Abstract:
INTRODUCTION:An important side effect of sirolimus, a drug often used in organ transplantation, is pulmonary toxicity. MATERIALS AND METHODS:We present five kidney transplant patients who developed this toxicity associated with sirolimus. All underwent chest radiography computed tomography, fiberoptic bronchoscopy with bronchoalveolar lavage (BAL), microbiological studies of the bronchial aspirate, blood, and sputum, and cytomegalovirus (CMV) polymerase chain reaction (PCR) in blood as well as two had transbronchial biopsies. RESULTS:All five were men of mean age 54.8 +/- 10.3 years. In two sirolimus formed part of de novo therapy, and three were converted from calcineurin inhibitors. The mean treatment time was 16.6 +/- 13.7 months, with trough levels of 11.3 +/- 3 ng/mL. The patients presented with fever, cough, dyspnea, anemia, and dyslipidemia. The radiological pattern was diffuse alveolointerstitial (n = 2), or bilateral basal interstitial (n = 2), or bilateral basal alveolar (n = 1). The cell count in the BAL was 95% to 99% macrophages. In two patients cultures for bacteria were positive: Hemophilus and Pseudomonas. Tests for fungi, mycobacteria, pneumocystis, and legionella, as well as PCR for CMV were all negative. Transbronchial biopsy yielded insufficient material in one patient and a deposit of fibrinoid material and nonnecrotizing granuloma in the other. Antibacterial therapy was started, three with cotrimoxazole and two with ganciclovir, with no response. The respiratory symptoms improved after withdrawal of sirolimus (mean, 2.4 +/- 1.5 days). The mean hospital stay was 19.8 +/- 14.1 days. CONCLUSION:Pulmonary toxicity due to sirolimus should be included in the differential diagnosis of kidney transplant patients who display signs of interstitial pneumonia. Its diagnosis is difficult requiring exclusion of other pulmonary diseases. Resolution of the symptoms was quick after suspension of the drug.
journal_name
Transplant Procjournal_title
Transplantation proceedingsauthors
Sola E,Lopez V,Burgos D,Cabello M,Gutierrez C,Martin A,Peña M,Gonzalez-Molina Mdoi
10.1016/j.transproceed.2006.08.037subject
Has Abstractpub_date
2006-10-01 00:00:00pages
2438-40issue
8eissn
0041-1345issn
1873-2623pii
S0041-1345(06)00934-1journal_volume
38pub_type
杂志文章abstract::The aims of this study were to define in a cohort of 310 liver transplant recipients, the incidence of post-liver transplantation (LT) non-carbapenem-resistant Klebsiella pneumoniae (CRKP) and CRKP infections, pre- and post-LT CRKP colonization, CRKP-associated mortality, and risk factors for non-CRKP and CRKP infecti...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2017.02.028
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:The risk of the development of renal cell cancer (RCC) in renal transplant recipients is several times higher than the general population. There can often be a delay between initial radiological imaging and patients undergoing renal transplantation. We present and evaluate the prevalence and clinical charact...
journal_title:Transplantation proceedings
pub_type: 杂志文章,多中心研究
doi:10.1016/j.transproceed.2015.06.009
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Introduction of everolimus (RAD) has been established as a new immunosuppressive medication for kidney transplant (KT) recipients. Administration of RAD is capable of reducing the dosage of coadministrated calcineurin inhibitors (CNI). However, histological investigations have rarely been performed. METHODS...
