor Blood ◽  
Post Transplantation ◽  
Duration Of Therapy

Abstract Background Based on expert opinion, solid organ transplant recipients from donors with bacteremia are treated with 7-14 days of pre-emptive antibiotic therapy (PAT). However, studies addressing necessity, optimal duration of therapy, and outcomes in kidney transplant recipients (KTR) are lacking. Methods We retrospectively reviewed all kidney transplants performed at our institution from 01/01/2015-01/01/2021 to identify those cases where matched deceased donors had positive blood cultures. Bacteremia was defined per CDC criteria. We analyzed rate of infection in the KTR with the same organism identified in the donor blood culture within 30 days of transplantation. Results A total of 56 KTRs with donor positive blood cultures were identified. Demographic data are summarized in Table 1. Twenty of 56 cases (35.8%) had bacteremia and 36 (64.2%) had organisms classified as common commensals. The most common organisms in the bacteremia group were Gram-negative bacteria (12/20) and Staphylococcus aureus (6/20). Most common commensals were coagulase-negative staphylococci (26/36) (Table 2). All KTR received preoperative antibiotics at the time of transplantation, primarily cefazolin (15/20), and vast majority received TMP/SMX prophylaxis, for Pneumocystis jirovecii, post-transplant (19/20). PAT was administered in 70% (14/20) cases of bacteremia for a median of 8.5 days (IQR 7-14), while six cases were left untreated (Table 2). In contrast, majority of cases with common commensals were not treated (75%, 27/36). Of the cases treated (9/36), median duration of therapy was 7 days (IQR 5-14). No cases of infection with the same organism identified in the donor blood culture were reported in KTR within 30 days of transplantation. Conclusion KTR donors with bacteremia who were treated received a median of 8.5 days of PAT with no instances of breakthrough infection. In contrast, majority of donor blood cultures with organisms classified as common commensals were not treated and did well. Future studies are needed to assess whether perioperative antibiotics coupled with TMP/SMX prophylaxis post-transplantation are sufficient in select cases of transplantation from donors with bacteremia. Disclosures All Authors: No reported disclosures

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