Abstract:
:We sought to determine the incidence, risk factors, and consequences of acute rejection (AR) after conversion from a calcineurin inhibitor (CNI) to a proliferation signal inhibitor (PSI) in maintenance heart transplantation. Relevant clinical data were retrospectively obtained for 284 long-term heart transplant recipients from nine centers in whom CNIs were replaced with a PSI (sirolimus or everolimus) between October 2001 and March 2009. The rejection rate at one yr was 8.3%, stabilizing to 2% per year thereafter. The incidence rate after conversion (4.9 per 100 patient-years) was significantly higher than that observed on CNI therapy in the pre-conversion period (2.2 per 100 patient-years). By multivariate analysis, rejection risk was associated with a history of late AR prior to PSI conversion, early conversion (<5 yr) after transplantation and age <50 yr at the time of conversion. Use of mycophenolate mofetil was a protective factor. Post-conversion rejection did not significantly influence the evolution of left ventricular ejection fraction, renal function, or mortality during further follow-up. Conversion to a CNI-free immunosuppression based on a PSI results in an increased risk of AR. Awareness of the clinical determinants of post-conversion rejection could help to refine the current PSI conversion strategies.
journal_name
Clin Transplantjournal_title
Clinical transplantationauthors
González-Vílchez F,Vázquez de Prada JA,Paniagua MJ,Almenar L,Mirabet S,Gómez-Bueno M,Díaz-Molina B,Arizón JM,Delgado J,Pérez-Villa F,Crespo-Leiro MG,Martínez-Dolz L,Roig E,Segovia J,Lambert JL,Lopez-Granados A,Escribano Pdoi
10.1111/ctr.12241subject
Has Abstractpub_date
2013-11-01 00:00:00pages
E649-58issue
6eissn
0902-0063issn
1399-0012journal_volume
27pub_type
杂志文章,多中心研究abstract:INTRODUCTION:Heart transplant (HTx) recipients need to follow a complex therapeutic regimen. We assessed the international prevalence and variability in nonadherence to six nonpharmacologic treatment components (physical activity, sun protection, diet, alcohol use, nonsmoking, and outpatient follow-up visits). METHODS...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13280
更新日期:2018-07-01 00:00:00
abstract::Tuberculosis remains one of the most serious infections after organ transplantation. Isoniazid prophylaxis for liver transplant recipients with a history of tuberculosis is generally recommended. However, its benefit is controversial because of potential hepatotoxicity of isoniazid. It is crucial to determine appropri...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2006.00630.x
更新日期:2007-03-01 00:00:00
abstract::Acute allograft glomerulopathy (AAG) characterized by hypercellularity, enlargement of endothelial cells, infiltration of glomeruli by mononuclear cells and webs of PAS-positive material has been reported as an unusual but distinct form of acute rejection in kidney transplant recipients. We present a case of persisten...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2001.0150s5002.x
更新日期:2001-01-01 00:00:00
abstract:BACKGROUNDS:Recurrent hepatitis C virus (HCV) infection is universal post-transplantation. Fibrosis (F) stage ≥2 at 12 months identifies patients with rapid fibrosis progression. Antiviral therapy (AVT) remains the only option to attenuate fibrosis progression. We hypothesized that CXCL10 levels can distinguish between...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12354
更新日期:2014-05-01 00:00:00
abstract::The study included 110 consecutive patients with hematological malignancies receiving fludarabine-based reduced intensity conditioning (RIC) and hematopoietic stem cell transplantation (HSCT) from matched unrelated donors. The median age was 55 yr (range 11-68) and all but 15 patients received peripheral blood stem ce...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12131
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Prior liver transplantation and immunosuppression potentially translate into significant morbidity and poor outcomes after any type of pancreatic surgery. Little is known about the outcomes of pancreatic surgery after liver transplantation. This study was designed to review our experience regarding the indic...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12317
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:Chronic allograft nephropathy (CAN), associated with late-allograft dysfunction is caused by alloantigen-dependent and -independent mechanisms, and eventually leads to interstitial fibrosis (ci). Activation of complement cascade is considered to be a poor prognostic marker of graft survival. This study was d...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2005.00426.x
更新日期:2005-12-01 00:00:00
