Journal of Transplantation最新文献_第10页

Attitudes to medication after kidney transplantation and their association with medication adherence and graft survival: a 2-year follow-up study. 肾移植术后用药态度及其与药物依从性和移植物存活的关系:一项2年随访研究。

IF 2.5

Journal of Transplantation Pub Date : 2014-01-01 Epub Date: 2014-04-28 DOI: 10.1155/2014/675301

Mirjam Tielen, Job van Exel, Mirjam Laging, Denise K Beck, Roshni Khemai, Teun van Gelder, Michiel G H Betjes, Willem Weimar, Emma K Massey

{"title":"Attitudes to medication after kidney transplantation and their association with medication adherence and graft survival: a 2-year follow-up study.","authors":"Mirjam Tielen, Job van Exel, Mirjam Laging, Denise K Beck, Roshni Khemai, Teun van Gelder, Michiel G H Betjes, Willem Weimar, Emma K Massey","doi":"10.1155/2014/675301","DOIUrl":"https://doi.org/10.1155/2014/675301","url":null,"abstract":"Background. Nonadherence to medication is a common problem after kidney transplantation. The aim of this study was to explore attitudes towards medication, adherence, and the relationship with clinical outcomes. Method. Kidney recipients participated in a Q-methodological study 6 weeks after transplantation. As a measure of medication adherence, respondents completed the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS(©)-interview). Moreover, the intrapatient variability in the pharmacokinetics of tacrolimus was calculated, which measures stability of drug intake. Data on graft survival was retrieved from patient records up to 2 years after transplantation. Results. 113 renal transplant recipients (19-75 years old) participated in the study. Results revealed three attitudes towards medication adherence-attitude 1: \"confident and accurate,\" attitude 2: \"concerned and vigilant,\" and attitude 3: \"appearance oriented and assertive.\" We found association of attitudes with intrapatient variability in pharmacokinetics of tacrolimus, but not with self-reported nonadherence or graft survival. However, self-reported nonadherence immediately after transplantation was associated with lower two-year graft survival. Conclusion. These preliminary findings suggest that nonadherence shortly after kidney transplantation may be a risk factor for lower graft survival in the years to follow. The attitudes to medication were not a risk factor. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2014 ","pages":"675301"},"PeriodicalIF":2.5,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/675301","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32375884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 72

Anemia control in kidney transplant recipients using once-monthly continuous erythropoietin receptor activator: a prospective, observational study. 肾移植受者使用每月一次的连续促红细胞生成素受体激活剂控制贫血:一项前瞻性观察性研究。

IF 2.5

Journal of Transplantation Pub Date : 2014-01-01 Epub Date: 2014-05-04 DOI: 10.1155/2014/179705

Klemens Budde, Thomas Rath, Volker Kliem

{"title":"Anemia control in kidney transplant recipients using once-monthly continuous erythropoietin receptor activator: a prospective, observational study.","authors":"Klemens Budde, Thomas Rath, Volker Kliem","doi":"10.1155/2014/179705","DOIUrl":"https://doi.org/10.1155/2014/179705","url":null,"abstract":"In a multicenter, prospective, observational study of 279 kidney transplant recipients with anemia, the efficacy and safety of once-monthly continuous erythropoietin receptor activator (C.E.R.A.) were assessed to a maximum of 15 months. The main efficacy variable was the proportion of patients achieving a hemoglobin level of 11-12 g/dL at each of visits between months 7 and 9. At study entry, 224 patients (80.3%) were receiving erythropoiesis stimulating agent (ESA) therapy including darbepoetin alfa (98), epoetin beta (61), and C.E.R.A. (45). The mean (SD) time between C.E.R.A. applications was 34.0 (11.9) days. Among 193 patients for whom efficacy data were available, mean (SD) hemoglobin was 11.1 (0.99) g/dL at study entry, 11.5 (1.1) g/dL at month 7, 11.6 (1.3) g/dL at month 9, and 11.4 (1.1) g/dL at month 15. During months 7-9, 20.7% of patients had all hemoglobin values within the range 11-12 g/dL and 64.8% were within 10-13 g/dL. Seven patients (2.5%) discontinued C.E.R.A. due to adverse events or serious adverse events. In this observational trial under real-life conditions, once-monthly C.E.R.A. therapy achieved stable hemoglobin levels in stable kidney transplant recipients with good tolerability, and with no requirement for any dose change in 43% of patients. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2014 ","pages":"179705"},"PeriodicalIF":2.5,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/179705","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32387225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11

