Pharmacokinetics of methylprednisolone and rejection episodes in kidney transplant patients.


:Rejection crises after kidney transplantation could be associated with individual variability of pharmacokinetic parameters of steroids. We therefore investigated the individual pharmacokinetics of methylprednisolone on day 2 (60 mg intravenously) and day 4 (60 mg per os) in 40 patients after kidney transplantation. Methylprednisolone was determined in serum by HPLC. Within 6 months, all rejection episodes were recorded and confirmed by kidney transplant biopsy. Values are given as nonparametric medians with the 95% confidence interval (0.95 CI). The 7 patients with a rejection within the first 10 days had a methylprednisolone clearance of 437 ml/min (162-756) that was significantly higher than the 220 ml/min (121-604) in the 22 patients without a rejection episode (P = 0.04). In the complete group of 18 patients having a transplant rejection episode within 6 months, the methylprednisolone elimination half-life after oral dosage was 2.5 hr (1.6-3.9) and significantly shorter than 2.9 hr (1.7-4.0) in 22 patients without rejections (P = 0.03). No differences were seen for body weight, number of mismatches, cold ischemia time, immunosuppressive regimens, and other pharmacokinetic parameters of methylprednisolone (e.g. bioavailability, distribution volume, trough levels). We conclude that pharmacokinetic variability may contribute to the lack of immunosuppressive efficacy in patients with a short halflife of steroids. Therefore, a twice daily dose fraction might be useful for low-dose steroid regimens in kidney transplantation.






Keller F,Hemmen T,Schöneshöfer M,Schwarz A,Offermann G




Has Abstract


1995-08-27 00:00:00












  • A possible explanation for anemia in patients treated with mycophenolic acid.

    abstract:BACKGROUND:Clinical studies suggest that the immunosuppressant mycophenolate mofetil is associated with anemia. However, the mechanism for this is not known. Here, we studied the effect of mycophenolic acid (MPA), the active metabolite of mycophenolate mofetil, on erythropoiesis in vitro. METHODS:Both UT-7 cells and p...


    pub_type: 杂志文章


    authors: Pile T,Kieswich J,Harwood S,Yaqoob MM

    更新日期:2011-12-27 00:00:00

  • The graft-versus-host reaction and immune function. II. Recruitment of pre-T-cells in vivo by graft-versus-host-induced dysplastic thymuses following irradiation and bone marrow treatment.

    abstract::The graft-versus-host (GVH) reaction induces thymic dysplasia and an arrest in T cell differentiation. Studies were performed to test the effect of irradiation and reconstitution with bone marrow on GVH-induced thymic dysplasia and T cell differentiation. GVH reactions were induced in CBAxAF1 adult mice by the injecti...


    pub_type: 杂志文章


    authors: Seddik M,Seemayer TA,Lapp WS

    更新日期:1984-03-01 00:00:00

  • The decrease in organ donations from 1985 to 1990 caused by increasing medical contraindications and refusals by relatives.

    abstract::After the progressive improvement in the results of organ transplantation we now face the challenge of shortage in organ supply. The decreasing number of organ retrievals performed in 1990 at our hospital has raised questions concerning loss of potential organ donors and opposition to donation by the next of kin. We i...


    pub_type: 杂志文章


    authors: Faltin DL,Jeannet M,Suter PM

    更新日期:1992-07-01 00:00:00

  • Human herpesvirus-6 and acute liver failure.

    abstract:BACKGROUND:In patients with acute liver failure (ALF) of unknown cause, viral infections are believed to be involved. This study investigates the involvement of human herpesvirus-6 (HHV-6). METHODS:Thirty-two patients with ALF who underwent transplantations during a 6-year period were studied for viruses in biopsies f...


    pub_type: 杂志文章


    authors: Härmä M,Höckerstedt K,Lautenschlager I

    更新日期:2003-08-15 00:00:00

  • Full reconstitution of hematopoietic system by murine umbilical cord blood.

    abstract:BACKGROUND:Murine umbilical cord blood cells (UCBCs) were studied for their ability to reconstitute the hematopoietic system. METHODS:On average, 150 microL of cord blood per fetus containing 1.2 to 2 x 10(4) nucleated cells were collected from day 18.5 fetal umbilical cord, and 3 to 6 x 10(3) cells per fetus were obt...


    pub_type: 杂志文章


    authors: Migishima F,Oikawa A,Kondo S,Ema H,Morita Y,Nakauchi H,Yokoyama M,Song SY,Nishijima M,Okabe M,Shinohara N

    更新日期:2003-06-15 00:00:00

  • Prevalence and correlates of self-reported pretransplant nonadherence with medication in heart, liver, and lung transplant candidates.

