Abstract:
:Sirolimus (SRL) has become an option in kidney transplantation, especially among patients who develop chronic allograft nephropathy (CAN). This study sought to evaluate the safety and efficacy of SRL in 103 kidney recipients of mean age 40 years, including 78 recipients of organs from deceased donors. The major reason for conversion was calcineurin inhibitor (CNI) nephrotoxicity (42.3%) followed by CAN (35.4%). A preconversion kidney biopsy was performed in 89 patients with CAN diagnosed in 51. Mean time to conversion was 40.5 months. The new therapy was: SRL/mycophenolate mofetil (MMF)/prednisone (Pred) in 79 patients; SRL/tacrolimus (TAC)/Pred in 15; and other SRL combinations in 9. The target SRL trough level was 5.0 to 8.0 ng/mL. To evaluate the impact of conversion on renal function, we compared the proteinuria and inverse serum creatinine at 3 months before conversion, at conversion, and at 1, 3, 6, 12, and 24 months postconversion. The overall mean follow-up time was 13.2 months. The analysis showed significant improvement in renal function at month 1 postconversion (P<.05) with stabilization thereafter. The SRL/MMF combination frequently induced anemia and/or leukopenia (n=23). Infections included pneumonia (n=10), herpes zoster (n=7), herpes simplex (n=3), cytomegalovirus (n=2), histoplasmosis (n=2), tuberculosis (n=2), and neurocryptococcosis (n=1). Reasons for SRL discontinuation were myelotoxicity (n=4), infection (n=3), nephrotoxicity (n=3), gastrointestinal intolerance (n=3), myopathy (n=1), pneumonitis (n=1), hyperlipidemia (n=1), and other reasons (n=3). Graft loss occurred in 29 patients due to CAN (n=21) followed by death (cardiovascular, n=2; infectious, n=2), acute rejection (n=3), and infection following immunosuppression withdrawal (n=1). We concluded that SRL represented an option but reducing associated immunosuppression should strongly be considered to minimize the frequent side effects, especially infections.
journal_name
Transplant Procjournal_title
Transplantation proceedingsauthors
Saber LT,Ikeda MY,Almeida JMdoi
10.1016/j.transproceed.2007.04.021subject
Has Abstractpub_date
2007-12-01 00:00:00pages
3098-100issue
10eissn
0041-1345issn
1873-2623pii
S0041-1345(07)00956-6journal_volume
39pub_type
杂志文章abstract:UNLABELLED:The indications of progressive neurological deterioration despite no hepatic insufficiency, for liver transplant (OLT) in patients with Wilson's disease (WD) who do not improve with medical treatment is widely debated. The aim of this paper was to present our OLT experience in WD. PATIENTS AND METHODS:Fourt...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2007.06.039
更新日期:2007-09-01 00:00:00
abstract::Significantly lower graft survival has been observed among recipients of a third (G3) compared with a first or second kidney transplantation. Because patients awaiting G3 are largely HLA immunized, they are usually transplanted with a high HLA match. Moreover, their rate of acute rejection episodes is similar to a fir...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.12.007
更新日期:2009-03-01 00:00:00
abstract:PURPOSE:The study was designed to compare the outcomes of sirolimus (SRL) combined with tacrolimus (TAC) and mycophenolate mofetil (MMF) combined with TAC in kidney transplantation recipients. METHODS:A literature search of PubMed, Embase, and Web of Science was performed to identify relevant studies, and the last upd...
