scholarly journals Is the pretransplant C2 an optimum predictor of posttransplant dose for tacrolimus in renal transplantation patients?

2019 ◽  
Vol 4 (1) ◽  
pp. IPK03
Author(s):  
Smita Pattanaik ◽  
Ashish Sharma ◽  
Praveen Kumar-M ◽  
Sarbpreet Singh ◽  
Vikram Shetty ◽  
...  

Aim: The study evaluated whether a single dose pretransplant 2-h tacrolimus concentration (C2) could predict the post-transplantation trough concentration (C0). Materials & methods: C2 concentration of tacrolimus was measured after single-dose administration (0.1 mg/kg) in 20 patients, 4–7 days prior to renal transplantation. Tacrolimus C0 monitoring was done on post-transplant day 2, 5, 10, 15 and 30. Results: The mean C2 was 21.79 ± 16.83 ng/ml (4.25–69.46) and the mean C0 obtained 48 h after transplant was 10.2 ± 6.27 (1.63–22.07) ng/ml. The Spearman correlation between C2 and C0 was 0.71 (p < 0.01). Conclusion: Pretransplant C2 could explain only 50% of the total variation in the post-transplant dose requirement hence it may not be sole predictor of the post-transplant dose.

Author(s):  
Ana Ferreira ◽  
◽  
Aníbal Ferreira ◽  
◽  
◽  
...  

Chronic kidney disease – mineral and bone disorders (CKD -MBD) tends to improve or to change phenotypically in the post -transplant period. Mineral and bone disorders post -transplantation (MBD -PT) seem to be associated with high fracture risk and cardiovascular morbidity, and so it is necessary to be aware of its presence to minimize the MBD -PT impact. In this article we summarize the features of MBD -PT.


1996 ◽  
Vol 10 (6) ◽  
pp. 351-356
Author(s):  
David R. Edelstein ◽  
Charles P. Kimmelman

The underlying basis of the antibiotic treatment of sinusitis is still unclear. Critical to the use of antibiotics in patients with sinusitis is the tissue penetration of the curative agent. However, there is scant information available regarding maxillary mucosal tissue levels in patients with this disease. We present the results of plasma and sinus tissue concentrations of loracarbef in six patients and one control. Levels were taken at 2 and 3 hours after the oral administration of the medication. The mean sinus tissue level was 2.5 mcg/gm and 2.7 mcg/gm at 2 and 3 hours after administration respectively. Although therapeutic efficacy cannot be predicted by the concentrations attained in a specific body fluid or tissue, we believe that these levels are excellent based on mean inhibitory concentrations. Additional studies are underway to document the penetration of this and comparable other drugs in multiple sinuses.


2010 ◽  
Vol 17 (1) ◽  
pp. 159-167 ◽  
Author(s):  
Dheeraj Karamchandani ◽  
Ramiro Arias-Amaya ◽  
Nora Donaldson ◽  
Jackie Gilbert ◽  
Klaus-Martin Schulte

Kidney transplantation and the associated immune suppression are associated with a significantly increased risk of developing cancer during long-term follow-up. Thyroid cancer has been recognised as a potential post-transplant risk but has not yet been subject of a focused review. We therefore performed a meta-analysis on data of 50 861 patients with a total follow-up of 198 595 patient-years and identified a 6.9-fold higher standardised incidence ratio (95% confidence interval 5.6–8.7, P<0.001) of thyroid cancer post renal transplantation as compared with a non-transplant group. All such cancers were of papillary type as far as histopathology was known. The mean time to discovery was 6.0 years post transplantation. This puts thyroid cancer into the group of high cancer risk following solid organ transplantation which already includes cervical cancer, non-melanoma skin cancer, oral and lip cancer and haematological malignancies. It is unclear what causes the increased cancer incidence. Inclusion of thyroid ultrasound in long-term post-transplant evaluation may help to ensure timely recognition of this condition.