journal_title:Transplantation proceedings
pub_type: 临床试验,杂志文章
doi:10.1016/j.transproceed.2014.09.180
更新日期:2015-04-01 00:00:00
abstract:INTRODUCTION:Rabbit antithymocyte globulin (RATG) is recommended for central administration, and no evidence justifies the common practice of adding heparin to the bag, but the evaluation of thrombocytopenia may be complicated by coadministration. We recently phased out the use of heparin in RATG in our kidney and kidn...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2004.09.086
更新日期:2004-12-01 00:00:00
abstract::The Prometheus system is a plasma filtration treatment coupling adsorption and hemodialysis (FPSA) aimed to blood purification in liver failure. After separation through an albumin-permeable membrane, plasma enters a secondary circuit where protein-bound toxic substances are removed by two adsorbers; p01, a neutral re...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2006.02.017
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate the early protection of ischemic preconditioning (IPC) and its mechanisms in transplanted rat kidneys. MATERIALS AND METHODS:Thirty-six male Sprague-Dawley (SD) rat donors and recipients were randomly divided into the following groups: sham-operated group (A; n = 6); ...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.06.113
更新日期:2008-12-01 00:00:00
abstract::The primary cause of morbidity and mortality in renal transplantation is cardiovascular disease. Increased oxidative stress implies a greater degree of atherogenesis in these patients. N-acetylcysteine (NAC) which has a thiol group that is the source of l-cysteine and reduced glutathione, acts against atherosclerosis ...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.08.109
更新日期:2008-11-01 00:00:00
abstract::In vitro studies have demonstrated that cold ischemic preservation (CIP) employed in small bowel transplantation produces loss of intestinal motility due to severe lesions of autonomic enteric nerves and that this autonomic dysfunction is attenuated by antioxidant agents. In this work, we investigated whether preserva...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2006.05.024
更新日期:2006-07-01 00:00:00
abstract:OBJECTIVES:Organ preservation is one of the important steps that predicts the patient outcome. However, after revascularization, the high concentration of potassium that influxes into the circulation might cause immediate postreperfusion hyperkalemia. To prevent this complication, the portal vein has been washed out wi...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.06.035
更新日期:2008-09-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2010.08.028
更新日期:2010-11-01 00:00:00
abstract:PURPOSE:The aim of this study is to evaluate the incidence, risk factors, and prognosis of acute kidney injury (AKI) after lung transplantation (LTx). METHODS:Records of patients who underwent LTx in a single center were retrospectively reviewed. The prevalence of post-transplant AKI, the use of continuous renal repla...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2020.10.031
更新日期:2020-12-14 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate the frequency and main risk factors for corneal graft rejection. PATIENTS AND METHODS:This retrospective study included 285 eyes in 256 patients who underwent a penetrating keratoplasty (KPT) from January 1995 to December 2004. The minimum follow-up was 12 months to eval...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2007.08.020
更新日期:2007-10-01 00:00:00
abstract::The FcgammaRIIa receptors, which provide a crucial link between cellular and humoral components of the immune response, display allelic polymorphism. Individuals are homozygous for either arginine 131 (RR131) or histidine 131 (HH131) or are heterozygous for these two alleles (RH131). The HH131 genotype binds human IgG...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2004.05.076
更新日期:2004-06-01 00:00:00
abstract::Establishment of an efficient gene delivery system for human pancreatic beta cells is important for the development of diabetes-targeted cell therapies. The human immunodeficiency virus type 1 (HIV-1)-derived lentiviral vector is well documented to be an effective gene transfer tool for various types of cells. Thus, w...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2004.08.140
更新日期:2004-09-01 00:00:00
abstract:UNLABELLED:Extravesical ureteroneocystostomy to reestablish urinary tract continuity in renal transplantation has been examined through a meta-analysis of more than 14,000 kidney transplants leading to the finding that stented anastomosis was associated with a lower urologic complication rate compared with nonstented a...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2004.10.061
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:Clinical studies of uterus transplantation have been performed to treat uterine factor infertility. Because the uterus is a pelvic visceral organ, the method of perfusion for the procurement of vital organs from a brain-dead donor should be modified for removal of the uterus. Herein, we report the results of...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2015.12.105
更新日期:2016-05-01 00:00:00
