scholarly journals The impact of calcineurin inhibitors and mammalian target of rapamycininhibitors on anxiety and depression scores in kidney transplant patients

2016 ◽  
Vol 46 ◽  
pp. 1341-1347 ◽  
Author(s):  
Ebru GÖK OĞUZ ◽  
Gülay ULUSAL OKYAY ◽  
Hadim AKOĞLU ◽  
Güner KARAVELİ GÜRSOY ◽  
Zafer ERCAN ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Calcineurin Inhibitors ◽  
Anxiety And Depression ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
The Impact

scholarly journals Clinical Relevance of Corticosteroid Withdrawal on Graft Histological Lesions in Low-Immunological-Risk Kidney Transplant Patients

2021 ◽  
Vol 10 (9) ◽  
pp. 2005
Author(s):  
Domingo Hernández ◽  
Juana Alonso-Titos ◽  
Teresa Vázquez ◽  
Myriam León ◽  
Abelardo Caballero ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Rejection Rate ◽  
Open Label ◽  
Post Transplantation ◽  
Protocol Biopsy ◽  
Corticosteroid Withdrawal ◽  
Transplant Patients ◽  
Prospective Phase ◽  
Kidney Transplant Patients ◽  
The Impact

The impact of corticosteroid withdrawal on medium-term graft histological changes in kidney transplant (KT) recipients under standard immunosuppression is uncertain. As part of an open-label, multicenter, prospective, phase IV, 24-month clinical trial (ClinicalTrials.gov, NCT02284464) in low-immunological-risk KT recipients, 105 patients were randomized, after a protocol-biopsy at 3 months, to corticosteroid continuation (CSC, n = 52) or corticosteroid withdrawal (CSW, n = 53). Both groups received tacrolimus and MMF and had another protocol-biopsy at 24 months. The acute rejection rate, including subclinical inflammation (SCI), was comparable between groups (21.2 vs. 24.5%). No patients developed dnDSA. Inflammatory and chronicity scores increased from 3 to 24 months in patients with, at baseline, no inflammation (NI) or SCI, regardless of treatment. CSW patients with SCI at 3 months had a significantly increased chronicity score at 24 months. HbA1c levels were lower in CSW patients (6.4 ± 1.2 vs. 5.7 ± 0.6%; p = 0.013) at 24 months, as was systolic blood pressure (134.2 ± 14.9 vs. 125.7 ± 15.3 mmHg; p = 0.016). Allograft function was comparable between groups and no patients died or lost their graft. An increase in chronicity scores at 2-years post-transplantation was observed in low-immunological-risk KT recipients with initial NI or SCI, but CSW may accelerate chronicity changes, especially in patients with early SCI. This strategy did, however, improve the cardiovascular profiles of patients.

scholarly journals Effect of Remdesivir on COVID-19 PCR Positivity and Cycle Threshold in Kidney Transplant Recipients

2021 ◽  
Vol 2 (3) ◽  
pp. 291-293
Author(s):  
Ryan J. Winstead ◽  
Johanna Christensen ◽  
Sara Sterling ◽  
Megan Morales ◽  
Dhiren Kumar ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Cycle Threshold ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
Polymerase Chain ◽  
New Diagnosis ◽  
The Impact ◽  
Median Change

Information regarding Coronavirus disease 2019 in the transplant population is lacking. Recently it has been suggested that cycle threshold values obtained on polymerase chain reaction tests may serve as a marker of disease severity with lower values (i.e., higher viral load) being associated with higher mortality. This study was done to assess the impact of remdesivir use on the time to a negative COVID-19 PCR as well as the degree of change between two Ct’s based on treatment. A total of 30 kidney transplant patients with a new diagnosis of COVID-19 were assessed. Serial PCR results were followed from the time of diagnosis then every 2–4 weeks until negative. In patients who received remdesivir immediately after COVID-19 confirmation compared to no remdesivir, time to negative PCR was not statistically different with a median duration of 57 days in both groups (p = 0.369). The change in the Ct between the first and the second PCR test was also not statistically different between groups with a median change of 18.4 cycles in the remdesivir group and 15.7 cycles without remdesivir (p = 0.516). The results of this small single-center analysis suggest that remdesivir may not be beneficial in shortening time to a negative COVID-19 PCR.

Long-term Results of Conversion From Calcineurin Inhibitors to Sirolimus in 150 Maintenance Kidney Transplant Patients

2012 ◽  
Vol 10 (2) ◽  
pp. 110-118 ◽  
Author(s):  
Cyril Garrouste ◽  
Nassim Kamar ◽  
Céline Guilbeau-Frugier ◽  
Joëlle Guitard ◽  
Laure Esposito ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Calcineurin Inhibitors ◽  
Long Term Results ◽  
Transplant Patients ◽  
Kidney Transplant Patients

RETROSPECTIVE STUDY ON THE IMPACT OF HEPATITIS C VIRUS INFECTION ON KIDNEY TRANSPLANT PATIENTS OVER 20 YEARS

1998 ◽  
Vol 66 (4) ◽  
pp. 471-476 ◽  
Author(s):  
Touru Hanafusa ◽  
Yasuji Ichikawa ◽  
Hidefumi Kishikawa ◽  
Masahiro Kyo ◽  
Takanobu Fukunishi ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Retrospective Study ◽  
Hepatitis C ◽  
Virus Infection ◽  
Kidney Transplant ◽  
Hepatitis C Virus Infection ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
The Impact

scholarly journals Effect of CYP3A4*22, POR*28, and PPARA rs4253728 on Sirolimus In Vitro Metabolism and Trough Concentrations in Kidney Transplant Recipients

