Correlation between Cyclosporine Blood Concentration-Dose Ratio and Biochemical Parameters in Living-Donor Lung Transplant Patients

ABSTRACT Appropriate exposure to posaconazole (PSZ) has been limited until the recent approval of the delayed-release oral tablet formulation. Our goal was to determine the exposure obtained by using the standard dose of 300 mg once a day in lung transplant (LT) patients, including patients with cystic fibrosis (CF). PSZ trough concentrations ( C 0 ) were determined using a liquid chromatography-tandem mass spectrometry assay. Indicative thresholds of interest were <0.7 mg/liter for prophylaxis and 1 to 3 mg/liter for cure. The tacrolimus (TRL) and everolimus (ERL) C 0 measured during PSZ exposure were also collected. The interaction with proton-pump inhibitors (PPI) was evaluated. We recorded the results for 21 CF patients with LT (CFLT patients), 11 non-CF patients with LT (NCFLT patients), and 27 nontransplant (NT) patients in pneumology departments. The weights of the NCFLT, CFLT, and NT patients were 59.2 ± 8.4, 48.8 ± 8.4, and 63.7 ± 16.6 kg, respectively ( P = 0.001* [asterisk means that statistical test is significant]), and the PSZ C 0 exposures for these patients were 1.9 ± 1.5, 1.1 ± 0.8, and 2.4 ± 1.8 mg/liter, respectively ( P < 0.00001*). More than 60% of the concentrations were in the therapeutic range. In CFLT patients, the administration of one 300-mg PSZ tablet quickly achieved an exposure similar to that achieved with the PSZ oral suspension formulation (OSF) administered 3 or 4 times a day for several months. The TRL C 0 /dose ratio ( C 0 / D ) was 7.4 ± 4.4 mg/liter with PSZ tablets, whereas it was 4.6 ± 0.8 mg/liter with the PSZ oral solution ( P = 0.034*). The ERL C 0 / D was similar with both formulations. PPI had no impact on the PSZ concentration (1.49 ± 1.07 mg/liter without PPI versus 1.33 ± 1.17 mg/liter with PPI; P = 0.4134*). Despite the high levels of exposure, PSZ remained well tolerated (one case of diarrhea and one case of fatigue were reported). PSZ tablet administration allows satisfactory exposure, even in CFLT patients, with a dosage lower than that of the PSZ OSF. This once-a-day formulation was not impacted by PPI, which are extensively used in CF patients.

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Mother to Child: First Living Donor Lung Transplant

JAMA ◽

10.1001/jama.1990.03450210014003 ◽

1990 ◽

Vol 264 (21) ◽

pp. 2724 ◽

Cited By ~ 32

Author(s):

Marsha F. Goldsmith

Keyword(s):

Living Donor ◽

Lung Transplant ◽

Donor Lung ◽

Mother To Child

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Mother to child: first living donor lung transplant

JAMA ◽

10.1001/jama.264.21.2724b ◽

1990 ◽

Vol 264 (21) ◽

pp. 2724b-2724 ◽

Cited By ~ 8

Author(s):

M. F. Goldsmith

Keyword(s):

Living Donor ◽

Lung Transplant ◽

Donor Lung ◽

Mother To Child

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A comparison of airway microbiota in donors and recipients of lung transplants

Russian Pulmonology ◽

10.18093/0869-0189-2019-29-2-184-188 ◽

2019 ◽

Vol 29 (2) ◽

pp. 184-188

Author(s):

M. Sh. Khubutiya ◽

A. M. Gasanov ◽

E. A. Tarabrin ◽

T. V. Chernen’kaya ◽

T. E. Kallagov ◽

...

Keyword(s):

Comparative Analysis ◽

Lung Transplant ◽

Bacterial Flora ◽

Pulmonary Complications ◽

Post Transplant ◽

Transplant Patients ◽

Donor Lung ◽

Bronchial Washing ◽

Lung Transplants ◽

Marginal Donors

This study was aimed at investigation of relationships between bronchial washing culture in post-transplant recipient and bronchial flora of the lung donor. Methods. A comparative analysis of bronchial washing cultures from 30 post-transplant lung recipients was performed. All lung donors were stratified to ideal, suboptimal and marginal donors according to the lung transplant suitability. Results. As a result, development of post-transplant pulmonary complications was directly related to bacterial flora of the donor lung. The incidence of pneumonia in post-transplant patients was 3.3% after transplantation of ideal donor lungs, 20% after transplantation of suboptimal donors lungs and 100% after transplantation of marginal donor lungs. Conclusion. The rate of pneumonia in transplanted lungs was directly related to bronchial flora in the donor lungs. This should be taken into account when planning antibacterial therapy after lung transplantation.

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Implant treatment followed by living donor lung transplant: A follow-up case report

Journal of Prosthodontic Research ◽

10.1016/j.jpor.2013.11.001 ◽

2014 ◽

Vol 58 (2) ◽

pp. 127-131 ◽

Cited By ~ 4

Author(s):

Akinari Nakagawa ◽

Naoki Shitara ◽

Yasunori Ayukawa ◽

Kiyoshi Koyano ◽

Kenji Nishimura

Keyword(s):

Case Report ◽

Living Donor ◽

Lung Transplant ◽

Donor Lung ◽

Implant Treatment

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Lung cancer in lung transplantation: incidence and outcome

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2017-134868 ◽

2017 ◽

Vol 94 (1107) ◽

pp. 15-19 ◽

Cited By ~ 6

Author(s):

David Pérez-Callejo ◽

María Torrente ◽

Consuelo Parejo ◽

Rosalia Laporta ◽

Piedad Ussetti ◽

...

Keyword(s):

Lung Cancer ◽

Lung Transplantation ◽

Cause Of Death ◽

Lung Transplant ◽

Primary Tumour ◽

High Risk Group ◽

Transplant Patients ◽

Native Lung ◽

Donor Lung ◽

Lung Transplant Recipients

IntroductionMalignancies are one of the causes of mortality after lung transplantation. However, little is known about lung cancer outcome after lung transplantation.MethodsWe performed a retrospective search of the lung transplantation database at our institution to identify patients diagnosed with lung cancer after lung transplantation.ResultsOut of 633 lung transplant patients, lung cancer was detected in 23 of them (3.63%). The most common causes for transplantation were idiopathic pulmonary fibrosis (47.8%) and emphysema (43.4%). A total of 18 patients were diagnosed during follow-up, 12 cases in the native lung (52.2%) and 6 cases in the donor lung (26.1%). The diagnosis was evidenced in the explanted lung in five patients (21.7%). The median of time from transplantation to cancer diagnosis was 39.7 months (24.356.6). Lung cancer was the cause of death in 16 patients. Survival rate at1year from diagnosis of lung cancer was 45.64% (95% CI 0.2431 to 0.6473).ConclusionsLung transplant recipients constitute a high-risk group for developing lung cancer. Among our patients, lung cancer was predominantly diagnosed in the native lung and at an advanced stage. The primary tumour was the main cause of death in most of these patients.

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