Monitoring changes in cyclosporine dosage by trough level testing.

Abstract:

:The concept of a narrow therapeutic window has guided the management of transplant recipients on cyclosporine immunosuppression since its inception more than a decade ago. The need to maintain immunosuppression and avoid toxicity imposed the requirement of monitoring cyclosporine levels within a limited range. The use of circulating trough levels to aid in the adjustment of dosage, however, has also led to controversies. Trough levels did not immediately reflect the dose, and circulating drug levels varied even in the absence of dose changes, indicating the role of factors other than the dose. By introducing a time factor or delay between the dose and trough levels, the sequential delay analysis allows a clearer demonstration of the relationship between doses and trough levels. Using dose adjustments as markers, corresponding changes in the trough levels were observed for most markers after a short delay. The existence of a time factor imposes some restrictions on the scheduling of dose changes and trough level tests. Adjustments in dose need to be separated to avoid interference from each other and the frequency of testing after a change increased to assure its detection. Consideration of the delay should aid in the adjustment of doses and provide an initial step in the understanding of other factors in the relationship between the dose and circulating trough levels.

journal_name

Clin Transplant

journal_title

Clinical transplantation

authors

Takasugi M,Takasugi JK,Barba L

subject

Has Abstract

pub_date

1995-04-01 00:00:00

pages

98-105

issue

2

eissn

0902-0063

issn

1399-0012

journal_volume

9

pub_type

杂志文章
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    authors: Sánchez Fructuoso A,Ruiz JC,Franco A,Diekmann F,Redondo D,Calviño J,Serra N,Aladrén MJ,Cigarrán S,Manonelles A,Ramos A,Gómez G,González Posada JM,Andrés A,Beneyto I,Muñiz AL,Perelló M,Lauzurica R

    更新日期:2020-01-01 00:00:00

  • Post-transplant changes of segment 4 after living related liver transplantation.

    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...

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    doi:

    authors: Cheng YF,Chen CL,Haung TL,Lee TY,Chen TY,Chen YS,Liu PP,Chiang YC,Eng HL,Wang CC,Cheung HK,Jawan B,Goto S

    更新日期:1998-10-01 00:00:00

  • Sequential biological immunosuppression. Induction therapy with rabbit antithymocyte globulin.

    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

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    doi:

    authors: Guttmann RD,Flemming C

    更新日期:1997-06-01 00:00:00

  • Nitric oxide attenuates ischaemia-reperfusion (I/R) injury in the diabetic liver.

    abstract:BACKGROUND:Liver ischaemia-reperfusion (I/R) occurs during resuscitation from haemorrhagic shock, hepatic transplantation and anatomic resection of the liver. This injury is associated with hepatocellular enzyme release and hepatocyte necrosis. The impact of chronic illnesses such as diabetes mellitus (DM) on hepatic I...

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    doi:10.1111/j.1399-0012.2004.00210

    authors: Rogers H 3rd,Zibari GB,Roberts J,Turnage R,Lefer DJ

    更新日期:2004-01-01 00:00:00

  • The effect of sirolimus on sex hormone levels of male renal transplant recipients.

    abstract:BACKGROUND:It is unclear whether sirolimus, a newer immunosuppressive agent, widely used in renal transplantation, affects male sex hormone levels or sexual function. METHODS:Sex hormone profiles in male renal transplant recipients were obtained and compared between a sirolimus-treated group and a group not on sirolim...

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    pub_type: 杂志文章

    doi:10.1111/j.1399-0012.2005.00257.x

    authors: Lee S,Coco M,Greenstein SM,Schechner RS,Tellis VA,Glicklich DG

    更新日期:2005-04-01 00:00:00

  • Foot problems in the diabetic transplant recipient.

    abstract::Diabetic transplant recipients are at a high risk for foot pathology leading to amputation. This retrospective study from 1/85 to 2/95 examines the risk of foot complications in a population (n = 340) of diabetic renal and combined renal/pancreas transplant recipients. All groups suffered high lower extremity amputati...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:

    authors: Kalker AJ,Pirsch JD,Heisey D,Sollinger HW,Belzer FO,Knechtle SJ,D'Alessandro AM

