Abstract:
BACKGROUND:Renal dysfunction often occurs in liver transplant (LT) recipients receiving calcineurin inhibitor (CNI)-based immunosuppressive regimens, increasing morbidity and mortality rates. Replacement of CNIs by mTOR inhibitor-based immunosuppressive protocols may prevent renal impairment in LT recipients. MATERIAL/METHODS:Outcomes in patients who underwent LT between 1996 and 2010 at our center and who were switched from CNI-based to mTOR inhibitor-based immunosuppression were retrospectively analyzed. Renal course, hyperlipidemia, and graft rejection were assessed in patients maintained on this CNI-free regimen for at least 24 months. RESULTS:Of the 85 patients switched from CNI-based to mTOR inhibitor-based, CNI-free immunosuppression, 78 met the inclusion criteria. Within the first 6 weeks after switching, the covariable adjusted estimated glomerular filtration rate (eGFR) increased 5.6 mL/min [95% confidence interval 2.6-8.7 mL/min, p<0.001], but there were no further statistically noticeable changes in eGFR. Concentrations of cholesterol and triglycerides increased statistically, noticeable within the first 12 months after drug conversion. Histologically proven graft rejection was observed in 4 patients (5.1%) after conversion. CONCLUSIONS:Conversion from CNI-based to CNI-free, mTOR inhibitor-based immunosuppression after LT is safe and can result in significant renal recovery. CNI-free, mTOR inhibitor-based immunosuppression is a potential option for patients with contraindications for CNIs and for LT recipients with rapid reduction in kidney function due to CNIs.
journal_name
Ann Transplantjournal_title
Annals of transplantationauthors
Hüsing A,Schmidt M,Beckebaum S,Cicinnati VR,Koch R,Thölking G,Stella J,Heinzow H,Schmidt HH,Kabar Idoi
10.12659/aot.895320subject
Has Abstractpub_date
2015-11-26 00:00:00pages
707-13eissn
1425-9524issn
2329-0358pii
895320journal_volume
20pub_type
杂志文章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::BACKGROUND Percutaneous liver biopsy is an established diagnostic procedure for the assessment of liver pathologies. Limited data are available on the clinical impact of liver biopsies in liver transplant recipients. MATERIAL AND METHODS Liver transplant recipients undergoing liver biopsy between 2000 and 2013 were an...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:10.12659/aot.901487
更新日期:2017-02-24 00:00:00
abstract:BACKGROUND:Early initiation of enteral nutrition is recommended after some surgical procedures. This study retrospectively analyzed the effects of addition of early enteral nutrition (EEN) support during the postoperative phase in patients after living-donor liver transplantation (LDLT). MATERIAL AND METHODS:The subje...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:10.12659/AOT.893421
更新日期:2015-06-25 00:00:00
abstract::Even in the case of live related kidney donation, coercion within families is applied on the most vulnerable amongst them. This vulnerability could be financial, social or psychological In this paper we discuss how to assess the willingness or unwillingness of a kidney donor and discover if any coercion has been appli...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:
更新日期:2005-01-01 00:00:00
abstract::For each individual, there is a limit to the capacity to perform exercise. The limitation, however, depends on the nature of the task and is also influenced by a number of other factors. Muscle strength is determined largely by muscle mass, specifically muscle cross-sectional area, but is also influenced by neural dri...
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::Advances in molecular biology techniques allowed for introduction of PCR-based methods for HLA typing. In routine HLA typing for organ transplantation serological method is still being used as a standard, although molecular techniques are applied more and more often. The aim of our study was to compare HLA-DR typing u...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract::Organ transplantation program has been slowly developing over last 30 years. The number of DD (deceased donors) stabilized on the level of approximately 13/million of population. Multiorgan donation has been 45%, due to some problems with donor management. Polish Transplant Coordinating Center POLTRANSPLANT which is r...
journal_title:Annals of transplantation
pub_type: 社论
doi:
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Transplantation is the only effective method of treatment for end-stage and acute liver failure. Increased average survival time has been observed, and results from improved surgical technique and amended immunosuppression protocols. However, longer survival of patients after orthotopic liver transplantation...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:10.12659/aot.882005
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:The results of pancreas transplantation depend in a large degree on appropriate pancreas allograft donor selection. Several risk factors of early surgical complications or pancreas allograft loss following transplantation have been identified, but the final decision on pancreas harvesting for transplantation...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:10.12659/aot.894464
更新日期:2015-11-03 00:00:00
abstract::BACKGROUND Long-term real-world data are relatively sparse regarding recurrence of chronic hepatitis B virus (HBV) infection after liver transplantation using hepatitis B immunoglobulin (HBIg) and nucleos(t)ide analogue (NUC) prophylaxis. MATERIAL AND METHODS Data from 371 adults transplanted for HBV-related disease a...
