Abstract:
BACKGROUND:Data in kidney transplant recipients regarding elimination of calcineurin inhibitor (CNI) therapy from a de novo regimen based on low CNI exposure and an mTOR inhibitor are sparse, and restricted to CNI elimination within the first six months post-transplant. MATERIAL/METHODS:In a 12-month, randomized, multicenter, open-label study, kidney transplant patients who had received everolimus, low-exposure cyclosporine and corticosteroids from transplantation to month 12 (with proteinuria <1 g/24 h at month 12) were randomized to convert from cyclosporine to mycophenolate sodium 720 mg/day with increased everolimus exposure (6-10 ng/mL [CNI-free group], n=15) or continue unchanged (everolimus 3-8 ng/mL [CNI group], n=15). RESULTS:Median (range) baseline mGFR was 54 (21-87) mL/min and 37 (range 18-69) mL/min (p=0.053) in the CNI-free and CNI groups, respectively, compared to 56 (18-126) mL/min and 32 (12-63) mL/min at month 12 (p=0.007). The between-group difference in change in mGFR from baseline to month 12 post-conversion (the primary endpoint) was -14.4 mL/min (95% CI -29.3 to 0.6 mL/min, p=0.059 [least squares mean]). Changes in serum creatinine and estimated GFR to month 12 were significantly in favor of CNI-free patients. One CNI patient experienced biopsy-proven acute rejection. Study drug was discontinued due to adverse events in one CNI-free patient (7%) and three CNI-treated patients (20.0%). CONCLUSIONS:Elimination of CNI from a de novo regimen of everolimus with low-exposure CNI at one year post-transplant maintained efficacy and led to a non-significant but clinically relevant improvement in renal function, although patients numbers were low (n=30). Findings from this small study require confirmation in a larger controlled trial.
journal_name
Ann Transplantjournal_title
Annals of transplantationauthors
Albano L,Alamartine E,Toupance O,Moulin B,Merville P,Rerolle JP,Tetaz R,Moal MC,Kamar N,Legendre C,Quéré S,Di Giambattista F,Terpereau A,Dantal Jdoi
10.12659/aot.882637subject
Has Abstractpub_date
2012-01-01 00:00:00pages
58-67issue
1eissn
1425-9524issn
2329-0358pii
882637journal_volume
17pub_type
杂志文章,多中心研究,随机对照试验abstract:AIM OF THE STUDY:was to examine the influence of conversion from cyclosporine-based therapy to tacrolimus/mycophenolate mofetil (MMF) on renal graft survival in patients with refractory rejection and on the recurrence of rejection in patients converted at the time of the first episode of rejection. PATIENTS AND METHOD...
journal_title:Annals of transplantation
pub_type: 杂志文章,评审
doi:
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVES AND METHODS:Brain death related hemodynamic instability and/or cardiac dysfunction is frequently described in the potential organ donor which may lead to exclusion of the heart from transplantation. The underlying mechanisms are controversely discussed. Therefore, in the present study, potential brain death ...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Fungal infections have a significant impact on patient survival after liver transplantation, mostly caused by Candida and Aspergillus. The clinical manifestations vary, and range from colonization, active local infection, to severe invasive form. A high degree of suspicion is required for the early diagnosis...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:10.12659/AOT.892132
更新日期:2014-12-22 00:00:00
abstract:BACKGROUND:Abdominal complications are recognized as a common complication of solid organ transplantation. These complications can range from gastritis with minor morbidity to viscus perforation and death. This study addresses specifically colonic complications in lung transplant patients to highlight their high incide...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Transplant renal artery stenosis (TRAS) is a serious vascular complication due to non-specific clinical manifestations, causing serious diagnostic difficulties. Contrast-enhanced ultrasound (CE-US) can complement standard sonographic examination in evaluation of TRAS. MATERIAL AND METHODS:Standard ultrasoun...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:10.12659/AOT.883896
更新日期:2013-04-26 00:00:00
abstract:BACKGROUND:Given the current organ shortage, an accurate assessment of the patient's outcome after orthotopic liver transplantation (OLTX) for fulminant hepatic failure (FHF) is crucial in order to determine the suitability for transplantation. The purpose of this study was to assess whether APACHE II and III scores wo...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:
更新日期:2011-01-01 00:00:00
