Effect of renal allograft dysfunction upon cyclosporine trough levels in host blood.

Abstract:

:Cyclosporine (CsA) dose adjustment after renal transplantation is generally based on serum, plasma, or whole-blood trough level values. In the face of increased levels, the dosage is reduced in order to prevent CsA-induced nephrotoxicity. There is a paucity of data, however, on the kinetics of CsA in association with dysfunction of the transplanted kidney. This study documents dramatic rises in serum cyclosporine trough levels at the time of rejection crises, as well as following periods of nonimmunological allograft oliguria. Decreases in CsA dosage in such patients failed to result in a significant lowering in trough levels. Therapeutic CsA trough levels were generally at the 70-140 ng/ml level; at the time of rejection, the same doses of CsA resulted in a rise of trough levels to 300-500 ng/ml. As the rejection crises resolved and kidney function improved, the CsA serum trough levels returned to their lower levels. These results suggest that the urinary elimination of CsA and its metabolites may be a key determinant of CsA trough levels, and that the status of renal function at the time of testing must be considered in the interpretation of the data. In support of this observation, the CsA concentrations in 4-6 hr post-CsA-administration urine samples ranged from 400 ng/ml to 4500 ng/ml, as measured by high pressure liquid chromatography. The data suggest that rising CsA trough levels in a previously stable recipient may serve as a valuable early warning index of impending allograft dysfunction (rejection, infection, and obstruction). This appears particularly true during the first 30 days after renal transplantation, when the incidence of rejection is the greatest in this patient population.

journal_name

Transplantation

journal_title

Transplantation

authors

Arnold AN,Waltzer WC,Anaise D,Weinstein SW,Rapaport FT

doi

10.1097/00007890-198512000-00006

subject

Has Abstract

pub_date

1985-12-01 00:00:00

pages

605-10

issue

6

eissn

0041-1337

issn

1534-6080

journal_volume

40

pub_type

杂志文章
  • Real-time direct measurement of human liver allograft temperature from recovery to transplantation.

    abstract::Temperature is a key parameter in organ preservation that has been consistently linked to primary nonfunction (PNF). In this communication, and for the first time anywhere, continued and direct measurements of human liver intraparenchymal temperatures are reported in six clinical cases of orthotopic liver transplantat...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000195903.12999.bc

    authors: Villa R,Fondevila C,Erill I,Guimerà A,Bombuy E,Gómez-Suárez C,Sacristán JC,García-Valdecasas JC

    更新日期:2006-02-15 00:00:00

  • Islets in alginate macrobeads reverse diabetes despite minimal acute insulin secretory responses.

    abstract:BACKGROUND:Encapsulation of islets has been widely investigated as a treatment for diabetes. The characteristics and dynamics of insulin secretion by encapsulated islets in response to glucose and other secretagogues are not well understood. METHODS:In our study, macroencapsulated syngeneic islets at 3-4 wk after tran...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200101270-00006

    authors: Trivedi N,Keegan M,Steil GM,Hollister-Lock J,Hasenkamp WM,Colton CK,Bonner-Weir S,Weir GC

    更新日期:2001-01-27 00:00:00

  • Current status of clinical islet transplantation.

    abstract::Islet transplantation is currently being explored as a treatment for patients with type 1 diabetes. At present, the number of patients becoming insulin-independent is rapidly increasing world-wide applying the transplantation protocol originally described by the group in Edmonton. A hallmark in this procedure is repea...

    journal_title:Transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/01.tp.0000157273.60147.7c

    authors: Korsgren O,Nilsson B,Berne C,Felldin M,Foss A,Kallen R,Lundgren T,Salmela K,Tibell A,Tufveson G

    更新日期:2005-05-27 00:00:00

  • Apoptosis after intestinal ischemia-reperfusion injury: a morphological study.

    abstract:BACKGROUND:Apoptosis has been identified after ischemia-reperfusion (IR) injury to the brain, heart, kidney, retina, and the adrenals. Intestinal IR injury causes villous and crypt damage, which has so far been attributed to cellular necrosis. This study was undertaken to investigate the possible role of apoptosis afte...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199711270-00003

    authors: Shah KA,Shurey S,Green CJ

    更新日期:1997-11-27 00:00:00

  • Expression of RT1.A and RT1.B/D antigens on endothelium of rat kidneys.

    abstract::The presence of major histocompatibility complex (MHC)-encoded antigens (RT1) on endothelium of rat kidneys was investigated using hyperimmune allogeneic rat sera (HIS) in an indirect immunofluorescence technique with kidney sections. Endothelial antigens detected with anti-MHC sera segregated in an F2 generation with...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198209000-00002

    authors: Paul LC,Paradysz JM,Milford EL,Kunz HW,Carpenter CB

    更新日期:1982-09-01 00:00:00

  • CD47 blockade reduces ischemia-reperfusion injury and improves outcomes in a rat kidney transplant model.