Risk-stratified cardiovascular screening including angiographic and procedural outcomes of percutaneous coronary interventions in renal transplant candidates. 风险分层心血管筛查，包括经皮冠状动脉介入治疗肾移植候选人的血管造影和手术结果。

IF 2.5

Journal of Transplantation Pub Date : 2014-01-01 Epub Date: 2014-06-19 DOI: 10.1155/2014/854397

Julian König, Martin Möckel, Eda Mueller, Wolfgang Bocksch, Seema Baid-Agrawal, Nina Babel, Ralf Schindler, Petra Reinke, Peter Nickel

{"title":"Risk-stratified cardiovascular screening including angiographic and procedural outcomes of percutaneous coronary interventions in renal transplant candidates.","authors":"Julian König, Martin Möckel, Eda Mueller, Wolfgang Bocksch, Seema Baid-Agrawal, Nina Babel, Ralf Schindler, Petra Reinke, Peter Nickel","doi":"10.1155/2014/854397","DOIUrl":"10.1155/2014/854397","url":null,"abstract":"Background. Benefits of cardiac screening in kidney transplant candidates (KTC) will be dependent on the availability of effective interventions. We retrospectively evaluated characteristics and outcome of percutaneous coronary interventions (PCI) in KTC selected for revascularization by a cardiac screening approach. Methods. In 267 patients evaluated 2003 to 2006, screening tests performed were reviewed and PCI characteristics correlated with major adverse cardiovascular events (MACE) during a follow-up of 55 months. Results. Stress tests in 154 patients showed ischemia in 28 patients (89% high risk). Of 58 patients with coronary angiography, 38 had significant stenoses and 18 cardiac interventions (6.7% of all). 29 coronary lesions in 17/18 patients were treated by PCI. Angiographic success rate was 93.1%, but procedural success rate was only 86.2%. Long lesions (P = 0.029) and diffuse disease (P = 0.043) were associated with MACE. In high risk patients, cardiac screening did not improve outcome as 21.7% of patients with versus 15.5% of patients without properly performed cardiac screening had MACE (P = 0.319). Conclusion. The moderate procedural success of PCI and poor outcome in long and diffuse coronary lesions underscore the need to define appropriate revascularization strategies in KTC, which will be a prerequisite for cardiac screening to improve outcome in these high-risk patients. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2014 ","pages":"854397"},"PeriodicalIF":2.5,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/854397","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32520870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

Interstitial Lung Disease Associated with mTOR Inhibitors in Solid Organ Transplant Recipients: Results from a Large Phase III Clinical Trial Program of Everolimus and Review of the Literature. 实体器官移植受者的间质性肺病与 mTOR 抑制剂有关：依维莫司大型 III 期临床试验计划的结果及文献综述》。

IF 2.5

Journal of Transplantation Pub Date : 2014-01-01 Epub Date: 2014-12-18 DOI: 10.1155/2014/305931

Patricia Lopez, Sven Kohler, Seema Dimri

{"title":"Interstitial Lung Disease Associated with mTOR Inhibitors in Solid Organ Transplant Recipients: Results from a Large Phase III Clinical Trial Program of Everolimus and Review of the Literature.","authors":"Patricia Lopez, Sven Kohler, Seema Dimri","doi":"10.1155/2014/305931","DOIUrl":"10.1155/2014/305931","url":null,"abstract":"Interstitial lung disease (ILD) has been reported with the use of mammalian target of rapamycin inhibitors (mTORi). The clinical and safety databases of three Phase III trials of everolimus in de novo kidney (A2309), heart (A2310), and liver (H2304) transplant recipients (TxR) were searched using a standardized MedDRA query (SMQ) search for ILD followed by a case-by-case medical evaluation. A literature search was conducted in MEDLINE and EMBASE. Out of the 1,473 de novo TxR receiving everolimus in Phase III trials, everolimus-related ILD was confirmed in six cases (one kidney, four heart, and one liver TxR) representing an incidence of 0.4%. Everolimus was discontinued in three of the four heart TxR, resulting in ILD improvement or resolution. Outcome was fatal in the kidney TxR (in whom everolimus therapy was continued) and in the liver TxR despite everolimus discontinuation. The literature review identified 57 publications on ILD in solid organ TxR receiving everolimus or sirolimus. ILD presented months or years after mTORi initiation and symptoms were nonspecific and insidious. The event was more frequent in patients with a late switch to mTORi. In most cases, ILD was reversed after prompt mTORi discontinuation. ILD induced by mTORi is an uncommon and potentially fatal event warranting early recognition and drug discontinuation. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2014 ","pages":"305931"},"PeriodicalIF":2.5,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4281397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32968615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Outcomes of Renal Transplantation in Brunei Darussalam over a Twenty-Year Period (1993-2012). 文莱达鲁萨兰国在1993-2012年期间肾脏移植的结果。

