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 Society of Transplantation members on their perceptions of ASI including frequency, perceived QOL impact, causal attribution, management strategies, and success. Sixty-one clinicians participated in the survey of 12 ASI (tremor, diarrhea, nausea, constipation, dyspepsia, insomnia, edema, dyspnea, arthralgia, acne, mouth sores, paresthesias), for a 22% response rate. Forty-nine completed the survey (80% completion rate). Diarrhea, dyspepsia, and insomnia were most frequent, requiring management in ≥ 2% of patients by 96%, 90%, and 82% of respondents, respectively. Diarrhea, insomnia, and dyspnea were deemed to have an important QOL impact by 92%, 82%, and 69%. Immunosuppressants were universally implicated as causative of tremor, diarrhea, acne, and mouth sores. Over 80% reported success in managing mouth sores, dyspepsia, and constipation. Management strategies included adjustment of immunosuppressant or other medications, drug therapy, and nonpharmacologic approaches and varied according to perceived causal attribution. More study is needed to compare clinician and patient views. These results will be used to establish priorities for further investigation of ASI.
journal_name
Clin Transplantjournal_title
Clinical transplantationauthors
Harrison JJ,Mansell H,Blydt-Hansen Tdoi
10.1111/ctr.12940subject
Has Abstractpub_date
2017-05-01 00:00:00issue
5eissn
0902-0063issn
1399-0012journal_volume
31pub_type
杂志文章abstract:BACKGROUND/OBJECTIVES:Vascular thrombosis is the most common cause of early graft loss after transplantation. Routine grayscale and Doppler ultrasound frequently fail to adequately visualize vascular compromise. Contrast-enhanced ultrasound is a novel approach to identifying these complications. METHODS:This was a pro...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13733
更新日期:2019-12-01 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::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::Endothelium-dependent vasodilation in the peripheral circulation may be impaired in heart transplant recipients (HTx rec). Conflicting results have been obtained and the mechanisms involved have not been examined. In the present study, we examined whether long-time survivors of heart transplantation (Tx) show signs of...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2000.140307.x
更新日期:2000-06-01 00:00:00
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 conducte...
journal_title:Clinical transplantation
pub_type: 杂志文章,meta分析,评审
doi:10.1111/ctr.12872
更新日期:2017-02-01 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:BACKGROUND:Despite a survival benefit from transplantation and acceptable outcomes, patients with human immunodeficiency virus (HIV+) face barriers to kidney transplantation. Little is known about the acceptance or decline of organ offers on their behalf because waitlist registry data do not include HIV serostatus. ME...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13466
更新日期:2019-02-01 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:UNLABELLED:In order to determine risk factors for bone loss after renal transplantation, dual energy X-ray absorptiometry was performed in 125 renal transplant patients. The bone mineral density (BMD) was expressed as a percentage of the normal population (BMD%) and Z-score (SD from normal). The whole body, lumbar spin...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2000.140503.x
更新日期:2000-10-01 00:00:00
abstract::In France, liver grafts which have been refused by at least five centers are proposed as rescue allocation (RA). The aim of this study is to clarify the feasibility and safety of RA grafts in liver transplantation (LT). Short- and long-term outcomes of patients who received RA grafts (RA group) were compared with thos...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.14046
更新日期:2020-07-19 00:00:00
abstract::Tacrolimus (TAC) is a useful immunosuppressive agent in the prevention of rejection. However, the blood level between its therapeutic and toxic levels is narrow such that its nephrotoxicity is a problem. Moreover, its bioavailability and pharmacokinetics are highly variable. We experienced a case of acute nephrotoxici...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2000.0140s3030.x
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Severe systemic hypertension (HTN) is a risk factor for perioperative cardiovascular complications; however, its impact at the time of kidney transplantation (KTX) is not well defined. METHODS:A retrospective cohort study of adult kidney-only transplant recipients between October 2009 and December 2012 was ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12579
更新日期:2015-09-01 00:00:00
abstract::The long-term side effects of lifelong steroid immunosuppression are well documented, therefore, steroid withdrawal (SW) if safe would clearly be of benefit. From 1987-1996, 470 kidney transplants were performed at our institution. During this time period, steroid withdrawal was offered to a select group of patients (...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1997-10-01 00:00:00
abstract::Renal transplantation remains the definitive treatment for end-stage renal disease (ESRD). The shorter renal vein in right donor nephrectomies is associated with higher incidence of technical failure. We present here our experience with autologous internal jugular vein (IJV) conduits to facilitate living-donor transpl...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.13312
更新日期:2018-08-01 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
abstract::Reducing acute care utilization is a means of improving long-term patient outcomes. We sought to assess high inpatient (IP) admission and standalone emergency department (ED) utilization within a 9-month period post-kidney transplantation and to identify mutable factors to reduce utilization. In this ten-year retrospe...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.13522
更新日期:2019-05-01 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::The morphological characteristics of a kidney biopsy specimen taken 1 h after reperfusion of blood into the graft (1-h biopsy) during a cadaveric transplant operation were studied. The aim of the 1-h biopsy is to evaluate the pre-transplant risk factors for the delayed graft function, assess the renal function of the ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::Aboriginals experience high rates of end-stage renal disease (ESRD) and are less likely to receive a kidney transplant from a living donor. We hypothesized that higher rates of hypertension and diabetes in Aboriginal communities would result in fewer potential living donors coming forward and more exclusions for medic...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2011.01491.x
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVES:Autologous islet transplantation (IAT) following pancreatectomy is now a recognized, albeit highly specialized procedure carried out in a small number of centers worldwide. Current clinical principles and best practice with emphasis on examining the technical aspects of surgery in centers with significant IA...