    更新日期:1996-12-01 00:00:00

  • Pattern of resolution of pulmonary hypertension, long-term allograft right ventricular function, and exercise capacity in high-risk heart transplant recipients listed under oral sildenafil.

    abstract::Unresponsive pulmonary hypertension (PH) implies poor posttransplant outcomes. Data on late adaptation of the right ventricle (RV) are still few. This study evaluated three-yr RV function and remodeling, exercise capacity, and hemodynamic data in a selected group of patients initially disqualified because of PH. Betwe...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/ctr.12387

    authors: De Santo LS,Buonocore M,Agrusta F,Bancone C,Galdieri N,Romano G,Maiello C,Amarelli C

    更新日期:2014-07-01 00:00:00

  • Liver allocation: urgency of need or prospect of success? Ethical considerations.

    abstract::In German legislation and in Eurotransplant's practice of liver allocation, urgency of need is considered as the primary distribution criterion. However, at a certain stage, the "sickest-first" principle is regarded as counterproductive as the performance status of these patients receiving an organ is on average criti...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/ctr.12154

    authors: Bobbert M,Ganten TM

    更新日期:2013-07-01 00:00:00

  • Factors associated with skin cancer in lung transplant recipients: A single-center experience.

    abstract:BACKGROUND:Skin cancer is common after solid organ transplantation, but few have investigated it after lung transplant (LTx). OBJECTIVE:We assessed incidence and predictors of non-melanoma skin cancer (NMSC) post-LTx. METHODS:We studied patients who underwent LTx at our center from 2012 to 2015. RESULTS:Of 287 patie...

    journal_title:Clinical transplantation

    pub_type: 临床试验,杂志文章

    doi:10.1111/ctr.13718

    authors: Elnahas S,Olson MT,Kang P,Panchanathan R,Masuda T,Walia R,Zeitouni NC,Smith MA,Bremner RM

    更新日期:2019-12-01 00:00:00

  • A call to action: Feasible strategies to reduce the discard of transplantable kidneys in the United States.

    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

    authors: Stewart ZA,Shah SA,Formica RN,Kandaswamy R,Paramesh AS,Friedman J,Squires R,Cooper M,Axelrod DA

    更新日期:2020-09-01 00:00:00

  • Parvovirus B19 infection in a liver transplant recipient: case report and review in organ transplant recipients.

    abstract::We report an adult liver transplant recipient with parvovirus B19 infection, presenting as chronic transfusion-dependent anemia ensuing 1 month post-transplantation. Both serum and bone marrow cells were positive for parvovirus B19 DNA detected by polymerase chain reaction. The bone marrow biopsy revealed erythroid hy...

    journal_title:Clinical transplantation

    pub_type: 杂志文章,评审

    doi:

    authors: Chang FY,Singh N,Gayowski T,Marino IR

    更新日期:1996-06-01 00:00:00

  • Adverse drug reaction driven immunosuppressive drug manipulations: a single-center comparison of enteric-coated mycophenolate sodium vs. mycophenolate mofetil.

    abstract:UNLABELLED:Enteric-coated mycophenolate sodium (MPS) has been developed to help circumvent the upper gastrointestinal side-effects of mycophenolic acid by facilitating drug release in the small intestine. Many questions regarding the side-effect profile of MPS remain. Therefore, the purpose of this study is to review a...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/j.1399-0012.2008.00820.x

    authors: Hardinger KL,Hebbar S,Bloomer T,Murillo D

    更新日期:2008-09-01 00:00:00

  • Urinary tract infections after renal transplantation: a retrospective review at two US transplant centers.

    abstract::Urinary tract infections (UTIs) are the most common infectious complication following renal transplantation. Previous studies uniformly report that renal transplant recipients develop UTIs more often than the general population, but widely differ on how frequently UTIs occur after transplantation. These studies also d...