abstract::BACKGROUND Dual kidney transplantation (DKT) of expanded-criteria donors is a cost-intensive procedure that aims to increase the pool of available deceased organ donors and has demonstrated equivalent outcomes to expanded-criteria single kidney transplantation (eSKT). The objective of this study was to develop an allo...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:10.12659/aot.898328
更新日期:2016-09-08 00:00:00
abstract:BACKGROUND:Induction of the hepatic and intestinal cytochrome P450-3A4 system and intestinal P-glycoprotein is an unavoidable consequence of rifampin administration which requires substantial increase in tacrolimus dose when given concurrently. Chronic diarrhea is known to precipitate tacrolimus toxicity irrespective o...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:
更新日期:2010-01-01 00:00:00
abstract::BACKGROUND Normothermic machine perfusion (NMP) preservation is superior to cold preservation during reduced-size liver transplantation (RSLT) in pigs. However, the mechanism of this protective effect has not been explained. We aimed to compare the effects of NMP preservation with that of cold preservation (CS) in pro...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:10.12659/AOT.910774
更新日期:2019-01-04 00:00:00
abstract:BACKGROUND:Despite documented positive effect of MachinePerfusion (MP) on long-term kidneys-graft function its wide use is restricted due to higher costs. The aim of this study was to analyze the difference in costs of kidney transplantation in patients who received organ stored in ColdStorage (CS) vs those who receive...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:
更新日期:2009-04-01 00:00:00
abstract::Ischemic reperfusion injury is a complex pathophysiological event associated with significant impairment of multiple vascular and cellular responses. Oxidative damage due to the presence of radical oxygen species is the essential step that initiates a wide range of intracellular stress signaling processes that culmina...
journal_title:Annals of transplantation
pub_type: 杂志文章,评审
doi:
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:This study evaluated the effect of liver transplantation (LTX) and STACE on overall survival in palliative patients with HCC exceeding Milan criteria. MATERIAL AND METHODS:At a single center 63 HCC patients exceeding Milan criteria were retrospectively analyzed. Forty patients underwent STACE as palliative ...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:10.12659/AOT.884018
更新日期:2013-10-01 00:00:00
abstract::Recovery of the patients after transplantation of non-renal organs may be complicated by multi-faceted chronic renal failure (CKD) which is regarded as an independent risk factor of graft dysfunction and mortality. The occurrence of CKD in non-renal transplant recipients depends mainly on a type of transplanted organ,...
journal_title:Annals of transplantation
pub_type: 杂志文章,评审
doi:
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Bone marrow mesenchymal stem cells (BMSC) are common seed cells for transplantation. However, there are some limitations in their use that have not yet been resolved. Our research modified tumor-related genes temporarily on BMSC which simulated tumorigenesis temporarily in vitro. The cells were named tempora...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:10.12659/aot.881995
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Animal models to investigate pathophysiology and xenotransplantation require complex techniques and significant animal utilization. The aim of the study was to develop a reliable ex-vivo technique to test xenotransplant interventions. MATERIAL/METHODS:Miniature Swine being utilized for a nonsurvival study a...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:The activation of the tryptophane catabolizing enzyme Indoleamine 2,3-dioxygenase leads to the formation of kynurenine and other metabolites that counter-regulate immune activation resulting in restoration of immune homeostasis. But in chronic immune activation, as in hemodialysed patients, the immunosuppres...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:10.12659/AOT.889764
更新日期:2014-01-27 00:00:00
abstract:BACKGROUND:Organ transplantation increases the risk of cancer including lymphomas through various and insidious mechanisms. In this study, we aimed to gather and analyze data of 5 international studies on late onset lymphoproliferative disorders after renal and liver transplantation. MATERIAL/METHODS:We conducted a co...
journal_title:Annals of transplantation
pub_type: 杂志文章,评审
doi:
更新日期:2009-10-01 00:00:00
abstract::BACKGROUND Numerically, nurses represent the largest healthcare profession, thus setting norms for the quality and safety of direct patient care. Evidence of a global shortage of nurses in all clinical practice settings across different healthcare systems and countries has been documented. The aims of the present stud...