    abstract:BACKGROUND:Evidence on prevalence and correlates of pretransplant medication nonadherence (MNA) is limited. The present study explored self-reported prevalence and correlates of MNA before heart, liver, and lung transplantation. METHODS:This cross-sectional descriptive study included 174 patients: 69 lung, 33 heart, a...


    pub_type: 杂志文章


    authors: Dobbels F,Vanhaecke J,Desmyttere A,Dupont L,Nevens F,De Geest S

    更新日期:2005-06-15 00:00:00

  • Dependence of murine obstructive airway disease on CD40 ligand.

    abstract:BACKGROUND:Human lung transplantation carries a poor prognosis because of chronic rejection in the form of obliterative bronchiolitis syndrome (OBS). Using the mouse model of heterotopic tracheal transplantation, we examined the role of costimulation in the allograft rejection that characterizes obstructive airway dise...


    pub_type: 杂志文章


    authors: Rumbley CA,Silver SJ,Phillips SM

    更新日期:2001-11-27 00:00:00

  • Heart transplantation in diabetic recipients.

    abstract::Preexisting diabetes mellitus (DM) has been regarded as a contraindication to heart transplantation (HT). This prejudice has been based upon concern over increased infection rates and worsening DM with the initiation of prednisone immunosuppression. To better evaluate these suppositions, we reviewed our experience wit...


    pub_type: 杂志文章


    authors: Ladowski JS,Kormos RL,Uretsky BF,Griffith BP,Armitage JM,Hardesty RL

    更新日期:1990-02-01 00:00:00

  • Characterization of immunoreactive trypsin as a means of differentiating graft pancreatitis and allograft rejection after porcine pancreatic transplantation.

    abstract::Graft pancreatitis and allograft rejection were both accompanied by increased serum levels of immunoreactive anionic trypsin (irAT) in a porcine pancreatic allograft transplantation model. Characterization of this immunoreactivity by gel filtration revealed different elution profiles in these conditions that can be he...


    pub_type: 杂志文章


    authors: Källén R,Borgström A

    更新日期:1992-01-01 00:00:00

  • Early immune reaction after reduced-intensity cord-blood transplantation for adult patients.

    abstract:BACKGROUND:To investigate immune reactions after reduced-intensity cord-blood transplantation (RI-CBT). MATERIALS AND METHODS:We reviewed medical records of 57 adult RI-CBT recipients. Preparative regimen comprised fludarabine, total-body irradiation, and either melphalan (n=51) or busulfan (n=6). Graft-versus-host di...


    pub_type: 杂志文章


    authors: Kishi Y,Kami M,Miyakoshi S,Kanda Y,Murashige N,Teshima T,Kusumi E,Hara S,Matsumura T,Yuji K,Masuoka K,Wake A,Morinaga S,Kanemaru M,Hayashi T,Tanaka Y,Taniguchi S,Tokyo Stem Cell Transplant Consortium.

    更新日期:2005-07-15 00:00:00

  • Clinical and histologic patterns of early graft failure due to recurrnet hepatitis C in four patients after liver transplantation.

    abstract::Hepatitis C viral recurrence after orthotopic liver transplantation is almost universal. Hepatitis C induced graft failure may occur, but the clinical and histologic profiles are not well defined. The aim of this study was to describe the pattern of early graft failure in patients with recurrent hepatitis C after live...


    pub_type: 杂志文章


    authors: Dickson RC,Caldwell SH,Ishitani MB,Lau JY,Driscoll CJ,Stevenson WC,McCullough CS,Pruett TL

    更新日期:1996-03-15 00:00:00

  • Thymectomy impairs but does not uniformly abrogate long-term acceptance of semi-identical liver allograft in inbred miniature Swine temporarily treated with FK506.

    abstract:BACKGROUND:Long-term acceptance of semi-identical orthotopic liver transplants (OLTs) in inbred swine is induced by a 12-day course of FK506. To study whether acceptance is attributable to central or peripheral immune mechanisms, the effect of complete thymectomy was determined. METHODS:Total thymectomy was performed ...


    pub_type: 杂志文章


    authors: Uryuhara K,Ambiru S,Dehoux JP,Oike F,Talpe S,Gianello P

    更新日期:2004-04-27 00:00:00

  • T-cell receptor beta-chain usage in directly activated alloreactive CD4+ T cells: unrestricted Vbeta gene usage with CDR3 size limitations.

    abstract:BACKGROUND:Alloreactive immune responses may engage both direct and indirect antigen allorecognition. This study focuses on T-cell receptor (TCR) beta-chain usage by in vitro generated alloreactive CD4+ T cells involved in direct allorecognition pathway. METHODS AND RESULTS:We have established Lewis anti-Brown Norway ...


    pub_type: 杂志文章


    authors: Zhai Y,Kupiec-Weglinski JW

    更新日期:2003-02-27 00:00:00

  • Serial transplantation resulting in tolerance to an unrelated cord blood graft.