IF 2.5

Journal of Transplantation Pub Date : 2014-01-01 Epub Date: 2014-11-12 DOI: 10.1155/2014/784805

Jackson Tan, Muhammad Abdul Mabood Khalil, Si Yen Tan, Muhammad Khalil, Dalinatul Ahmed, Shaukat Zinna, William Chong

{"title":"Outcomes of Renal Transplantation in Brunei Darussalam over a Twenty-Year Period (1993-2012).","authors":"Jackson Tan, Muhammad Abdul Mabood Khalil, Si Yen Tan, Muhammad Khalil, Dalinatul Ahmed, Shaukat Zinna, William Chong","doi":"10.1155/2014/784805","DOIUrl":"https://doi.org/10.1155/2014/784805","url":null,"abstract":"Objectives. Brunei Darussalam has a high prevalence and incidence of end stage renal disease (ESRD). Up until 2012, all renal transplantations were performed in overseas centres, either as government-sponsored (living-related transplantation) or as self-sponsored (commercialized transplantation) ones. We hypothesize that graft and patient survival of Brunei renal transplant patients are on a par with international standards. Materials and Methods. Data of all renal transplant patients in Brunei were analysed over a twenty-year period from registry records and case notes. Comparative survival data from other countries were obtained from PubMed-listed literature. Results. A total of 49 transplantation procedures were performed in foreign centres between 1993 and 2012. 29 were government-sponsored and 20 were self-sponsored transplantations. The 5- and 10-year overall patient survival rates were 93.3% and 90.1%, respectively. The 5- and 10-year overall graft survival rates were 91.1% and 81.2%. There is no difference in the survival outcomes of government-sponsored and self-sponsored patients. Living-related (government-sponsored) and commercialised (self-sponsored) grafts had equivalent survival to those reported in the literature. Conclusion. Our survival data was on par with those achieved in many countries. We hope to use this information to convince local stakeholders and patients to favour transplantation as the preferred modality of RRT. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2014 ","pages":"784805"},"PeriodicalIF":2.5,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/784805","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32883303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

Resolution of Mild Ganciclovir-Resistant Cytomegalovirus Disease with Reduced-Dose Cidofovir and CMV-Hyperimmune Globulin. 减少剂量西多福韦和巨细胞病毒高免疫球蛋白治疗轻度更昔洛韦耐药巨细胞病毒病

IF 2.5

Journal of Transplantation Pub Date : 2014-01-01 Epub Date: 2014-06-01 DOI: 10.1155/2014/342319

Samir J Patel, Samantha A Kuten, Richard J Knight, Dana M Hong, A Osama Gaber

{"title":"Resolution of Mild Ganciclovir-Resistant Cytomegalovirus Disease with Reduced-Dose Cidofovir and CMV-Hyperimmune Globulin.","authors":"Samir J Patel, Samantha A Kuten, Richard J Knight, Dana M Hong, A Osama Gaber","doi":"10.1155/2014/342319","DOIUrl":"https://doi.org/10.1155/2014/342319","url":null,"abstract":"Ganciclovir-resistant cytomegalovirus (CMV) is associated with significant morbidity in solid organ transplant recipients. Management of ganciclovir-resistant CMV may be complicated by nephrotoxicity which is commonly observed with recommended therapies and/or rejection induced by \"indirect\" viral effects or reduction of immunosuppression. Herein, we report a series of four high serologic risk (donor CMV positive/recipient CMV negative) kidney transplant patients diagnosed with ganciclovir-resistant CMV disease. All patients initially developed \"breakthrough\" viremia while still receiving valganciclovir prophylaxis after transplant and were later confirmed to exhibit UL97 mutations after failing to eradicate virus on adequate dosages of valganciclovir. The patients were subsequently and successfully treated with reduced-dose (1-2 mg/kg) cidofovir and CMV-hyperimmune globulin, given in 2-week intervals. In addition, all patients exhibited stable renal function after completion of therapy, and none experienced acute rejection. The combination of reduced-dose cidofovir and CMV-hyperimmune globulin appeared to be a safe and effective regimen in patients with mild disease due to ganciclovir-resistant CMV. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2014 ","pages":"342319"},"PeriodicalIF":2.5,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/342319","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32479005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11