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    pub_type: 杂志文章

    doi:10.1111/j.1399-0012.2005.00327.x

    authors: Chuang P,Parikh CR,Langone A

    更新日期:2005-04-01 00:00:00

  • Prognostication of inflammatory cells in liver transplantation: Is the waitlist neutrophil-to-lymphocyte ratio really predictive of tumor biology?

    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

    authors: McVey JC,Sasaki K,Firl DJ,Fujiki M,Diago-Uso T,Quintini C,Eghtesad B,Miller CC,Hashimoto K,Aucejo FN

    更新日期:2019-12-01 00:00:00

  • Quality of life assessment in renal transplant: review and future directions.

    abstract::We performed a systematic search of the literature using the MEDLINE (through 2006) database to identify the patient-reported outcome measures of quality of life (QOL) used most often in the renal transplant literature. After applying limits and reviewing references, we identified 338 renal transplant articles with a ...

    journal_title:Clinical transplantation

    pub_type: 杂志文章,评审

    doi:10.1111/j.1399-0012.2007.00784.x

    authors: Butt Z,Yount SE,Caicedo JC,Abecassis MM,Cella D

    更新日期:2008-05-01 00:00:00

  • Use of immune globulin to prevent symptomatic cytomegalovirus disease in transplant recipients--a meta-analysis.

    abstract::The objective of this meta-analysis was to review the evidence for the use of immune globulin in the prevention of symptomatic cytomegalovirus (CMV) disease in transplant recipients. A computerized search of Medline from 1980 to October 1991 was conducted using the textword "cytomegalo:" and the subheading "prevention...

    journal_title:Clinical transplantation

    pub_type: 杂志文章,meta分析

    doi:

    authors: Glowacki LS,Smaill FM

    更新日期:1994-02-01 00:00:00

  • Crystalloid flush with backward unclamping may decrease post-reperfusion cardiac arrest and improve short-term graft function when compared to portal blood flush with forward unclamping during liver transplantation.

    abstract::During liver transplant (LT), the release of vasoactive substances into the systemic circulation is associated with severe hemodynamic instability that is injurious to the recipient and/or the post-ischemic graft. Crystalloid flush with backward unclamping (CB) and portal blood flush with forward unclamping (PF) are t...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:10.1111/ctr.12130

    authors: Fukazawa K,Nishida S,Hibi T,Pretto EA Jr

    更新日期:2013-07-01 00:00:00

  • Conversion from sirolimus to everolimus in kidney transplant recipients receiving a calcineurin-free regimen.

    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

    authors: Carvalho C,Coentrão L,Bustorff M,Patrício E,Sampaio S,Santos J,Oliveira G,Pestana M

    更新日期:2011-07-01 00:00:00

  • Sequential anastomosis of accessory renal artery to inferior epigastric artery in the management of multiple arteries in live related renal transplantation: a critical appraisal.

    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

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    doi:10.1034/j.1399-0012.2001.150209.x

    authors: Kumar A,Gupta RS,Srivastava A,Bansal P

    更新日期:2001-04-01 00:00:00

  • Cardiac diastolic dysfunction in renal-transplant recipients is associated with increased circulating Adrenomedullin.

    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

    authors: Geny B,Ellero B,Chakfé N,Kretz JG,Brandenberger G,Piquard F

    更新日期:2006-05-01 00:00:00

  • Kaposi's sarcoma in two primary liver allograft recipients occurring under FK506 immunosuppression.

    abstract::Of 1463 liver allograft recipients receiving the combination of FK506 and steroids as their primary immunosuppressive regimen, 2 patients developed Kaposi's sarcoma. Although previously described as a complication of organ transplantation, this is the first case report of Kaposi's sarcoma occurring in association with...

    journal_title:Clinical transplantation

    pub_type: 杂志文章

    doi:

    authors: Kadry Z,Bronsther O,Van Thiel DH,Randhawa P,Fung JJ,Starzl TE

    更新日期:1993-01-01 00:00:00

  • Perspectives on donor lung allocation from both sides of the Atlantic: The United States.

    abstract::Donor lung allocation in the United States focuses on decreasing waitlist mortality and improving recipient outcomes. The implementation of allocation policy to match deceased donor lungs to waitlisted patients occurs through a unique partnership between government and private organizations, namely the Organ Procureme...