journal_title:Clinical transplantation
pub_type: 杂志文章,meta分析,评审
doi:10.1111/ctr.12695
更新日期:2016-04-01 00:00:00
abstract:INTRODUCTION:Controlled donation after circulatory death (DCD) remains ethically controversial. The authors developed a controlled DCD protocol in which comfort therapy is regularly used. The aim of this study was to determine whether this policy shortens the DCD donors' life. METHODS:The authors retrospectively analy...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12276
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:The goal of immunosuppressive therapy in heart transplantation is to maximize safety and efficacy while minimizing morbidity and mortality. We now have numerous drug combinations, but few have been compared with each other. AIM:To compare various immunosuppressive regimens assessing morbidity and mortality ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2007.00751.x
更新日期:2008-01-01 00:00:00
abstract::Steroid withdrawal has potential risks (rejection) and benefits (fewer complications). Most data on steroid-related complications predates cyclosporine (CsA). We tabulated the incidence of posttransplant complications considered to be steroid-related in 748 adult kidney transplant recipients (with at least 1 year of f...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
abstract:AIM:Uncontrolled donation after cardiac death (uDCD) remains an underutilized source of kidney allografts in the United States. The objective of this study was to estimate the impact of the implementation of a uDCD program on transplantation rates and long-term survival for patients with end-stage renal disease (ESRD) ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13868
更新日期:2020-07-01 00:00:00
abstract:INTRODUCTION:Totally implantable venous access devices (TIVADs) are the preferred devices for patients with advanced lung disease who require long-term venous access. The primary purpose of this study was to describe the natural history of TIVADs left in place at the time of transplant. METHODS:This multicenter retros...
journal_title:Clinical transplantation
pub_type: 杂志文章,多中心研究
doi:10.1111/ctr.13465
更新日期:2019-02-01 00:00:00
abstract::With increasing shortage of donor organs and changes in organ allocation systems, there is a considerable need for alternative or supportive techniques in the field of liver transplantation. Liver cell transplantation (LCT) is such an innovative technique that is especially promising for use in children, because it is...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/j.1399-0012.2009.01113.x
更新日期:2009-12-01 00:00:00
abstract::Subclinical rejection (SCR) is quite common early following renal transplantation and decreases progressively with time. The immunological profile of the recipient, the immunosuppressive regimen used, and the occurrence of prior episodes of clinical acute rejection (AR) are all risk factors for SCR. SCR, in turn, is a...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/j.1399-0012.2008.00888.x
更新日期:2009-03-01 00:00:00
abstract::This paper describes 108 consecutively treated patients receiving 109 cadaveric (CD) and living donor (LD) renal allografts using a protocol of quadruple sequential immunosuppression with a rabbit anti-human thymocyte IgG (Thymoglobuline), azathioprine, tapering corticosteroids, and delayed introduction of cyclosporin...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1997-06-01 00:00:00
abstract:BACKGROUND:More data are needed regarding the incidence, risk factors, and outcomes for Clostridioides difficile infection (CDI) and colonization in patients undergoing an autologous hematopoietic stem cell transplantation (AHSCT). METHODS:We studied 472 consecutive patients admitted for a first AHSCT and conducted a ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13712
更新日期:2019-11-01 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