    abstract::Unrelated cord blood (UCB) hematopoietic stem cells were serially transplanted into two human leukocyte antigen (HLA)-identical siblings with T cell, B cell, natural killer cell severe combined immunodeficiency. Brother A received a 4/6-matched, HLA DRbeta1-identical but class I-disparate UCB graft after myeloablative...


    pub_type: 杂志文章


    authors: Goebel WS,Nelson RP Jr,Brahmi Z,Gowan DJ,Towell PJ,Robertson KA,Haut PR

    更新日期:2006-06-15 00:00:00

  • Combined living donor liver/small bowel transplantation.

    abstract::We are reporting the first known case of sequential combined living donor liver/small bowel transplantation (LDL/SBT). A 2-year-old boy born with gastroschisis and intestinal malrotation lost his entire small bowel and colon shortly after birth. He underwent a living donor small bowel transplant at 1 year of age that ...


    pub_type: 杂志文章


    authors: Testa G,Holterman M,John E,Kecskes S,Abcarian H,Benedetti E

    更新日期:2005-05-27 00:00:00

  • MicroRNA-155 Deficiency in Kupffer Cells Ameliorates Liver Ischemia-Reperfusion Injury in Mice.

    abstract:BACKGROUND:MicroRNA-155 (miR-155) is known to be involved in autoimmune diseases, inflammation, and transplantation. However, its role in a warm hepatic ischemia-reperfusion (IR) model has not been fully elucidated. METHODS:Partial hepatic IR was performed in wild-type and miR-155-deficient mice treated with or withou...


    pub_type: 杂志文章


    authors: Li Y,Ma D,Wang Z,Yang J

    更新日期:2017-07-01 00:00:00

  • Pyruvate inhibits hepatic ischemia-reperfusion injury in rats.

    abstract:BACKGROUND:Ischemia/reperfusion (I/R) injury is a limiting factor in liver transplantation. We have recently shown that pyruvate (PY) inhibits intestinal and renal I/R injury. This study aims to evaluate the protective effect of PY on hepatic I/R injury. METHODS:ACI rats were treated with PY, whereas control animals r...


    pub_type: 杂志文章


    authors: Sileri P,Schena S,Morini S,Rastellini C,Pham S,Benedetti E,Cicalese L

    更新日期:2001-07-15 00:00:00

  • Long-term outcome of controlled, non-heart-beating donor liver transplantation.

    abstract:BACKGROUND:Previous reports have established the feasibility of using livers from controlled, non-heart-beating donors (CNHBD) with good immediate graft function. This has been largely borne out of necessity because of the donor shortage. METHODS:Retrospective database review for the last 7 years (1995-2002), encompas...


    pub_type: 杂志文章


    authors: Manzarbeitia CY,Ortiz JA,Jeon H,Rothstein KD,Martinez O,Araya VR,Munoz SJ,Reich DJ

    更新日期:2004-07-27 00:00:00

  • Lack of secondary suppressor response in enhanced allografted rats with endogenous suppressor activity in spleen and diminished cytotoxic T cell response.

    abstract::In order to better understand the mechanisms of alloimmunization occurring in transplantation, we studied the immune response of an inbred rat strain (WF) to varied presentation of alloantigens (LEW). Hyperimmunized rats acutely reject transplanted allografts and demonstrate direct cytotoxic activity, as well as an ex...


    pub_type: 杂志文章


    authors: Weir MR,Salomon DR,Cohen DJ,Carpenter CB

    更新日期:1988-11-01 00:00:00

  • Analysis of T cell subpopulations and cyclosporine levels in the blood of two neonates born to immunosuppressed heart-lung transplant recipients.

    abstract::The influence of continuous immunosuppression on the immune system of 2 neonates born to heart-lung transplant recipients was analyzed. T cells, T cell subpopulations, B cells and cyclosporine levels were measured in maternal and cord blood at the time of delivery. Cyclosporine, both parent compound, and metabolites w...


    pub_type: 杂志文章


    authors: Rose ML,Dominguez M,Leaver N,Lachno R,Yacoub MH

    更新日期:1989-08-01 00:00:00

  • Induction of stable mixed chimerism by embryonic stem cells requires functional Fas/FasL engagement.

    abstract:BACKGROUND:Recent data show the efficacy of embryonic stem cells (ESC) to engraft in allogeneic recipients without host pretreatment. This property is due to their low expression of major histocompatibility complex (MHC) class I antigens and lack of MHC class II expression. Here, we tested the hypothesis that the const...


    pub_type: 杂志文章


    authors: Fabricius D,Bonde S,Zavazava N

    更新日期:2005-05-15 00:00:00

  • Neighborhood Poverty and Sex Differences in Live Donor Kidney Transplant Outcomes in the United States.