2013 ◽  
Vol 59 (12) ◽  
pp. 1761-1769 ◽  
Author(s):  
Jean-Baptiste Woillard ◽  
Nassim Kamar ◽  
Sandra Coste ◽  
Lionel Rostaing ◽  
Pierre Marquet ◽  
...  
Keyword(s):  
Adverse Events ◽  
Kidney Transplant ◽  
Calcineurin Inhibitor ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
Trough Concentrations ◽  
The Impact

BACKGROUND Recent studies have identified new candidate polymorphisms in the genes related to CYP3A activity or calcineurin inhibitor dose requirements in kidney transplant recipients. These genes and polymorphisms are CYP3A4 (cytochrome P450, family 3, subfamily A, polypeptide 4) (rs35599367-C>T; *22); POR [P450 (cytochrome) oxidoreductase] (rs1057868-C>T; *28); and PPARA (peroxisome proliferator-activated receptor alpha) (rs4253728-G>A). We investigated the impact of these polymorphisms on sirolimus (SRL) in vitro hepatic metabolism, SRL trough concentrations (C0), and SRL adverse events in kidney transplant recipients. METHODS The clinical study included 113 stable kidney transplant patients switched from a calcineurin inhibitor to SRL (SRL C0 measured at 1, 3, and 6 months thereafter). We investigated SRL metabolism in vitro using human liver microsomes derived from individual donors (n = 31). Microsomes and patients were genotyped by use of Taqman® allelic discrimination assays. The effects of polymorphisms and covariates were studied using multilinear regression imbedded in linear mixed-effect models or logistic regressions. RESULTS In vitro, the CYP3A4*22 allele resulted in approximately 20% lower metabolic rates of SRL (P = 0.0411). No significant association was found between CYP3A4, CYP3A5, or PPARA genotypes and SRL dose, C0, or C0/dose in kidney transplant patients. POR*28 was associated with a minor but significant decrease in SRL log-transformed C0 [CT/TT vs CC, β = −0.15 (0.05); P = 0.0197] but this did not have any impact on the dose administered, which limited the relevance of the finding. After adjustment for nongenetic covariates and correction for false discovery finding, none of the single-nucleotide polymorphisms tested showed significant association with SRL adverse events. CONCLUSIONS These recently described polymorphisms do not seem to substantially influence the pharmacokinetics of SRL or the occurrence of SRL adverse events in kidney transplant recipients.

scholarly journals The impact of induction therapy on the homeostasis and function of regulatory T cells in kidney transplant patients

2014 ◽  
Vol 29 (8) ◽  
pp. 1587-1597 ◽  
Author(s):  
A. P. Bouvy ◽  
M. Klepper ◽  
M. M. L. Kho ◽  
K. Boer ◽  
M. G. H. Betjes ◽  
...  
Keyword(s):  
T Cells ◽  
Regulatory T Cells ◽  
Kidney Transplant ◽  
Induction Therapy ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
And Function ◽  
The Impact

scholarly journals Response to Tozinameran (BNT162b2) booster in twice-vaccinated kidney transplant and maintenance dialysis patients

2021 ◽  
Author(s):  
Iddo Z. Ben-Dov ◽  
Keren Tzukert ◽  
Hadas Prichen ◽  
Yonatan Oster ◽  
Esther Oiknine-Djian ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Booster Vaccination ◽  
Fold Increase ◽  
Kidney Transplant Recipients ◽  
Dialysis Patients ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
Maintenance Dialysis ◽  
Antibody Levels ◽  
The Impact

Background Patients needing chronic RRT are at risk for severe COVID-19 and mount a lesser response to mRNA vaccination. We describe the impact of booster administration in these patients, amidst a third wave of infections and deaths. Methods In the setting of a prospective COVID-19-centred cohort study in dialysis and kidney transplant patients we examined humoral responses to booster vaccination, and subsequent infection risk. Results We quantified antibodies (DiaSorin) in 198 maintenance dialysis patients, 314 kidney transplant patients and 82 controls, without prior COVID-19 infection. Prior to boosting, 79% of controls, 35% of dialysis and 11% of transplant patients had levels ≥59 AU/ml (putatively protective), while 8-54 days after a third injection, respective rates were 100%, 93% and 58%. Risk factors for antibodies <60 AU/ml despite booster injection were transplant vs dialysis, OR=18.4 (p<0.0001), transitioning from dialysis to transplantation or vice versa, OR=15.7 (p<0.01) and days post injection, OR=0.953 (p<0.05). Antibody step-up after the booster inversely correlated with the second dose step-up (r=-0.33, p<0.01). In this surge, 2 controls, 2 dialysis and 9 transplant patients had COVID-19. Antibody level ≥59 AU/ml at any time point independently associated with reduced risk of infection during this surge, OR=0.264 (p=0.048). Conclusions We show that a third dose of tozinameran boosts antibody levels in patients receiving RRT, as it did in controls. Most patients have now reached antibody levels likely to protect from infection. Antibodies were higher after the third dose compared to previous peaks, which may hint that the latest immune response may be more robust and sustainable, even in immune-compromised patients. Kidney transplant recipients showed the most striking enhancement, exhibiting >5.5-fold increase in the percentage of patients with protective antibody levels. However, many transplant patients remain below threshold even after boost injection, necessitating further boosting strategies.

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