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    authors: Tsuang WM,Snyder LD,Budev MM

    更新日期:2020-07-01 00:00:00

  • Perioperative outcomes of coronary artery bypass graft in renal transplant recipients in the United States: results from the Nationwide Inpatient Sample.

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    pub_type: 杂志文章

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    authors: Tooley JE,Bohl DD,Kulkarni S,Rodriguez-Davalos MI,Mangi A,Mulligan DC,Yoo PS

    更新日期:2016-10-01 00:00:00

  • Prolonged cardiac allograft ischemic time--no impact on long-term survival but at what cost?

    abstract:INTRODUCTION:The aim of this paper was to review the outcomes of cardiac transplantation with regards to short- and long-term survival, focusing particularly on patients who receive organs with long ischemic times and the resource utilization necessary to support such patients through their postoperative period. METHO...

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    pub_type: 杂志文章

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    authors: Marasco SF,Esmore DS,Richardson M,Bailey M,Negri J,Rowland M,Kaye D,Bergin PJ

    更新日期:2007-05-01 00:00:00

  • Multiple renal arteries do not pose an impediment to the routine use of laparoscopic donor nephrectomy.

    abstract:UNLABELLED:Since the first description by Ratner and collegues in 1996, laparoscopic live-donor nephrectomy is gaining wide acceptance in an attempt to minimize the donor morbidity, length of hospital stay and length of time to return to work. It is unknown whether multiple renal arteries pose additional problems with ...

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    pub_type: 杂志文章

    doi:10.1034/j.1399-0012.2001.00012.x

    authors: Johnston T,Reddy K,Mastrangelo M,Lucas B,Ranjan D

    更新日期:2001-01-01 00:00:00

  • Lung transplantation for patients with end-stage Sauropus androgynus-induced bronchiolitis obliterans (SABO) syndrome.

    abstract::Sauropus androgymus (SA), a vegetable of the Euphorbiaceae family, is a common food source in Malaysia. In Taiwan, over 30 patients have developed progressive respiratory failure after consuming the extract from raw SA leaves as a means of losing weight. Symptoms consistent with a severe obstructive ventilatory defect...

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    authors: Luh SP,Lee YC,Chang YL,Wu HD,Kuo SH,Chu SH

    更新日期:1999-12-01 00:00:00

  • Transplantation of a severely lacerated liver--a case report with review of the literature.

    abstract::Using lacerated livers for liver transplantation (LTx) can add an option to the extended donor criteria. We present an LTx case using a severely lacerated liver and review of the literature for reported cases. We used a high-grade lacerated liver from a 19-yr-old brain-dead patient caused by traffic accident. The live...

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    更新日期:2009-06-01 00:00:00

  • Indications and outcomes of pancreatic surgery after liver transplantation.

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    pub_type: 杂志文章

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    更新日期:2014-03-01 00:00:00

  • Pseudoaneurysm of the superior mesenteric artery with an arteriovenous fistula after simultaneous kidney-pancreas transplantation.

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    pub_type: 杂志文章

    doi:10.1034/j.1399-0012.1999.130310.x

    authors: Khan TF,Ciancio G,Burke GW 3rd,Sfakianakis GN,Miller J

    更新日期:1999-06-01 00:00:00

  • Limitations of pediatric donor kidneys for transplantation.

    abstract:BACKGROUND:The shortage of grafts for kidney transplantation (Tx) has resulted in an expansion of criteria for pediatric donors. However, the limitations of pediatric donors for kidney Tx are not yet clearly established. We investigated the outcomes of recipients with pediatric kidney grafts from Colorado to elucidate ...

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    pub_type: 杂志文章

    doi:

    authors: Yagisawa T,Kam I,Chan L,Springer JW,Dunn S

    更新日期:1998-12-01 00:00:00