abstract::Although the kidney transplant program at this center has been active for the past 18 yr, five out of the seven cases of post-transplant lymphoma in kidney transplant patients were observed over the past 2 yr. During this period, we have shifted from cyclosporine to tacrolimus (FK506 or prograf) for maintenance immuno...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1997-06-01 00:00:00
abstract::During liver transplant (LT), the release of vasoactive substances into the systemic circulation is associated with severe hemodynamic instability that is injurious to the recipient and/or the post-ischemic graft. Crystalloid flush with backward unclamping (CB) and portal blood flush with forward unclamping (PF) are t...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12130
更新日期:2013-07-01 00:00:00
abstract::Daclizumab (DAC) is a molecularly engineered humanized IgGa monoclonal Ab directed against the alpha chain of the interleukin-2 receptor (IL2R). Inhibiting the amplification of the immune response by blocking IL2R can reduce the frequency of acute rejection without the attendant risk of infection. The purpose of this ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2000.14040902.x
更新日期:2000-08-01 00:00:00
abstract::In recent years, several researchers have unraveled the previously unrecognized effects of granulocyte colony-stimulating factor (G-CSF) on hematopoiesis and the immune cell functions of bone marrow in healthy donors. In human leukocyte antigen-matched or haploidentical transplant settings, available data have establi...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/j.1399-0012.2010.01298.x
更新日期:2011-01-01 00:00:00
abstract::Pancreas transplant longevity is limited by immune rejection, which is diagnosed by graft biopsy using the Banff Classification. The histological criteria for antibody-mediated rejection (AMR) are poorly reproducible and inconsistently associated with outcome. We hypothesized that a 34-gene set associated with antibod...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.14065
更新日期:2020-11-01 00:00:00
abstract::Unresponsive pulmonary hypertension (PH) implies poor posttransplant outcomes. Data on late adaptation of the right ventricle (RV) are still few. This study evaluated three-yr RV function and remodeling, exercise capacity, and hemodynamic data in a selected group of patients initially disqualified because of PH. Betwe...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12387
更新日期:2014-07-01 00:00:00
abstract:INTRODUCTION:Health-related quality of life (HRQOL) is severely impaired in advanced liver disease. The purpose of this study was to evaluate the impact of actual liver function and disease-specific factors on HRQOL of patients evaluated for liver transplantation. PATIENTS AND METHODS:Disease-specific QOL was analyzed...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12426
更新日期:2014-12-01 00:00:00
abstract::As many as 50% of liver transplant patients suffer gastrointestinal (GI) disturbances post-transplant. Conversion from mycophenolate mofetil (MMF) to mycophenolate sodium (EC-MPS) alleviates GI symptom burden in renal transplant recipients. We employed a validated patient and physician-reported assessment to evaluate ...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-0012.2011.01444.x
更新日期:2012-01-01 00:00:00
abstract::After cardiac transplant, there is often development of restrictive cardiac physiology. Little is known about the factors that contribute to this physiology and its correlation with pathology. Heart retransplantation provides a valuable opportunity to further understand this relationship. In this study, we investigate...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.12250
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:Urinary tract infections (UTIs) account for significant morbidity after kidney transplantation (KT). Screening for asymptomatic bacteruria (AB) has proven to be beneficial in certain population including pregnant women; however, it is not well-studied in KT population. We reviewed the incidence, clinical feat...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12954
更新日期:2017-05-01 00:00:00
abstract::Endothelin-1 is a vasoconstrictor peptide released by the vascular endothelium by various chemical and mechanical factors. Cellular rejection is one of the most common complications following orthotopic liver transplantation, endotheliitis being its most specific and consistent histological feature. To assess the role...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1997-02-01 00:00:00
abstract:BACKGROUND:Numerous studies of steroid withdrawal have been carried out in kidney and liver transplant recipients, but only a few in pancreas transplant recipients. Yet, pancreas transplant recipients could have significant long-term benefits from steroid withdrawal. METHODS:We performed a retrospective analysis to de...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2000.140114.x