An Association between BK Virus Replication in Bone Marrow and Cytopenia in Kidney-Transplant Recipients. 肾移植受者骨髓中BK病毒复制与细胞减少的关系

IF 2.5

Journal of Transplantation Pub Date : 2014-01-01 Epub Date: 2014-04-29 DOI: 10.1155/2014/252914

Emilie Pambrun, Catherine Mengelle, Geneviève Fillola, Patrick Laharrague, Laure Esposito, Isabelle Cardeau-Desangles, Arnaud Del Bello, Jacques Izopet, Lionel Rostaing, Nassim Kamar

{"title":"An Association between BK Virus Replication in Bone Marrow and Cytopenia in Kidney-Transplant Recipients.","authors":"Emilie Pambrun, Catherine Mengelle, Geneviève Fillola, Patrick Laharrague, Laure Esposito, Isabelle Cardeau-Desangles, Arnaud Del Bello, Jacques Izopet, Lionel Rostaing, Nassim Kamar","doi":"10.1155/2014/252914","DOIUrl":"https://doi.org/10.1155/2014/252914","url":null,"abstract":"The human polyomavirus BK (BKV) is associated with severe complications, such as ureteric stenosis and polyomavirus-associated nephropathy (PVAN), which often occur in kidney-transplant patients. However, it is unknown if BKV can replicate within bone marrow. The aim of this study was to search for BKV replication within the bone marrow of kidney-transplant patients presenting with a hematological disorder. Seventy-two kidney-transplant patients underwent bone-marrow aspiration for cytopenia. At least one virus was detected in the bone marrow of 25/72 patients (35%), that is, parvovirus B19 alone (n = 8), parvovirus plus Epstein-Barr virus (EBV) (n = 3), cytomegalovirus (n = 4), EBV (n = 2), BKV alone (n = 7), and BKV plus EBV (n = 1). Three of the eight patients who had BKV replication within the bone marrow had no detectable BKV replication in the blood. Neutropenia was observed in all patients with BKV replication in the bone marrow, and blockade of granulocyte maturation was observed. Hematological disorders disappeared in all patients after doses of immunosuppressants were reduced. In conclusion, an association between BKV replication in bone marrow and hematological disorders, especially neutropenia, was observed. Further studies are needed to confirm these findings. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2014 ","pages":"252914"},"PeriodicalIF":2.5,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/252914","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32375883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11

Use of adjuvant sorafenib in liver transplant recipients with high-risk hepatocellular carcinoma. 佐剂索拉非尼在高危肝癌肝移植受者中的应用

IF 2.5

Journal of Transplantation Pub Date : 2014-01-01 Epub Date: 2014-04-10 DOI: 10.1155/2014/913634

Kirti Shetty, Chiranjeev Dash, Jacqueline Laurin

{"title":"Use of adjuvant sorafenib in liver transplant recipients with high-risk hepatocellular carcinoma.","authors":"Kirti Shetty, Chiranjeev Dash, Jacqueline Laurin","doi":"10.1155/2014/913634","DOIUrl":"https://doi.org/10.1155/2014/913634","url":null,"abstract":"The efficacy of liver transplantation (LT) for hepatocellular (HCC) is limited by tumor recurrence rates of 10-15%. We undertook this pilot study to examine the use of sorafenib as adjuvant therapy in high-risk LT recipients. Methods. We prospectively enrolled patients transplanted for HCC into a treatment protocol utilizing sorafenib if their explant examination showed evidence of viable tumor exceeding Milan criteria. We utilized as historical controls patients transplanted previously, whose explant tumor characteristics exceeded Milan criteria, but who were not \"preemptively\" treated with sorafenib. Wilcoxon two-sample test and Fisher's exact test were used to compare survival and recurrence rates between the two groups. Results. Seven patients were treated with sorafenib and compared to 12 historical \"controls.\" Two of 7 treated patients suffered from HCC recurrence. Of the comparison group, 9 experienced HCC recurrence and all succumbed to disease. Dose reduction improved tolerance of drug. The overall rate of HCC recurrence was decreased in the adjuvant therapy group compared to historical controls (29% versus 75%, P = 0.07). Disease free 1-year survival for the treated versus untreated group was 100% versus 66%, respectively. Conclusion. Adjuvant use of sorafenib is safe and decreases risk of HCC recurrence in high-risk LT recipients. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2014 ","pages":"913634"},"PeriodicalIF":2.5,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/913634","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32332266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 30