journal_title:Transplantation proceedings
pub_type: 杂志文章,meta分析
doi:10.1016/j.transproceed.2018.08.056
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Intimal hyperplasia plays an important role in vein graft stenosis. Inflammatory injury, especially nuclear factor kappaB (NF-κB) gene activation, is highly involved in stenosis progression. We examined whether neointimal hyperplasia and vein graft stenosis could be inhibited by silencing the NF-κB gene with...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2013.03.045
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVE:Acute cellular rejection in heart transplants is characterized by an active lymphocytic infiltration, whereas the humoral response shows complement deposits in myocardial tissue. Both reactions may produce hemodynamic compromise during the first months after orthotopic heart transplantation (OHT). The aim of ...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2009.08.028
更新日期:2009-10-01 00:00:00
abstract:INTRODUCTION:Adequate perfusion and oxygenation to liver graft after transplantation is essential for its viability. Hepatic oximetry (hepatic tissue oxygenation [LSrO2]) through near infrared spectroscopy (NIRS) can help by showing real time oxygen content of the graft. METHODS:In this prospective study, we enrolled ...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2018.10.023
更新日期:2019-03-01 00:00:00
abstract::Abdominal trauma is divided into blunt and penetrating causes. Massive intraabdominal hemorrhage after injury represents the most dangerous precipitating factor that can affect survival if not promptly managed. The first target to achieve management of bleeding patients is control of the source, and then adequate resu...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.03.119
更新日期:2008-05-01 00:00:00
abstract::Overall, the results seen in this study are encouraging. In this high-risk group of patients where the expected disease rate would normally be at least 55% to 60% without prophylaxis, a combination protocol of GCV, ACV, and CMVIG limited the rate of disease to 19%. When disease occurred, it was generally mild and easi...
journal_title:Transplantation proceedings
pub_type: 杂志文章,评审
doi:
更新日期:1996-12-01 00:00:00
abstract::Diarrhea is a frequent complication of small bowel transplantation in patients and experimental models. Although there are many potential causes, the underlying basis for most are not fully understood. Improved therapeutic approaches will come about through better understanding of mechanisms of bowel adaptation and re...
journal_title:Transplantation proceedings
pub_type: 杂志文章,评审
doi:
更新日期:1996-10-01 00:00:00
abstract:BACKGROUND:In an effort to expand the deceased donor pool, transplant centers have accepted expanded-criteria donors as appropriate for many of the patients in the deceased donor pool. We investigated expanded-criteria deceased donor kidney transplantation and compared the outcomes of kidney transplantation according t...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2013.12.014
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Alterations of erythrocyte membrane fatty acid (FA) composition play important roles in cellular function because they change the membrane microenvironment, including transmembrane receptors. The erythrocyte membrane oleic acid content is higher among patients with acute coronary syndrome and also in dialysi...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2012.04.041
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Kidney transplantation is known to increase the survival of dialysis patients by ameloriating cardiac status, including both systolic and diastolic functions. We aimed to evaluate the role of immunosuppressive drug regimens on cardiac functions of kidney transplant recipients (KTRs). METHODS:We prospectivel...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2017.02.007
更新日期:2017-04-01 00:00:00
abstract:INTRODUCTION:Daclizumab is a monoclonal antibody that binds to the interleukin-2 receptor. It has been used as induction therapy in heart transplantation with two to five repeated administrations over several weeks. The objective of our study was to estimate the efficacy and safety of induction therapy with only one do...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2005.10.086
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:Fas ligand gene transfer to induce peripheral allograft tolerance in animal models has shown controversial results. The immunosuppression effects mediated by engineered FasL depend on whether alloreactive T cells are selectively deleted. In the present study, we tested the feasibility of a strategy to induce...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2005.03.022
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND:Chronic kidney disease (CKD) is a worldwide public health problem and is expressed by increasing amounts of patients on renal replacement therapy (RRT), with significant economic and social impacts. The aim of this work was to analyze socioeconomic and mortality aspects of CKD patients in Santa Catarina (SC)...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2016.06.026
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Heart transplantation is the ultimate treatment for end-stage heart failure. Cardiac sarcoidosis has rarely been reported in heart transplantation worldwide. Their long-term prognosis after heart transplantation is unknown. Herein we have presented clinical and pathological observations among heart transplan...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2012.01.087
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVE:The main objective of the researchers was to determine the level of life quality among heart and kidney transplant recipients depending on the time and type of the transplant. METHODS:The study was conducted using standardized questionnaires: the 36-Item Short-Form Health Survey, Life Orientation Test-Revise...