    abstract:BACKGROUND:Neighborhood poverty has been associated with worse outcomes after live donor kidney transplantation (LDKT), and prior work suggests that women with kidney disease may be more susceptible to the negative influence of poverty than men. As such, our goal was to examine whether poverty differentially affects wo...


    pub_type: 杂志文章


    authors: Purnell TS,Luo X,Crews DC,Bae S,Ruck JM,Cooper LA,Grams ME,Henderson ML,Waldram MM,Johnson M,Segev DL

    更新日期:2019-10-01 00:00:00

  • The mechanism of anti-CD3 monoclonal antibodies. Mediation of cytolysis by inter-T cell bridging.

    abstract::OKT3, an anti-CD3 MAB, depletes T cells in vivo and is among the most potent inhibitors of acute allograft rejection. The mechanism of this inhibition is unknown. The present studies investigate whether anti-CD3 antibodies have the ability to crosslink CD3 on two different cells and induce TCR-dependent antibody-bridg...


    pub_type: 杂志文章


    authors: Wong JT,Eylath AA,Ghobrial I,Colvin RB

    更新日期:1990-10-01 00:00:00

  • Sirolimus-based therapy for kidney transplantation from expanded criteria donors.

    abstract::The new class of immunosuppressants--inhibitors of the mammalian target of rapamycin--has no nephrotoxicity and the capacity to inhibit vascular smooth cell proliferation. These characteristics may afford considerable clinical advantages in the transplantation of kidneys from expanded criteria donors (ECD). Six clinic...


    pub_type: 杂志文章


    authors: Rigotti P,Kahan BD

    更新日期:2009-04-27 00:00:00

  • Ranolazine--a new drug with beneficial effects on renal preservation.

    abstract::Ranolazine is a new drug with a novel mode of action as a metabolic modulator and membrane stabilizer. In this prospective randomized double-blind trial, a porcine model of renal autotransplantation was used to assess the effects of this drug during preservation and reperfusion of kidneys cold-stored for 24 hr in phos...


    pub_type: 杂志文章


    authors: Lodge JP,Lam FT,Perry SL,Giles GR

    更新日期:1990-11-01 00:00:00

  • In vitro cytokine profiles and their relevance to rejection following renal transplantation.

    abstract::Graft rejection remains an important cause of renal allograft failure, despite improvements in immunosuppression and HLA typing. Although HLA matching is beneficial, ensuring an exact match it is often impractical. Thus, a reliable in vitro method for quantitating and qualitating alloreactivity is an important goal. I...


    pub_type: 杂志文章


    authors: Kaminski ER,Kaminski A,Bending MR,Chang R,Heads A,Szydlo RM,Pereira RS

    更新日期:1995-10-15 00:00:00

  • Cyclosporine's effect on functional reserve in the renal allograft.

    abstract::Thirteen renal allograft recipients (6 patients on cyclosporine/7 patients on azathioprine) participated in a short-term oral protein-loading study to determine the effect of cyclosporine on an allograft's functional reserve. The baseline glomerular filtration rate of the two groups were similar (52 +/- 18 ml/min/1.73...


    pub_type: 杂志文章


    authors: Nunley JR,King A,Comstock T,Posner M,Marshall C,Sica DA

    更新日期:1991-01-01 00:00:00

  • Case report of combined pediatric heart-lung-liver transplantation.

    abstract::We present the youngest successful patient with combined heart-lung-liver transplantation. The patient was a 2.5-year-old child with Alagille syndrome suffering from tetralogy of Fallot with pulmonary atresia and multiple aortopulmonary collaterals and familial cholestasis. ...


    pub_type: 杂志文章


    authors: Gandhi SK,Reyes J,Webber SA,Siewers RD,Pigula FA

    更新日期:2002-06-27 00:00:00

  • Prolongation of liver allograft survival after interleukin-10 gene transduction 24-48 hours before donation.

    abstract:BACKGROUND:Interleukin- (IL) 10 may be a potent regulator for controlling of allograft rejection. A single administration of IL-10 is not effective for controlling graft rejection. Gene transfer is an attractive vehicle for prolonging the expression of short-lived proteins. METHODS:Donor or recipient livers were trans...


    pub_type: 杂志文章


    authors: Tashiro H,Shinozaki K,Yahata H,Hayamizu K,Okimoto T,Tanji H,Fudaba Y,Yamamoto H,Fan X,Ito H,Asahara T

    更新日期:2000-07-27 00:00:00

  • Potential therapeutic interventions to avoid or treat chronic allograft dysfunction.

    abstract::Despite the significant improvements that have occurred since the introduction of CsA, long-term renal allograft survival continues to be an area of concern. Management strategies that involve the use of sirolimus offer some promise. A number of observations suggest that sirolimus may have the ability to reduce the ra...


    pub_type: 杂志文章,评审


    authors: Kahan BD

    更新日期:2001-06-15 00:00:00