journal_title:Annals of transplantation
pub_type: 杂志文章,多中心研究
doi:10.12659/aot.898305
更新日期:2016-09-01 00:00:00
abstract::BACKGROUND Hypothermic machine perfusion (HMP) appears to exert a reconditioning effect on the ischemic damage of kidney grafts. However, some concerns still remain about its real effectiveness when it is delayed after a preliminary period of static cold storage (SCS) or with prolonged overall cold ischemia time (CIT)...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:10.12659/AOT.918997
更新日期:2020-02-25 00:00:00
abstract:BACKGROUND:Transarterial chemoembolization (TACE) induces ischemic tumor necrosis, which is intensified by regional chemotherapy. By reducing the active tumor tissue, it can be assumed that patients on the waiting list for liver transplantation may benefit from this locoregional treatment. The aim of this study was to ...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:10.12659/aot.896778
更新日期:2015-12-29 00:00:00
abstract:BACKGROUND:Post kidney transplantation Re-admissions are focused because they are costly and cause morbidity, or may end with unsatisfactory endpoints namely graft loss or death. We compared the pattern, outcome and cost of re-admissions in different post-kidney transplantation periods. MATERIAL/METHODS:In a retrospec...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:
更新日期:2009-10-01 00:00:00
abstract::BACKGROUND Left ventricular assist devices (LVAD) are used to treat heart failure. Preoperative prediction of RV function after LVAD implantation is crucial. Correlations were found between preoperative echo and RV function after LVAD implantation. MATERIAL AND METHODS We retrospectively reviewed 23 male patients (8 i...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:10.12659/aot.899054
更新日期:2016-08-11 00:00:00
abstract::The patient is a 28 year old woman who received a heart transplant in 1992 secondary to hypertrophic cardiomyopathy with unremarkable post-operative course. In the period immediately post transplantation the patient was on a four-drug immunosuppressive regimen which was subsequently changed to standard three-agent the...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract:UNLABELLED:Glutathione S-Tranferases (GST) are the enzymes which are strictly specific for epithelial cells of the proximal and distal tubules in the kidney. These enzymes are detected in the urine when some tubular damage process is found. In healthy people urine GST is hardly detected. The goal of this study was to e...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::BACKGROUND The prognosis of the patients of acute liver failure (ALF) with onset of hepatic coma is often dismal. ALF is a well-accepted indication for liver transplantation (LT) and has markedly improved the prognosis of these patients. However, its role in ALF patients with onset of hepatic coma has never been eluci...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:
更新日期:2018-03-13 00:00:00
abstract:BACKGROUND:Living liver donation is associated with size-dependent complications. The resectable size and its safety margin should be defined for the safety of donors. The purpose of the present study was to determine if the current partial hepatectomies are done under the safety margin of the resectable size, by measu...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:10.12659/AOT.892490
更新日期:2015-01-26 00:00:00
abstract::This paper outlines the effect that the Transplant Games have had in influencing public opinion and the translation of that effect resulting in increased organ donation and transplantation in the global venues in which this activity took place. A brief account of the history of the Transplant Games now 25 years after ...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:The Czech Bone Marrow Donor Registry (CBMD)--established 9 years ago, operates within the National HLA Centre, a constituent part of the Department of Immunology at the Institute for Clinical and Experimental Medicine. The Czech Cord Blood Register (CSCB) was recently established (in 1996) and started its act...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00
abstract::BACKGROUND ABO-incompatible (ABO-i) living donor liver transplantation (LDLT) is a feasible alternative for donor liver allograft in emergency situations, especially in Asia, where deceased-donor organs remain scarce. The reported outcomes of ABO-i LDLT after optimal desensitization are comparable to those of ABO-comp...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:10.12659/AOT.923502
更新日期:2020-09-18 00:00:00
abstract:BACKGROUND:Markers currently used to detect kidney damage are effective in both early (KIM-1, NGAL) and late (MCP-1, MMP, TIMP) stages of renal tubular damage, indicating the progression of chronic kidney disease. Immunosuppressive drugs may damage the transplanted organ through their direct toxic effects and by contri...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:10.12659/aot.895275
更新日期:2016-03-03 00:00:00