journal_title:Transplantation proceedings
pub_type: 杂志文章,多中心研究
doi:10.1016/j.transproceed.2020.03.038
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Hepatitis C viral graft reinfection is almost a universal event after liver transplantation with consequent disease progression. METHODS:We applied triple therapy (n = 21) with the use of telaprevir (TVR; n = 12) or simeprevir (SVR; n = 9). RESULTS:TVR was given at the dose 1,500 mg daily (n = 11) with red...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2014.10.058
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate the effects of using thromboembolic deterrent (TED) stockings and intermittent pneumatic compression (IPC) vs a muscle pump activator (MPA) device on limb edema and patient satisfaction after transplant. METHODS:In this single-center randomized controlled trial, 118 pati...
journal_title:Transplantation proceedings
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.transproceed.2019.04.032
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Melanoma is an immune responsive malignancy and the need for immunosuppression for successful transplantation may lead to recurrent disease. The recommended waiting time is unknown with various groups recommending anywhere from no wait to 5 years. METHODS:In this single-center, retrospective observational s...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2020.04.1823
更新日期:2020-12-01 00:00:00
abstract::In Italy, health-care telematic is funded and supported at the level of national government or regional institutions. In 1999, the Italian Ministry of Health started to fund the Liguria-Trento Transplant Network (LTTN) project, a health research project with the aim to build an informative system for donor management ...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2004.02.063
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:Compared to tacrolimus, cyclosporine increases cardiovascular risk. Furthermore, tacrolimus has a negative effect on glucose metabolism compared to cyclosporine. This study investigated the effect of the conversion from cyclosporine to tacrolimus for immunosuppressive therapy on glucose metabolism and cardio...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2019.04.081
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:The goal of this article is to present the experience of a new liver transplant team. MATERIALS AND METHODS:This review includes all patients who received a liver transplant between March 15, 2000 and March 15, 2003. RESULTS:We performed 87 transplantations on 84 patients; 39 were females and 45 were males ...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2004.06.020
更新日期:2004-07-01 00:00:00
abstract::In Poland there is growing demand for biostatic allogeneic bone transplantation mostly for traumatologic operations and orthopedic reconstructions. The bone material is primarily harvested during postmortem examinations in forensic and pathology laboratories. Nevertheless, the collected amounts are not sufficient, so ...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2005.11.075
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Induction therapy improves graft outcomes in kidney transplant recipients (KTRs). We aimed to compare the incidences of antibody-mediated rejection (AMR) and acute cellular rejection (ACR) as well as graft and patient outcomes in KTRs who underwent induction with alemtuzumab versus rabbit-antithymocyte globu...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2014.08.037
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Primary pulmonary hypertension can lead to hypertrophy of the right ventricle and ultimately to its insufficiency. Lung transplantation remains the only viable treatment for patients with certain forms of this disease. Usage of extracorporeal membrane oxygenation in veno-arterial form (VA-ECMO) after transpl...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2020.02.113
更新日期:2020-09-01 00:00:00
abstract:INTRODUCTION:Expansion of donor criteria has become necessary with the increasing number of liver transplantation candidates, as aged donors who have been considered to yield marginal organs. METHODS:Our database of 477 liver transplants (OLT) included 55 cases performed from donors at least 70 years old vs 422 with y...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2005.10.040
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:The loss of renal function and urination with dialysis can produce a strong emotional crisis in a patient. This study explored the correlation between psychic symptoms and quality of life among hemodialysis patients who were older than 55 years of age in relation to demographic characteristics of age, time o...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2012.06.015
更新日期:2012-09-01 00:00:00
abstract::A better understanding of tumor factors influencing patient and graft survival and recurrence of hepatocellular carcinoma (HCC) associated with hepatitis C virus (HCV) cirrhosis may be useful to maximize the benefits of liver transplantation (OLT). Sixty-three adults underwent OLT for end-stage liver disease secondary...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.09.022
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:A higher prevalence of bladder cancer is reported in solid organ recipients, and advanced cancer requires radical cystectomy combined with urinary diversion. Surgery is technically challenging in kidney transplant recipients because of urinary tract abnormalities. Here, we describe the use of a robot-assiste...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2019.12.002
更新日期:2020-03-01 00:00:00