Abstract:
BACKGROUND:Chronic renal failure (CRF) is a common complication of calcineurin inhibitor (CNI)-based immunosuppression following cardiac transplantation (HTx). The aim of this prospective study was to evaluate the impact of an immunosuppressive conversion from CNIs to mycophenolate mofetil (MMF) and steroids in cardiac transplant recipients with CRF on renal and cardiac graft function. METHODS:Since 1999, 12 HTx recipients (10 men; 58 +/- 3.6 yr of age; 8.7 +/- 4.2 yr after HTx) with CNI-based immunosuppression and a calculated creatinine clearance (CreaCl) <50 mL/min were included. Most patients (10/12) were on cyclosporine and two patients were on tacrolimus prior inclusion. MMF was started with 0.5 g/d and adjusted according to the target trough levels (2-4 ng/mL). Prednisone dosage was 0.4 mg/kg. Subsequently, CNIs were completely withdrawn. Acute rejection episodes were excluded one and three months after conversion by endomyocardial biopsy and by echocardiography every three months thereafter. RESULTS:After a mean follow-up of 20 +/- 16 months, CreaCl improved significantly: pre-conversion vs. post-conversion: 32.8 +/- 12.2 mg/dL vs. 42.8 +/- 21.14 mg/dL, p = 0.03. However, four acute rejection episodes occurred and patients were reconverted to CNIs. Additionally, six patients had a new onset of graft vessel disease (GVD) one yr after conversion. As a result of these adverse events, the study was stopped after inclusion of only 12 of the scheduled 30 patients. CONCLUSIONS:Conversion to MMF and steroids after HTx improves renal function, but increases the risk for recurrent rejection and GVD. Therefore, MMF and steroids should only be considered in patients with a markedly low risk for rejection.
journal_name
Clin Transplantjournal_title
Clinical transplantationauthors
Groetzner J,Kaczmarek I,Schirmer J,Uberfuhr P,Gulbins H,Daebritz S,Meiser B,Reichart Bdoi
10.1111/j.1399-0012.2008.00828.xsubject
Has Abstractpub_date
2008-09-01 00:00:00pages
587-93issue
5eissn
0902-0063issn
1399-0012pii
CTR828journal_volume
22pub_type
杂志文章abstract::From January 2007, we started to perform the tonsillectomy for every patient with recurrent IgA nephropathy (IgAN) after kidney transplantation. Up to September 2008, four recipients with primary IgAN had biopsy-proven recurrent IgAN. They had also progressive hematuria or proteinuria from on the average 14.3 months a...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.01003.x
更新日期:2009-08-01 00:00:00
abstract::Histoplasma capsulatum is a dimorphic fungus that most often causes asymptomatic infection in the immunocompetent population. In immunocompromised patients, including solid organ transplant (SOT) and hematopoietic cell transplant (HCT) recipients, however, it is likely to cause severe life-threatening infection. Post-...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
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更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:African American and non-African American pre-transplant patients' and their families' concerns about the financial costs of kidney transplantation have not been well studied. METHODS:We conducted structured group interviews among pre-transplant patients (seven African American, five non-African American) a...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12428
更新日期:2014-10-01 00:00:00
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journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/ctr.12121
更新日期:2013-07-01 00:00:00
abstract::Hepatitis C virus (HCV) is currently the leading indication worldwide for orthotopic liver transplantation. However, the majority of patients receiving transplant for HCV eventually develop histopathologic evidence of recurrent allograft HCV and approximately 10% die or require retransplantation within the first 5 pos...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2003.00049.x
更新日期:2003-06-01 00:00:00
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journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2001.150209.x
更新日期:2001-04-01 00:00:00
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journal_title:Clinical transplantation
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1399-0012.2011.01586.x
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Multidrug-resistant (MDR) gram-negative bacteria are a growing threat to solid organ transplantation (SOT) patients in the intensive care unit (ICU). We aimed to examine the mortality rates of gram-negative MDR bacterial infection in SOT patients compared with patient population undergoing other cardiothorac...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12575
更新日期:2015-09-01 00:00:00
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journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13730
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journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2007.00703.x
更新日期:2007-09-01 00:00:00
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journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.17.s10.1.x
更新日期:2003-01-01 00:00:00
abstract::We have developed a practical conditioning regimen without anti-thymocyte globulin (ATG), irradiation, or other myeloablative alkylating agent for low-income countries in which patients with severe aplastic anemia (SAA), who usually have heavily transfused and a prolonged disease history. The application of ATG, Busul...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.12061
更新日期:2013-03-01 00:00:00
