Abstract:
:Calcineurin inhibitors (CNI) are the mainstay of immunosuppression after liver transplantation (LT), but CNIs are associated with significant nephrotoxicity. Recently, mTOR inhibitors such as sirolimus and everolimus (EVR) have been used with or without CNIs in LT recipients for their renal-sparing effect. We conducted a systematic review and meta-analysis of randomized controlled trials (RCT) that examined the effect of EVR with CNI minimization or withdrawal on renal function in LT recipients. RCT of primary adult LT recipients with baseline GFR >30 mL/min who received EVR with CNI minimization or withdrawal were included. Four RCTs (EVR n=465, control n=428) were included. In three RCTs, EVR was initiated 4 weeks following LT; these studies were used to assess the primary outcome. All four studies were used to assess the secondary outcomes. Based on this study, EVR use with CNI minimization in LT recipients is associated with improved renal function at 12 months by GFR of 10.2 mL/min (95% CI: 2.75-17.8). EVR use was not associated with an increased risk of biopsy-proven acute rejection (RR 0.68, 95% CI: 0.31-1.46), graft loss (RR 1.60, 95% CI: 0.51-5.00), or mortality (RR 1.34, 95% CI 0.62-2.90). However, it was associated with an increased risk of overall infections (RR 1.45, 95% CI: 1.10-1.91).
journal_name
Clin Transplantjournal_title
Clinical transplantationauthors
Lin M,Mittal S,Sahebjam F,Rana A,Sood GKdoi
10.1111/ctr.12872subject
Has Abstractpub_date
2017-02-01 00:00:00issue
2eissn
0902-0063issn
1399-0012journal_volume
31pub_type
杂志文章,meta分析,评审abstract::Coronary artery disease (CAD) is a pathology often found in patients with end-stage lung disease. Although in the past CAD might have been considered an absolute contraindication, modern revascularization techniques have helped increase the number of transplants performed in this population. However, discrepancies in ...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/ctr.14078
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Relationships between race/ethnicity, recipient medical insurance, and living donor kidney transplantation (LKT) are incompletely described. METHODS:Associations between medical insurance and LKT were assessed in 447 recipients at a southeastern US transplant center. Primary and secondary payers were includ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12168
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Graft survival following solitary pancreas transplantation has traditionally lagged behind that of simultaneous pancreas-kidney transplants. Thymoglobulin (TMG), a polyclonal rabbit-derived antilymphocyte antibody was originally introduced as treatment for acute rejection of renal allografts. However, data r...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2002.02031.x
更新日期:2002-12-01 00:00:00
abstract::The aim of this study was to improve outcomes in living donor liver transplantation (LDLT) patients with portal vein thrombosis (PVT). Of 246 adult patients who underwent LDLT with a right lobe graft between January 2000 and May 2007, PVT was diagnosed in 50 patients (20.3%), who were further subdivided into partial (...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2010.01217.x
更新日期:2011-01-01 00:00:00
abstract::An increasing number of patients and families are utilizing online crowdfunding to support their medical expenses related to organ transplantation. The factors influencing the success of crowdfunding campaigns are poorly understood. Crowdfunding campaigns were abstracted from a popular crowdfunding web site. Campaigns...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13267
更新日期:2018-06-01 00:00:00
abstract::We report the case of a female with chronic pancreatitis who underwent multiple surgical procedures leading to total resection of the pancreas with successful islet auto-transplantation. Postoperatively, she developed heparin-induced thrombocytopenia. Heparinization prior to islet infusion is currently recommended to ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2005.00457.x
更新日期:2006-03-01 00:00:00
abstract::Cytomegalovirus (CMV) infection complicates the post-operative course of patients receiving solid organ transplants. While ganciclovir has significantly reduced the direct effects of CMV infection, some patients cannot tolerate the optimal therapeutic exposure required for CMV prevention and treatment. Few reports dir...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/j.1399-0012.2008.00942.x
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND/AIM:The aim of this study was to determine whether the expression of CD25, CD28 and CD38 (which reflects the degree of T-cell activation) by peripheral blood mononuclear cells constitutes a useful means of measuring the immune status of liver transplant recipients. METHODS:Fifty-two patients enrolled in a p...