abstract:UNLABELLED:Thymoglobulin is used as an induction agent in kidney transplantation, but the optimal dose is not well established. However, its use may be associated with increased infectious complications after transplantation. METHODS:This retrospective study of 61 high-risk renal recipients of transplants from decease...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2007.01.024
更新日期:2007-03-01 00:00:00
abstract:INTRODUCTION:Most psychosocial attitude studies for donors are not evaluated and are not valid. Validated questionnaires are necessary to compare results and guarantee that they measure what they are intended to measure. OBJECTIVE:To analyze the psychometric characteristics of the attitude questionnaire toward the don...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2017.11.063
更新日期:2018-03-01 00:00:00
abstract:INTRODUCTION:Nephropathy due to polyomavirus is usually diagnosed by renal biopsy after worsening of renal function. This is normally at an advanced stage of the disease. AIM:To study the early detection of the presence of BK and JC polyomavirus in urine by monthly real-time quantitative polymerase chain reaction (PCR...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.08.098
更新日期:2008-11-01 00:00:00
abstract::Although a generalized consensus has been reached for therapeutic drug monitoring of cyclosporine microemulsion in adult transplant patients, clear guidelines are recently not available for the pediatric population. In this retrospective analysis of pharmacokinetic data obtained from stable, long-term, pediatric kidne...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2004.03.010
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:Renal transplantation is the ideal renal replacement therapy in patients with end-stage renal disease. It was unclear whether a difference in dialysis modality influences outcomes after kidney transplantation. Therefore, we evaluated the influence of dialysis modality. METHODS:We compared various clinical a...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2011.01.027
更新日期:2011-03-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2013.10.009
更新日期:2013-01-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章
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更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:To evaluate the diagnostic accuracy of intravoxel incoherent motion (IVIM) parameters in estimation of hepatocellular carcinoma (HCC) grading. MATERIALS AND METHODS:Twenty-nine patients with histopathologically diagnosed as 42 HCC at explant were included in this retrospective study. All patients were exami...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2019.02.027
更新日期:2019-01-01 00:00:00
abstract::Posttransplant lymphoproliferative disease remains a serious morbidity. Herein we have reported a case of complete regression of a biopsy-proven B-cell lymphoma that occurred in the posttransplant period. A 48-year-old man received a living donor renal transplant for end-stage renal disease due to undetermined etiolog...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2007.03.092
更新日期:2007-05-01 00:00:00
abstract::The early results of liver transplantations (OLT) in patients with advanced hepatocellular carcinoma (HCC) were poor because of frequent tumor recurrence. However, OLT has significant, theoretical advantage that it removes both the tumor and the organ that is at a risk of malignancy. The Japanese law on organ transpla...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2012.01.029
更新日期:2012-03-01 00:00:00
abstract::Serum nucleosomes have been suggested to be markers for cell death and apoptosis. Increased hepatocyte apoptosis can be demonstrated in acute liver failure (ALF) as well as acute-on-chronic liver failure (ACLF). We investigated the relevance of nucleosomes in the setting of acute hepatic failure. Further, we studied t...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2009.08.073
更新日期:2009-12-01 00:00:00
abstract:OBJECTIVE:Human leukocyte antigen match is the most important donor factor affecting transplant outcome. The HLA-DPB1 mismatch on the clinical outcome of hematopoietic stem cell transplant (HSCT) is less clear. This study is the first meta-analysis to investigate the impact of HLA-DPB1 loci mismatch on clinical outcome...
journal_title:Transplantation proceedings
pub_type: 杂志文章,meta分析
doi:10.1016/j.transproceed.2019.04.053
更新日期:2019-01-01 00:00:00
abstract::To assess the safety and efficacy of allogeneic stem cell transplantation from haploidentical related donors (haplo-SCT) as 2nd transplantation for patients with early relapsed disease, we retrospectively evaluated 7 consecutive patients (median age, 42 years; range, 29-63 years) who experienced relapse within 1 year ...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2014.04.011
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Rejection is an important factor affecting graft function in renal transplant patients. Development of acute rejection even after induction treatment suggests that humoral and cellular immune systems are not the only mechanisms responsible for this event. The innate immune system can play roles in rejection....
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2020.02.176
更新日期:2020-12-01 00:00:00