abstract::The aim of this study was to evaluate pancreatic function in total parenteral nutrition (TPN)-dependent children with permanent intestinal failure by measuring immunoreactive trypsinogen (IRT) levels. Between 1992 and 1996, 105 pediatric patients with permanent intestinal failure were referred to the Children's Hospit...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.1999.130505.x
更新日期:1999-10-01 00:00:00
abstract:INTRODUCTION:Previously, increasing age has been a part of the exclusion criteria used when determining eligibility for a pancreas transplant. However, the analysis of pancreas transplantation outcomes based on age groupings has largely been based on single-center reports. METHODS:A UNOS database review of all adult p...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12407
更新日期:2014-09-01 00:00:00
abstract::Tacrolimus is the cornerstone of immunosuppressive therapy after kidney transplantation. Its narrow therapeutic window mandates serum level strict monitoring and dose adjustments to ensure the optimal risk-benefit balance. This observational retrospective study analyzed the effectiveness and safety of conversion from ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13767
更新日期:2020-01-01 00:00:00
abstract::Adverse symptoms of immunosuppressants (ASI) impact quality of life (QOL) in solid organ transplant recipients; however, standardized approaches for active ASI surveillance and intervention are lacking. While management is highly clinician dependent, clinician views remain largely unexplored. We surveyed Canadian Soci...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12940
更新日期:2017-05-01 00:00:00
abstract:PURPOSE:Frail patients who undergo renal transplantation (RT) have more complications; however, little is known if these patients can sustain the wait to RT. We used the Timed Up and Go Test (TUGT) and Montreal Cognitive Assessment (MoCA) to determine outcomes of RT candidates. METHODS:In this retrospective study, 526...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.14161
更新日期:2020-11-20 00:00:00
abstract::Solid organ transplant recipients are at increased risk of developing several human papillomavirus (HPV)-related malignancies, including cervical and anal cancers. The purpose of this prospective study was to assess the initial prevalence and risk factors for high-risk HPV (HR-HPV) cervical infections in liver transpl...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12894
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:Cardiovascular disease is the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD). In fact, death from cardiovascular disease is the number one cause of graft loss in kidney transplant (KTx) patients. Compared to patients on dialysis, CKD patients with KTx have increased qu...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12816
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVES:To analyze the characteristics of tuberculosis (TB) in Southern Chinese renal transplant recipients, and summarize the corresponding experiences in diagnosis and management. METHOD:Retrospectively study 41 documented post-transplant TB cases out of the 2333 patients who received kidney transplantation in th...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2008.00878.x
更新日期:2008-11-01 00:00:00
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pub_type: 杂志文章
doi:10.1111/j.1399-0012.2010.01260.x
更新日期:2010-11-01 00:00:00
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journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2007.00754.x
更新日期:2008-03-01 00:00:00
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journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1992-12-01 00:00:00
abstract::Hispanic race and low socioeconomic status are established predictors of disparity in access to kidney transplantation. This single-center retrospective review was undertaken to determine whether Hispanic race predicted kidney transplant outcomes. A total of 720 patients underwent kidney transplantation from January 1...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12662
更新日期:2016-02-01 00:00:00
abstract::Acute renal failure (ARF) is a common and severe complication after liver transplantation (LT). The aim of this study was to ascertain the impact of ARF requiring dialysis in the outcome of LT and to analyze the risk factors leading to this event in the early post-operative period. From October 1988 to December 1994, ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1998-04-01 00:00:00
abstract::Although many report intra-operative cardiac arrests (ICAs) in liver transplantation (LT), the incidence, major causes, and outcome remain unclear. We aimed to investigate retrospectively, the incidence, nature, and outcome of ICA in Asian population and to identify risk factors for ICA. Consecutive 1071 LTs in an ins...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12085
更新日期:2013-03-01 00:00:00
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journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00170.x
更新日期:2004-08-01 00:00:00
abstract::Acute rejection (AR) superimposed upon delayed graft function (DGF) following renal transplantation worsens graft outcomes. However, risk factors for AR in patients displaying DGF remain unclear. In this study, 71 patients displaying DGF >/= 5 d were investigated. All received cyclosporine, adjunctive azathioprine or ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2008.00837.x
更新日期:2008-09-01 00:00:00
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journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00220.x
更新日期:2004-01-01 00:00:00
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journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00