The First Fifty ABO Blood Group Incompatible Kidney Transplantations: The Rotterdam Experience. 前50例ABO血型不相容肾移植:鹿特丹经验。

IF 2.5

Journal of Transplantation Pub Date : 2014-01-01 Epub Date: 2014-02-06 DOI: 10.1155/2014/913902

Madelon van Agteren, Willem Weimar, Annelies E de Weerd, Peter A W Te Boekhorst, Jan N M Ijzermans, Jaqueline van de Wetering, Michiel G H Betjes

{"title":"The First Fifty ABO Blood Group Incompatible Kidney Transplantations: The Rotterdam Experience.","authors":"Madelon van Agteren, Willem Weimar, Annelies E de Weerd, Peter A W Te Boekhorst, Jan N M Ijzermans, Jaqueline van de Wetering, Michiel G H Betjes","doi":"10.1155/2014/913902","DOIUrl":"https://doi.org/10.1155/2014/913902","url":null,"abstract":"This study describes the single center experience and long-term results of ABOi kidney transplantation using a pretransplantation protocol involving immunoadsorption combined with rituximab, intravenous immunoglobulins, and triple immune suppression. Fifty patients received an ABOi kidney transplant in the period from 2006 to 2012 with a follow-up of at least one year. Eleven antibody mediated rejections were noted of which 5 were mixed antibody and cellular mediated rejections. Nine cellular mediated rejections were recorded. Two grafts were lost due to rejection in the first year. One-year graft survival of the ABOi grafts was comparable to 100 matched ABO compatible renal grafts, 96% versus 99%. At 5-year follow-up, the graft survival was 90% in the ABOi versus 97% in the control group. Posttransplantation immunoadsorption was not an essential part of the protocol and no association was found between antibody titers and subsequent graft rejection. Steroids could be withdrawn safely 3 months after transplantation. Adverse events specifically related to the ABOi protocol were not observed. The currently used ABOi protocol shows good short and midterm results despite a high rate of antibody mediated rejections in the first years after the start of the program. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2014 ","pages":"913902"},"PeriodicalIF":2.5,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/913902","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32211897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 24

The Role of mTOR Inhibitors in Liver Transplantation: Reviewing the Evidence. mTOR抑制剂在肝移植中的作用:证据回顾。

IF 2.5

Journal of Transplantation Pub Date : 2014-01-01 Epub Date: 2014-02-25 DOI: 10.1155/2014/845438

Goran B Klintmalm, Björn Nashan

{"title":"The Role of mTOR Inhibitors in Liver Transplantation: Reviewing the Evidence.","authors":"Goran B Klintmalm, Björn Nashan","doi":"10.1155/2014/845438","DOIUrl":"10.1155/2014/845438","url":null,"abstract":"Despite the success of liver transplantation, long-term complications remain, including de novo malignancies, metabolic syndrome, and the recurrence of hepatitis C virus (HCV) and hepatocellular carcinoma (HCC). The current mainstay of treatment, calcineurin inhibitors (CNIs), can also worsen posttransplant renal dysfunction, neurotoxicity, and diabetes. Clearly there is a need for better immunosuppressive agents that maintain similar rates of efficacy and renal function whilst minimizing adverse effects. The mammalian target of rapamycin (mTOR) inhibitors with a mechanism of action that is different from other immunosuppressive agents has the potential to address some of these issues. In this review we surveyed the literature for reports of the use of mTOR inhibitors in adult liver transplantation with respect to renal function, efficacy, safety, neurological symptoms, de novo tumors, and the recurrence of HCC and HCV. The results of our review indicate that mTOR inhibitors are associated with efficacy comparable to CNIs while having benefits on renal function in liver transplantation. We also consider newer dosing schedules that may limit side effects. Finally, we discuss evidence that mTOR inhibitors may have benefits in the oncology setting and in relation to HCV-related allograft fibrosis, metabolic syndrome, and neurotoxicity. ","PeriodicalId":45795,"journal":{"name":"Journal of Transplantation","volume":"2014 ","pages":"845438"},"PeriodicalIF":2.5,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/845438","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32252129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 67