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 adult heart transplant patients receiving quadruple sequential immunosuppression were prospectively randomized into CsA monitoring with T0 (Group I) vs. T6 levels (Group II). Oral CsA was started at a dosage of 2 mg/kg/d, 1-4 d after transplantation. The target range for either T0 or T6 was 150 to 250 ng/ml (enzyme multiplied immunologic technique), respectively. The CsA dose was increased or decreased by 0.5-1 mg/kg/d if the measured level was outside of the target range. Throughout the follow-up period (Group I, 11 +/- 2 months; Group II, 10 +/- 3 months), the incidence of acute rejection (ISHLT grade > or = 2) was 50% in each group. The left ventricular ejection fraction and serum creatinine were similar in both groups at 1 month and at the end of the follow-up. The maximal dose of CsA (mg/kg/d): 3.8 +/- 1 vs. 5 +/- 0.6 (P = 0.002), the minimal dose: 2.2 +/- 0.7 vs. 3.4 +/- 0.8 (P = 0.003), and the current dose: 2.6 +/- 0.6 vs. 3.5 +/- 1 (P = 0.02), were lower in Group II, as well as the cumulative dose of CsA (mg): 61,790 +/- 19,754 vs. 88,524 +/- 18,082 (P = 0.005), and its cost (CDN$): 3,589 +/- 1,116 vs. 5,106 +/- 1,045 (P = 0.005). In conclusion, CsA dose monitoring with T6 was associated with a 30% lower CsA dose and cost compared to T0, with the same effectiveness in the prevention of acute rejection, and similar cardiac and renal function.
journal_name
Clin Transplantjournal_title
Clinical transplantationauthors
Cantarovich M,Besner JG,Fitchett DH,Latter DAsubject
Has Abstractpub_date
1997-10-01 00:00:00pages
399-405issue
5 Pt 1eissn
0902-0063issn
1399-0012journal_volume
11pub_type
临床试验,杂志文章,随机对照试验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::The case of patient with glioblastoma metastatic to the peritoneal cavity 9 months after ventriculoperitoneal shunt surgery precluding cadaver organ procurement is presented. Even though central nervous tumors rarely metastasize spontaneously, the literature indicates that systemic metastases are related to previous s...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:
更新日期:1998-08-01 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::Transplant eligibility for tobacco and/or marijuana using candidates varies among transplant centers. This study compared the impact of marijuana use and tobacco use on kidney transplant recipient outcomes. Kidney transplant recipients at a single center from 2001 to 2015 were reviewed for outcomes of all-cause graft ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13706
更新日期:2019-10-01 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::The aim of this study was to identify indicators of outcome prior to transplantation in allogeneic hematopoietic stem cell transplantation (HCT). Clinical data of 106 patients with acute leukemia were retrospectively analyzed. We examined the role of pre-conditioning serum C-reactive protein (CRP) and ferritin levels,...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12028
更新日期:2012-09-01 00:00:00
abstract::Accurate prognostic indicators are lacking for livers with early marginal graft function, making the decision to re-transplant a difficult one. Therefore, we studied 99mTc-labeled DISIDA scanning as a predictor of recovery of marginal grafts. Records of 28 liver transplant recipients with prolonged periods of marginal...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1994-02-01 00:00:00
abstract:BACKGROUND:Arterial stiffness and left ventricular hypertrophy (LVH) are major independent risk factors for cardiovascular disease in healthy and renal population. In this study, we aimed to investigate comparative long-term effects of renal transplantation (RTx) and of hemodialysis (HD) on both arterial stiffness and ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2008.00794.x
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:The Southeastern Kidney Transplant Coalition was created in 2010 to improve kidney transplant (KTx) rates in Georgia, North Carolina, and South Carolina. To identify dialysis staff-reported barriers to transplant, the Coalition developed a survey of dialysis providers in the region. METHODS:All dialysis uni...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12693
更新日期:2016-04-01 00:00:00
abstract::Lung transplantation remains the only curative treatment option for selected patients with end-stage interstitial lung disease (ILD). Candidate selection is impeded by patient heterogeneity, particularly in the subgroup of non-idiopathic pulmonary fibrosis (non-IPF) interstitial lung diseases. We performed a descripti...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13661
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:This study aimed to investigate the characteristics of lung transplant recipients requiring additional pleural drainage catheters early post-lung transplantation and to determine the safety and efficacy of intrapleural fibrinolytics in these patients. METHODS:A retrospective review of lung transplant recipi...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13592
更新日期:2019-06-01 00:00:00