2020 ◽  
Vol 52 (10) ◽  
pp. 1863-1868
Author(s):  
Miroslav Tisljar ◽  
Hatem Ali ◽  
Charlie Gledhill-Flynn ◽  
Mila Garreus ◽  
Arvind Ponnusamy ◽  
...  

Abstract Purpose To assess the effect of receiving a kidney with PUJ dysfunction on the recipient renal graft function. Methodology 198 patients, who underwent renal transplantation from 1st January 2004 to 31st December 2014 in a single Center in the North West of England, were retrospectively reviewed using a computerized database. Split kidney function and the PUJ dysfunction for the donors were assessed using Tc-99 m MAG3 renogram. Each recipient with PUJ dysfunction was matched with a control recipient by age, gender, and number of days after transplantation. Both groups were followed up for 3.5 years post-transplantation. Results Of the 198 recipients included in the study, 19 recipients received kidneys from donors with PUJ dysfunction. Prevalence of PUJ dysfunction was 9.5% and it was more common in males than females. There was no difference between the case group and the control group in terms of age, gender, and follow-up time post-transplantation. There was also no difference between the case group and the control group in mean creatinine (130 µmol/l and 138 µmol/l respectively, p = 0.305) or the mean eGFR (48.6 ml/min and 47.5 ml/min respectively, p = 0.054) at 3.5 year post-kidney transplantation. Conclusion This study showed that PUJ dysfunction of renal allograft has a negligible effect on graft function over 3.5 years period post-transplantation. A prospective randomized trial is needed to test these findings. In the presence of widened gap between demand and supply in renal transplantation, PUJ dysfunction in potential donors should not preclude them from donation.


1981 ◽  
Vol 9 (3) ◽  
pp. 189-190 ◽  
Author(s):  
Markku Heikinheimo ◽  
Tapani Hovi

The absorption rate and serum level curves of two commercial phenoxymethylpenicillin mixture preparations were compared in adult volunteers. Both the potassium salt (Primcilliri®) and the benzathine salt (V-Pen ped forte®) of V-penicillin were rapidly absorbed and the mean peak serum levels were obtained with both preparations within the first hour after single dose administration. The mean peak level obtained with the potassium salt was several-fold higher (p < 0.001) and was also reached within a shorter time than that of the benzathine preparation. These results confirm the earlier evidence, obtained with other formulae, for the superior bioavailability of the potassium salt of V-penicillin as compared to most other derivatives used in V-penicillin mixtures.


Author(s):  
Mehroz Ahmed ◽  
Rahul Sudan ◽  
Imtiyaz Ahmed Wani ◽  
Muzaffar Maqsood Wani ◽  
Khurshid Ahmed Banday ◽  
...  

Background: New onset diabetes after transplantation (NODAT) is a common entity in the post-transplant period after several types of organ transplants like kidney, liver heart and lungs. NODAT is a common complication after solid organ transplantation and has been reported to have an adverse impact on patient and allograft outcomes. Risk stratification and intervention to minimize risk should be an integral part of management of transplant recipients.Methods: A total of 100 patients who underwent renal transplantation were observed for the development of NODAT in the post transplantation period. Patients were evaluated in the pre- transplant and post-transplant period. Risk factors which were associated with the development of NODAT were analyzed.Results: Out of 100 patients, 79 were males and 21 were females. The mean age of the patients undergoing renal transplantation was 40 years. The youngest patient was 18 years old and the eldest was 64 years old. Majority of the patients were in the age group of 31 to 50 years (60 patients, 60%). The incidence of NODAT in present study was 17%. The major risk factors for the development of NODAT were identified as male sex, positive family history of diabetes, history of alcohol intake before renal transplantation, hypertriglyceridemia, post renal transplantation hypomagnesemia, proteinuria, and use of drugs like tacrolimus and prednisolone.Conclusions: NODAT has been identified as a risk factor for graft rejection, long-term graft failure, and decreased patient survival. Once NODAT has been diagnosed, specific anti-hyperglycemic therapy is essential to reach a tight glycemic control, which contributes to significantly reduced post-transplantation morbidity. Due to the importance of NODAT, diabetes education and its impact on the outcome of post-transplantation morbidity and mortality becomes crucial point of research among organ transplantation populations. Diabetes education in a group setting can be adopted for organ transplantation recipients with NODAT.