    abstract:BACKGROUND:Ischemia-reperfusion injury (IRI) significantly contributes to delayed graft function and inflammation, leading to graft loss. Ischemia-reperfusion injury is exacerbated by the thrombospondin-1-CD47 system through inhibition of nitric oxide signaling. We postulate that CD47 blockade and prevention of nitric ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000000252

    authors: Lin Y,Manning PT,Jia J,Gaut JP,Xiao Z,Capoccia BJ,Chen CC,Hiebsch RR,Upadhya G,Mohanakumar T,Frazier WA,Chapman WC

    更新日期:2014-08-27 00:00:00

  • Vanishing bile-duct syndrome following liver transplantation--is it reversible?

    abstract::Loss of bile ducts is a characteristic feature of chronic rejection in the liver allograft (also known as irreversible rejection and vanishing bile-duct syndrome). Typically, this occurs as a progressive lesion resulting in irreversible damage and graft failure requiring retransplantation. In this study, we describe 6...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199105000-00014

    authors: Hubscher SG,Buckels JA,Elias E,McMaster P,Neuberger J

    更新日期:1991-05-01 00:00:00

  • Reconstitution of cytotoxic T lymphocyte activity following allogeneic bone marrow transplantation in man.

    abstract::Longitudinal studies over an eight-month period have been performed to follow the T killer response restoration after allogeneic bone marrow transplantation (BMT). The capacity of the patient's peripheral blood mononuclear cells (PBM) to develop cytotoxic effector cells directed either against allogeneic cells or agai...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198708000-00024

    authors: Tilkin AF,Bagot M,Dreyfus F,Kayibanda M,Cordonnier C,Vernant JP,Levy JP

    更新日期:1987-08-01 00:00:00

  • High incidence of monoclonal immunoglobulins in patients after liver or heart transplantation.

    abstract::Sera from 56 recipients of liver or heart transplants were investigated for monoclonal immunoglobulins (mIg) by immunofixation electrophoresis (IFE) at different times during 4 years after transplantation. Transient, changing, or stable mIgs were found in 18 patients. A significantly increased mIg incidence was observ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198809000-00011

    authors: Peest D,Schaper B,Nashan B,Wonigeit K,Raude E,Pichlmayr R,Haverich A,Deicher H

    更新日期:1988-09-01 00:00:00

  • The impact of cyclosporine dose reduction with or without the addition of rapamycin on functional, molecular, and histological markers of chronic allograft nephropathy.

    abstract:BACKGROUND:Overexposure to cyclosporine is a risk factor for chronic allograft nephropathy (CAN) and dose reduction has been advocated. The purpose of this study was to determine the impact of adding the non-nephrotoxic immunosuppressant, rapamycin, after cyclosporine dose reduction in renal-allograft recipients with C...

    journal_title:Transplantation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00007890-200303270-00008

    authors: Saunders RN,Bicknell GR,Nicholson ML

    更新日期:2003-03-27 00:00:00

  • Fungal infections in liver transplant recipients.

    abstract::Sixty-two adults who underwent orthotopic liver transplantations between February 1981 and June 1983 were followed for a mean of 170 days after the operation. Twenty-six patients developed 30 episodes of significant fungal infection. Candida species and Torulopsis glabrata were responsible for 22 episodes and Aspergil...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198510000-00002

    authors: Wajszczuk CP,Dummer JS,Ho M,Van Thiel DH,Starzl TE,Iwatsuki S,Shaw B Jr

    更新日期:1985-10-01 00:00:00

  • Posttransplant bone disease: a case illustrating dramatic improvements in bone density with vitamin D replacement therapy.

    abstract::Although bisphosponates are proposed as first-line treatment for posttransplant bone disease they are not optimal in all situations. A kidney transplant recipient developed hypercalcemia from mobilization of extraskeletal calcium. He had low serum parathyroid hormone and vitamin D; high calcium excretion; and normal c...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200106270-00025

    authors: Dhingra RK,Sprague SM,Ojo AO,Leavey SF

    更新日期:2001-06-27 00:00:00

  • Attenuation of acute xenograft rejection by short-term treatment with LF15-0195 and monoclonal antibody against CD45RB in a rat-to-mouse cardiac transplantation model.