abstract::Islet yield is an important predictor of acceptable glucose control after total pancreatectomy with islet autotransplantation (TP-IAT). We assessed if pancreas volume calculated with preoperative MRI could assess islet yield and postoperative outcomes. We reviewed dynamic MRI studies from 154 adult TP-IAT patients (20...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.14008
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:There are limited published data concerning the effects of different immunosuppressive regimens on the development of polyomavirus (BKV) viremia. We examined the risk of developing BKV viremia in kidney transplant recipients receiving everolimus (EVR) or mycophenolic acid (MPA) as maintenance therapy. METHO...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.12151
更新日期:2013-07-01 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::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:BACKGROUND:We performed a study to identify differences in the urinary microbiome associated with chronic allograft dysfunction (CAD) and compared the urinary microbiome of male and female transplant recipients with CAD. METHODS:This case-control study enrolled 67 patients within the Deterioration of Kidney Allograft ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13436
更新日期:2018-12-01 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::Mycophenolic acid (MPA) dose reduction is associated with increased risk of rejection and graft loss in renal transplantation. This analysis investigated the impact of MPA dose changes with enteric-coated mycophenolate sodium (EC-MPS) or mycophenolate mofetil (MMF) in de novo heart transplant recipients. In a 12-month...
journal_title:Clinical transplantation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1399-0012.2008.00887.x
更新日期:2008-11-01 00:00:00
abstract::Based on native CT scans of the pelvic region using a standardized calcification score, evaluation of iliac vascular calcification was performed between 2008 and 2012 prior to listing for renal transplantation in 205 patients with chronic kidney disease. Vascular calcification showed a decrease from proximal to distal...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12888
更新日期:2017-03-01 00:00:00
abstract::Hepatitis C virus (HCV) is currently the leading indication worldwide for orthotopic liver transplantation. However, the majority of patients receiving transplant for HCV eventually develop histopathologic evidence of recurrent allograft HCV and approximately 10% die or require retransplantation within the first 5 pos...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2003.00049.x
更新日期:2003-06-01 00:00:00
abstract::Bone mineral density (BMD) in the lumbar spine and femoral neck, the incidence of osteoporosis, and survival up to 10 years after heart transplantation (HT) were investigated in 169 patients who underwent HT at Skåne University Hospital in Lund, Sweden, 1988-2016. Within the first year post-transplantation, mean (SD) ...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.13477
更新日期:2019-03-01 00:00:00
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 ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1998-12-01 00:00:00
abstract:BACKGROUND:The pediatric end stage liver disease (PELD) score has been used widely to prioritize children awaiting cadaveric liver transplantation (LTx). To establish the objective parameter for optimal timing of living-related LTx (LRLTx), we have assessed our cases using the PELD score. METHODS:From 1997 to 2002, 24...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00194.x
更新日期:2004-10-01 00:00:00
abstract::Cytokines, produced by both the recipient and the newly vascularized allograft, are central mediators in the inflammatory response to allografted tissue. This study examines the relationship between pre- and intraoperative levels of TNF, IL-1, IL-6, and IL-8 and hepatic allograft function in the early postoperative pe...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1997-12-01 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: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::Simultaneous pancreas-kidney transplantation is an established procedure for patients with type I diabetes and end-stage renal disease. Continuous advances in the operation techniques with consequent reduction of perioperative morbidity and mortality and the introduction of modern immunosuppressive agents improved not...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/j.1399-0012.2006.00599.x
更新日期:2006-01-01 00:00:00
abstract::The shortage of kidney donors has led to broadening of the acceptance criteria for deceased donor organs beyond the traditional use of young donors. We determined long-term post-transplant outcomes in recipients of dual expanded criteria donor kidneys (dECD, n = 44) and compared them to recipients of standard criteria...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.00956.x
更新日期:2009-06-01 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::Chronic lung allograft dysfunction (CLAD) reduces long-term graft survival. It is important to distinguish CLAD subtypes: bronchiolitis obliterans syndrome (BOS) and restrictive allograft syndrome (RAS) as RAS has a worse prognosis and accurate subtyping could facilitate targeted treatments. However, the current diagn...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13027
更新日期:2017-08-01 00:00:00