journal_title:Annals of transplantation
pub_type: 杂志文章,多中心研究
doi:10.12659/AOT.910176
更新日期:2018-11-13 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:Fulminant liver failure (FLF) is a severe clinical condition usually accompanied by a coagulopathy, which is one of the key selection criteria for liver transplantation. Prolongation of prothrombin time can vary between etiologies of FHF, being one of the worst in fulminant presentation of Wilson's disease. ...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:
更新日期:2010-07-01 00:00:00
abstract::Human BK polyomavirus (BKV) infection is poorly documented in heart and lung transplant patients. BK viruria and viremia have been estimated to affect 19% and 5% of heart transplant recipients, respectively. Data are limited, especially for lung transplantation, but the proportion of patients progressing from BK virur...
journal_title:Annals of transplantation
pub_type: 杂志文章,评审
doi:10.12659/AOT.908429
更新日期:2018-05-11 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 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::The number of liver grafts obtained from a cadaver can be greatly increased with the application of split liver transplantation. In the last 10 years, pediatric waiting list mortality has been reduced significantly with the use of this form of liver transplantation, which has 2 major forms. In its most commonly used f...
journal_title:Annals of transplantation
pub_type: 杂志文章,评审
doi:10.12659/aot.896351
更新日期:2016-07-01 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::BACKGROUND The aim of this study was to investigate the clinical features and treatment strategies of transplant renal artery stenosis (TRAS) with kidneys from donation after cardiac death (DCD). MATERIAL AND METHODS We collected the clinical data of donors and recipients of single-center DCD-induced TRAS from January...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:10.12659/AOT.918076
更新日期:2020-02-04 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: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 Chronic allograft nephropathy (CAN) remains a major problem for long-term graft survival and different pathways participate in its development. CXC chemokine receptor 4 (CXCR4) is significantly upregulated following renal injury and fibrotic response. We investigated the effect of AMD3100, a CXCR4 antagonis...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:10.12659/AOT.899492
更新日期:2016-11-25 00:00:00
abstract:BACKGROUND:Infection remains the most common complication following renal transplantation (RT). Cytomegalovirus (CMV) is one of the most important pathogens in this patient population and Clostridium difficile-associated colitis (CDAC) has emerged as one of the most frequent gastrointestinal complications. Only few cas...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:
更新日期:2010-10-01 00:00:00
abstract::BACKGROUND Acute graft-versus-host disease (aGVHD) remains the most common and challenging complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT). An important obstacle to the therapeutic effect of aGVHD is the inability to identify risk factors for an individual patient at the onset of symp...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:10.12659/aot.901495
更新日期:2017-02-03 00:00:00
abstract:BACKGROUND:Antibody-mediated rejection (AMR), associated with the presence of C4d deposits, is well-defined in kidney transplantation but much less documented in liver transplantation (LTx). The aim of our study was to retrospectively analyze a group of pediatric liver transplant recipients who experienced episodes of ...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:10.12659/AOT.889921
更新日期:2014-03-04 00:00:00
abstract:BACKGROUND:Chronic nephrotoxic effects of calcineurin inhibitors may be responsible for late allograft dysfunction and reduced allograft half-life. Mammalian target of rapamycin inhibitors (mTOR-i's), a newer class of immunosuppressant, do not have the chronic nephrotoxic effects shown with calcineurin inhibitors (CNI)...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:10.12659/aot.881869
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:Studies have documented deficits of pneumococcal and other vaccinations in kidney and lung transplant patients, but the vaccination status of liver transplant (LT) recipients is unknown. This cross-sectional study investigated the prevalence of immunizations among LT patients at a large university medical ce...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:10.12659/aot.896436
更新日期:2016-04-07 00:00:00
abstract::Between August 2006 and August 2009, 34 ethnic Mongolians were the recipients of a kidney transplant at the Central Clinical Hospital in Ulaanbaatar, Mongolia. In 31 of the operations the donor was either a sibling or parent. In 4 recipients the donors were 2 recently deceased accident victims following controlled car...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:10.12659/aot.882647
更新日期:2012-01-01 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::Rat pancreatic islets were immunoisolated within alginate capsules with additional polyethyleneimine-protamine-heparin highly biocompatible membrane. Perifusion study in vitro demonstrated satisfactory similarities between the insulin release profiles of encapsulated and free islets. Concordant xenotransplantation of ...
journal_title:Annals of transplantation
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Autologous peripheral blood stem cell transplantation (PBSCT) is commonly used in the treatment of lymphoma patients. G-CSF is widely used to boost white blood cell recovery. However, there are no clear data indicating which strategy of using G-CSF provides the most benefit. The aim of our study was to compa...
journal_title:Annals of transplantation
pub_type: 杂志文章,多中心研究
doi:10.12659/AOT.883965
更新日期:2013-07-02 00:00:00