1981 ◽  
Vol 46 (03) ◽  
pp. 626-628 ◽  
Author(s):  
Edward D Gomperts ◽  
Mohammed H Malekzadeh ◽  
Richard N Fine

SummaryHemodialysis was initiated in a mild-moderate hemophiliac at 15 years of age. Hematuria had been a frequent and persisting feature from the age of five years without documented cause. Anemia and proteinuria was first detected at 13 years. A cadaver donor renal transplant was carried out after three months of hemodialysis. Massive intravesical bleeding complicated the immediate post-transplantation period. The allograft rejected after three months and the patient was maintained for eight years on home hemodialysis. A second cadaver donor allograft was carried out at 23 years of age. Again, massive intravesical hemorrhage was a problem post-transplant. The allograft is currently functioning 27 months post-transplant. Factor VIIIc activities have fluctuated between 5% and 40% in the absence of factor infusions.


2021 ◽  
Vol 14 (5) ◽  
pp. 480
Author(s):  
Martin Kallab ◽  
Kornelia Schuetzenberger ◽  
Nikolaus Hommer ◽  
Bhavapriya Jasmin Schäfer ◽  
Doreen Schmidl ◽  
...  

The purpose of this study was to evaluate the ocular pharmacokinetics, bio-distribution and local tolerability of γ-cyclodextrin (γCD) based irbesartan 1.5% eye drops and candesartan 0.15% eye drops after single and multiple topical administration in rabbit eyes. In this randomized, controlled study, a total number of 59 New Zealand White albino rabbits were consecutively assigned to two study groups. Group 1 (n = 31) received irbesartan 1.5% and group 2 (n = 28) candesartan 0.15% eye drops. In both groups, single dose and multiple administration pharmacokinetic studies were performed. Rabbits were euthanized at five predefined time points after single-dose administration, whereas multiple-dose animals were dosed for 5 days twice-daily and then euthanized 1 h after the last dose administration. Drug concentration was measured by using liquid chromatography-tandem mass spectrometry (LC-MS/MS) in the retinal tissue, vitreous humor, aqueous humor, corneal tissue and in venous blood samples. Pharmacokinetic parameters including maximal drug concentration (Cmax), time of maximal drug concentration (Tmax), half-life and AUC were calculated. To assess local tolerability, six additional rabbits received 1.5% irbesartan eye drops twice daily in one eye for 28 days. Tolerability was assessed using a modified Draize test and corneal sensibility by Cochet Bonnet esthesiometry. Both γCD based eye drops were rapidly absorbed and distributed in the anterior and posterior ocular tissues. Within 0.5 h after single administration, the Cmax of irbesartan and candesartan in retinal tissue was 251 ± 142 ng/g and 63 ± 39 ng/g, respectively. In the vitreous humor, a Cmax of 14 ± 16 ng/g for irbesartan was reached 0.5 h after instillation while Cmax was below 2 ng/g for candesartan. For multiple dosing, the observed Cmean in retinal tissue was 338 ± 124 ng/g for irbesartan and 36 ± 10 ng/g for candesartan, whereas mean vitreous humor concentrations were 13 ± 5 ng/g and <2 ng/g, respectively. The highest plasma concentrations of both irbesartan (Cmax 5.64 ± 4.08 ng/mL) and candesartan (Cmax 4.32 ± 1.04 ng/mL) were reached 0.5 h (Tmax) after single administration. Local tolerability was favorable with no remarkable differences between the treated and the control eyes. These results indicate that irbesartan and candesartan in γCD based nanoparticle eye drops can be delivered to the retinal tissue of the rabbit’s eye in pharmacologically relevant concentrations. Moreover, safety and tolerability profiles appear to be favorable in the rabbit animal model.


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