journal_title:Clinical transplantation
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1399-0012.2008.00815.x
更新日期:2008-07-01 00:00:00
abstract::In the general population, obesity is associated with an increased risk of developing hypertension (HTN), type 2 diabetes mellitus (DM), and end-stage renal disease (ESRD). Therefore, most transplant centers have a body mass index (BMI) threshold for accepting living kidney donors. But there have been no studies of po...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13360
更新日期:2018-09-01 00:00:00
abstract::Omega-3 fatty acids have been shown to play a role in preventing development of both acute and chronic rejection. New evidence also suggests that HMGCoA reductase inhibitors may have an immunomodulatory effect and may decrease the incidence of rejection in both animal and human transplant models. Omega-3 fatty acids a...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1995-06-01 00:00:00
abstract:OBJECTIVE:The objective of this retrospective study was to characterize the neutrophil to lymphocyte ratio (NLR) on the waitlist and determine its prognostic utility in liver transplantation (LT) for hepatocellular carcinoma (HCC) with special focus on longitudinal data. Biomarkers such as pre-operative NLR have been s...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13743
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:The clinical consequences of type 1 diabetes mellitus (IDDM) include diabetic triopathy: retinopathy, nephropathy, and neuropathy, as well as microangiopathy, accelerated atherosclerotic disease, and hypercoagulability. The etiology of the hypercoagulability is multifactorial, involving various clotting fact...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00183.x
更新日期:2004-08-01 00:00:00
abstract::The purpose of this study was to evaluate the outcome of the medial segment of the graft after living related liver transplantation (LRLT). Of the 12 pediatric recipients who underwent LRLT, 2 received whole left liver graft, 1 left lateral segment graft, and 9 extended left lateral segment grafts. The hepatic veins o...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1998-10-01 00:00:00
abstract::Obesity and weight gain are serious concerns after solid organ transplantation (Tx); however, no unbiased comparison regarding body weight parameter evolution across organ groups has yet been performed. Using data from the prospective nationwide Swiss Transplant Cohort Study, we compared the evolution of weight parame...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12896
更新日期:2017-03-01 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:BACKGROUND:The accurate estimation of liver volume and right/left ratio in donor candidates is critical, but there is no method using portal vein (PV) flow. METHODS:Of 125 donor candidates, right/left liver volume ratio was estimated using ultrasound (US)-PV area ratio and Doppler US-PV flow ratio, and the results wer...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13050
更新日期:2017-09-01 00:00:00
abstract::The purpose of this study was to compare CsA dose monitoring with trough levels (T0) vs. levels obtained 6 h after the morning dose of CsA (T6), with respect to the incidence of acute rejection and renal dysfunction, and the cumulative dose, as well as the cost of CsA after heart transplantation. Twenty consecutive ad...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1997-10-01 00:00:00
abstract::ABO-incompatible kidney transplantation (ABO-ILKT) has been reported to have a higher rate of early complications and higher medical costs than ABO-compatible kidney transplantation (ABO-CLKT). We aimed to compare the clinical outcomes, complications, and medical costs between ABO-ILKTs and ABO-CLKTs at 2 years post-t...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.13591
更新日期:2019-06-01 00:00:00
abstract::These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of tuberculosis in the pre- and post-transplant period. The challenges of screening for both latent and active TB in the setting of transplantation are...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13513
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Renal transplant outcomes in Hispanics have been conflicting regarding acute rejection (AR) and allograft survival. Additionally, the feasibility of early corticosteroid withdrawal (ECW) regimens among Hispanics has not been adequately addressed. The purpose of this study is to report outcomes following ECW ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12218
更新日期:2013-11-01 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:BACKGROUND:Everolimus (EVL) and sirolimus (SRL) were introduced into immunosuppressive regimens, in an attempt to replace or reduce the dose of the nephrotoxic calcineurin inhibitors (CNI). In our institution, due to an administrative decision, conversion from SRL to EVL, was carried out, providing us the opportunity t...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2011.01446.x
更新日期:2011-07-01 00:00:00
abstract::Approximately 8-11% of all organ donors are classified by Public Health Service (PHS) as increased-risk. The proportion of PHS increased-risk donors is on the rise. At the University of Washington Medical Center, in 2014, the proportion of transplants from PHS increased-risk donors was 28% of liver transplants and 23%...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12582
更新日期:2015-09-01 00:00:00
abstract::In live related renal transplant program, management of multiple renal arteries (MRA) is technically demanding and used to be considered a relative contraindication because of increased risk of vascular and urologic complications. We present a retrospective analysis of the outcome of grafts with MRA and suggest certai...
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
abstract:BACKGROUND:The value of importing expanded criteria donor (ECD) kidneys is uncertain. METHODS:We retrospectively reviewed our single-center experience with ECD kidney transplants (KT). RESULTS:Over 12.8 years, we performed 497 ECD KTs including 247 local and 250 imported from other donor service areas. The import ECD...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13029
更新日期:2017-08-01 00:00:00
abstract::Clinical small bowel transplantation (SBTx) has been associated with a high rate of infectious complications. Laparotomy, preservation injury, abnormal motility, lymphatic disruption, aberrant systemic venous drainage, rejection and antibiotic therapy could all be implicated in the etiology of these complications. In ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2000.140609.x
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:Renal transplantation is an excellent therapeutic alternative for end-stage renal diseases. Nevertheless, the cardiac function is often impaired in renal-transplant patients (RTR) and importantly determines their prognosis. Adrenomedullin (ADM), a peptide involved in cardiovascular homeostasis, is believed t...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2005.00486.x
更新日期:2006-05-01 00:00:00
abstract:UNLABELLED:Medicare pays for 80% of the cost of immunosuppressant agents needed within the first 3 years of solid organ transplantation; however, many patients cannot afford the remaining 20%. Furthermore, many patients who are beyond 3 years post-transplantation and have prescription coverage cannot afford the co-paym...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2000.140405.x
更新日期:2000-08-01 00:00:00
abstract::Changes to the United States kidney allocation system targeted at reducing organ discard have failed to improve organ utilization. High Kidney Donor Profile Index kidneys continue to be discarded at high rates as a result of the regulatory and financial barriers to widespread utilization of these organs. However, ther...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13990
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:With the aim to improve the inferior outcomes in elderly recipients of kidneys from elderly cadaver donors, we applied and investigated a therapeutic regimen consisting of calcineurin inhibitor (CNI)-free, mycophenolate mofetil (MMF)-based immunosuppressive (i.s.) induction/maintenance protocol. In this arti...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-0012.2005.00309.x
更新日期:2005-06-01 00:00:00