    abstract:BACKGROUND:We previously reported that Lewis rat hearts transplanted into BALB/c mice developed typical acute vascular rejection (AVR). The present study was undertaken to determine the efficacy of LF15-0195, a new analogue of 15-deoxyspergualin, in the prevention of AVR and to determine whether a combination of LF15-0...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.TP.0000057245.59998.95

    authors: Wang H,Hosiawa KA,Garcia B,Shum JB,Dutartre P,Kelvin DJ,Zhong R

    更新日期:2003-05-15 00:00:00

  • Science of composite tissue allotransplantation.

    abstract::The science of composite tissue allotransplantation (CTA) is rooted in progressive thinking by surgeons, fueled by innovative solutions, and aided by understanding the immunology of tolerance and rejection. These three factors have allowed CTA to progress from science fiction to science fact. Research using preclinica...

    journal_title:Transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/TP.0b013e318184ca6a

    authors: Swearingen B,Ravindra K,Xu H,Wu S,Breidenbach WC,Ildstad ST

    更新日期:2008-09-15 00:00:00

  • The Relationships Between Cold Ischemia Time, Kidney Transplant Length of Stay, and Transplant-related Costs.

    abstract:BACKGROUND:Recent changes in policies guiding allocation of transplant kidneys are predicted to increase sharing between distant geographic regions. The potential exists for an increase in cold ischemia time (CIT) with resulting increases in delayed graft function (DGF) and transplant-related costs (TRC). We sought to ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000002309

    authors: Serrano OK,Vock DM,Chinnakotla S,Dunn TB,Kandaswamy R,Pruett TL,Feldman R,Matas AJ,Finger EB

    更新日期:2019-02-01 00:00:00

  • Prediction of graft survival of living-donor kidney transplantation: nomograms or artificial neural networks?

    abstract:BACKGROUND:An artificial neural networks (ANNs) model was developed to predict 5-year graft survival of living-donor kidney transplants. Predictions from the validated ANNs were compared with Cox regression-based nomogram. METHODS:Out of 1900 patients with living-donor kidney transplant; 1581 patients were used for tr...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31818b221f

    authors: Akl A,Ismail AM,Ghoneim M

    更新日期:2008-11-27 00:00:00

  • Renal response to a protein load persists during long-term follow-up of children after renal transplantation.

    abstract:BACKGROUND:Kidney donors and transplant recipients may be at risk of complications from glomerular hyperfiltration of the single kidney. It has been assumed that tests of the existence of renal functional reserve [delta glomerular filtration rate (deltaGFR), delta effective renal plasma flow (deltaERPF)] can be used to...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200011150-00013

    authors: Englund M,Berg U

    更新日期:2000-11-15 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...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199010000-00030

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

    更新日期:1990-10-01 00:00:00

  • Upregulation of CD59: potential mechanism of accommodation in a large animal model.

    abstract:BACKGROUND:Survival of ABO-mismatched kidneys with stable renal function despite the persistence of anti-ABO antibodies is called accommodation. The mechanism of accommodation is unclear, but may involve complement regulatory proteins such as CD59. The development of alpha-1,3-galactosyltransferase knock-out (GalT-KO) ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e3181a19afc

    authors: Griesemer AD,Okumi M,Shimizu A,Moran S,Ishikawa Y,Iorio J,Arn JS,Yamada K

    更新日期:2009-05-15 00:00:00

  • Access to kidney transplantation in France of non-French patients and French patients living in overseas territories.

    abstract:BACKGROUND:In France, foreign patients, whether resident or not in France, can register on the national waiting list under certain conditions. We compared waiting time to kidney transplantation, the level of HLA matching and graft cold ischemia time between foreign patients and French patients living in mainland France...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000205182.96861.3a

    authors: Cantrelle C,Laurens C,Luciolli E,Loty B,Tuppin P

    更新日期:2006-04-27 00:00:00

  • Therapeutic effects of a non-β cell bioartificial pancreas in diabetic mice.

    abstract:BACKGROUND:Cell-based insulin therapies can potentially improve glycemic regulation in insulin-dependent diabetic patients. Enteroendocrine cells engineered to secrete recombinant insulin have exhibited glycemic efficacy, but have been primarily studied as uncontrollable growth systems in immune incompetent mice. Furth...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000000247

    authors: Tiernan AR,Thulé PM,Sambanis A

    更新日期:2014-09-15 00:00:00

  • The effect of renal ischemia on cyclosporine clearance in rabbits.

    abstract::The renal handling of cyclosporine was studied in ischemically damaged kidneys in New Zealand White rabbits and nonischemic control animals. CsA, 25 mg/kg/day, was administered intravenously for 10 days starting with the day of operation. Blood CsA (B CsA) was higher in the ischemic group compared with the controls (m...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199003000-00004

    authors: Karim MS,Wood RF,Dawnay AB,Fulton PA

    更新日期:1990-03-01 00:00:00

  • Renal Transplantation From Pediatric Donors in the United Kingdom.