更新日期:2000-02-01 00:00:00
abstract::ABO-incompatibility is a major obstacle to expanding exiguous donor pools in adult liver transplantation, especially in countries where grafts from deceased donors are uncommon. We present our preliminary results of ABO-incompatible (ABO-I) adult living donor liver transplantation (LDLT) using a new, simple protocol. ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12060
更新日期:2013-03-01 00:00:00
abstract::We investigated tolerability and efficacy of ezetimibe treatment (10 mg/d) in 25 heart allograft recipients already on stable statin therapy. Total cholesterol (TC), low-density cholesterol (LDL-C), high-density cholesterol (HDL-C), triglycerides (TG), immunosuppressant drug levels, laboratory and clinical parameters ...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-0012.2008.00838.x
更新日期:2008-09-01 00:00:00
abstract::Portal vein thrombosis (PVT), a common complication of end stage liver disease, is no longer considered a definite contraindication for liver transplantation (LTx). The clinical decision to perform an LTx in the case of PVT depends on the degree of PVT and the experience of the surgeon. Eversion thromboendovenectomy w...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/j.1399-0012.2006.00560.x
更新日期:2006-09-01 00:00:00
abstract::Pancreas retransplantation has become more frequent and represents a technical challenge for surgeons. Knowledge of alternative surgical options could be useful in difficult cases. We present a case of brutal diabetes mellitus in a patient with severe vascular disease that underwent a third pancreas transplant. Diffic...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.01149.x
更新日期:2010-05-01 00:00:00
abstract::Recent changes in Center for Medicare & Medicaid Services (CMS) condition for participation, using benchmark volume/outcomes requirements for certification, have been implemented. Consequently, the ability of a transplant center to assess its risk tolerance is important in successful management. An analysis of SRTR da...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2012.01658.x
更新日期:2012-05-01 00:00:00
abstract::Acute renal failure is a significant risk factor for death in patients with liver failure. The goal of this study was to analyze the impact of peri-transplant dialysis on the long-term mortality of liver transplant recipients. We performed a single-center, retrospective cohort study of 743 adult liver transplants; pat...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2010.01238.x
更新日期:2011-03-01 00:00:00
abstract::Subclinical acute rejection (SAR) occurs in about 30% of stable renal transplant patients and may be a risk factor for a poor allograft outcome. In the present study, the prevalence and clinical features of subclinical rejection, and the expression of immune activation markers in surveillance graft biopsies were asses...
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::Micafungin has been approved for the prophylaxis of Candida infections in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). Here, we report a single-center experience of three different dose levels regarding efficacy, toxicity, and colonization with Candida ssp. in clinical practice. ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12310
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:Hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) is an indication for orthotopic liver transplantation (OLT) in patients with tumor stage within the United Network for Organ Sharing criteria. The number of patients listed for HBV-related HCC is increasing, while the number of patients listed fo...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2010.01349.x
更新日期:2011-03-01 00:00:00
abstract::The evaluation and care of non-US citizen, non-US residents who wish to come to the United States to serve as international living kidney donors (ILKDs) can pose unique challenges. We surveyed US transplant programs to better understand practices related to ILKD care. We distributed the survey by email and professiona...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.14064
更新日期:2020-11-01 00:00:00
abstract:PURPOSE:Smoking is a major public health issue, and its effect on cardiovascular outcomes is well established. This study evaluates the impact of donor smoking on heart transplant (HT) outcomes. METHODS:HT recipients between January 1, 2005, and December 31, 2016, with known donor smoking status were queried from the ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.14127
更新日期:2020-10-23 00:00:00