    abstract:BACKGROUND:Significant disparity exists in the United Kingdom between the need for organ transplant and supply of deceased donor organs. In the recent years, efforts to increase donation has improved the rate of mainly deceased donors after circulatory death and from older donors. The rate of donation from pediatric po...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000000575

    authors: Dave RV,Hakeem AR,Dawrant MJ,Ecuyer CL,Lewington AJ,Attia MS,Hostert L,Finlay E,Ahmad N

    更新日期:2015-09-01 00:00:00

  • Prediction by a modified mixed leukocyte reaction assay of graft-versus-host disease and graft rejection after allogeneic bone marrow transplantation.

    abstract::In this report we describe a modified, sensitive MLR test that appears to detect fine antigenic disparities between HLA-identical siblings confirmed as such by serology and the standard MLR test. In a group of 40 consecutive allogeneic bone marrow transplants, reactivity detected by the modified MLR test correlated wi...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:

    authors: Bishara A,Brautbar C,Nagler A,Slavin S,Leshem B,Cohen I,Kedar E

    更新日期:1994-05-27 00:00:00

  • Association of T cells with proliferating cells in lymphoid follicles.

    abstract::Frozen sections of lymph nodes from normal mice were examined by immunofluorescence with anti-T lymphocyte and anti-Ig reagents and by autoradiography following [3H]TdR administration. The scattered T lymphocytes present among B lymphocytes of primary follicles were found to be mostly nonproliferating; the few prolife...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198111000-00018

    authors: Berman MA,Rafiei S,Gutman GA

    更新日期:1981-11-01 00:00:00

  • Apparent lack of H-Y-specific suppressor cells in female mice given male spleen cells intravenously.

    abstract::Mice given a pretransplant i.v. infusion of spleen cells from donors incompatible with the recipients with respect to individual minor H antigens exhibit a delayed rejection of skin grafts from these incompatible donors. Attempts were made to detect suppressor T cells, possibly induced by the i.v. infusion of donor ce...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199001000-00034

    authors: Johnson LL

    更新日期:1990-01-01 00:00:00

  • Thymoglobulin versus ATGAM induction therapy in pediatric kidney transplant recipients: a single-center report.

    abstract:BACKGROUND:Induction immunosuppressive therapy with the anti-T-cell antibody Thymoglobulin decreases the incidence of acute rejection in adult kidney transplant (KTx) recipients, but limited data are available for pediatric KTx recipients. METHODS:We conducted a historical cohort study to compare rates of survival, re...

    journal_title:Transplantation

    pub_type: 临床试验,杂志文章

    doi:10.1097/01.tp.0000158325.12837.a2

    authors: Khositseth S,Matas A,Cook ME,Gillingham KJ,Chavers BM

    更新日期:2005-04-27 00:00:00

  • Associations of characteristics of renal transplant recipients with clinicians' perceptions of adherence to immunosuppressant therapy.

    abstract:BACKGROUND:The objective of the study was to determine surveillance criteria for renal transplant recipients (RTRs) at highest risk for immunosuppressant therapy nonadherence. METHODS:Retrospective analyses were performed on follow-up data in the United States Renal Data System. Those who received transplants between ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000287189.33074.c8

    authors: Chisholm MA,Kwong WJ,Spivey CA

    更新日期:2007-11-15 00:00:00

  • Synergistic effects of mycophenolate mofetil and losartan in a model of chronic cyclosporine nephropathy.

    abstract:BACKGROUND:Combined treatments of mycophenolate mofetil (MMF) and losartan (LSRT) have synergistic effects on various renal diseases through their hemodynamic and anti-inflammatory effects. This study investigated whether MMF treatment is effective in inhibiting inflammatory processes in chronic cyclosporine A (CsA) ne...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.TP.0000045034.48833.51

    authors: Yang CW,Ahn HJ,Kim WY,Li C,Jung JY,Yoon SA,Kim YS,Cha JH,Kim J,Bang BK

    更新日期:2003-02-15 00:00:00

  • Guillain-Barre syndrome in organ and bone marrow transplant patients.

    abstract:BACKGROUND:Guillain-Barre Syndrome (GBS) is believed to be caused by autoimmune mechanisms that are predominantly T-cell mediated. We report GBS in organ transplant patients and bone marrow transplant patients, both of whom have iatrogenically suppressed T-cell function. METHODS:We reviewed the Duke University Medical...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200104270-00026

    authors: Bulsara KR,Baron PW,Tuttle-Newhall JE,Clavien PA,Morgenlander J

    更新日期:2001-04-27 00:00:00