Pub Date : 2009-04-20DOI: 10.2174/1874418400903010009
P. Falck, A. Fiane, O. Geiran, A. Åsberg, Oslo Norway
Background: The secondary metabolites of cyclosporine A (CsA), AM19, AM1c and AM1c9, have been indi- cated to be nephrotoxic. The aim of the present pilot study was to investigate the relationship between acute renal failure and CsA metabolite levels, including relevant pharmacokinetic genotypes, following heart transplantation. Methods: Whole-blood samples were drawn the first posttransplant week in 22 patients (median 54 years, range from 27 to 65). Whole blood concentrations of CsA and its six main metabolites were analyzed with a validated HPLC-MS/MS method, and relevant CYP3A5 and ABCB1 genotypes determined. Renal function was monitored daily during the first posttransplant month and also at months 3, 6 and 12. Results: One patient died early posttransplant. Six patients were in need of dialysis directly after transplantation. Nine pa- tients developed sustained impaired renal function, while six had stable renal function. Sustained renal impairment tended to be associated with high levels of toxic metabolites (P=0.08). Six of the patients with possible ABCB1 TTT-haplotype developed renal impairment (P=0.12). Conclusion: The present study indicates that toxic CsA metabolites seems to be associated with development of impaired renal function and together with ABCB1 genotyping they might be promising biomarkers for optimalization of immuno- suppressive drug treatment in future studies.
{"title":"Individual Differences in Cyclosporine A Pharmacokinetics and Its Association with Acute Renal Function Following Heart Transplantation","authors":"P. Falck, A. Fiane, O. Geiran, A. Åsberg, Oslo Norway","doi":"10.2174/1874418400903010009","DOIUrl":"https://doi.org/10.2174/1874418400903010009","url":null,"abstract":"Background: The secondary metabolites of cyclosporine A (CsA), AM19, AM1c and AM1c9, have been indi- cated to be nephrotoxic. The aim of the present pilot study was to investigate the relationship between acute renal failure and CsA metabolite levels, including relevant pharmacokinetic genotypes, following heart transplantation. Methods: Whole-blood samples were drawn the first posttransplant week in 22 patients (median 54 years, range from 27 to 65). Whole blood concentrations of CsA and its six main metabolites were analyzed with a validated HPLC-MS/MS method, and relevant CYP3A5 and ABCB1 genotypes determined. Renal function was monitored daily during the first posttransplant month and also at months 3, 6 and 12. Results: One patient died early posttransplant. Six patients were in need of dialysis directly after transplantation. Nine pa- tients developed sustained impaired renal function, while six had stable renal function. Sustained renal impairment tended to be associated with high levels of toxic metabolites (P=0.08). Six of the patients with possible ABCB1 TTT-haplotype developed renal impairment (P=0.12). Conclusion: The present study indicates that toxic CsA metabolites seems to be associated with development of impaired renal function and together with ABCB1 genotyping they might be promising biomarkers for optimalization of immuno- suppressive drug treatment in future studies.","PeriodicalId":90368,"journal":{"name":"The open transplantation journal","volume":"3 1","pages":"9-13"},"PeriodicalIF":0.0,"publicationDate":"2009-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68073095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-02-18DOI: 10.2174/1874418400903010004
M. Sette, E. Lopes, Â. Ferraz, M. Maia, M. Barros, M. Machado, T. Bacchella, R. Cury, H. Sette, E. Ferraz
This study aimed to compare the piggyback technique with and without inferior vena cava cross-clamping (IVC-CC). Between 2002 and 2005 at two Hospitals in Brazil, 136 patients were submitted to orthotopic liver transplant (OLT), but 36 were excluded due to the employment of different techniques. Depending on the piggyback technique em- ployed, the remaining 100 patients were divided into two groups: Group A (with IVC-CC) = 47 patients; and Group B (without IVC-CC) = 53 patients. The study revealed that the OLT using piggyback with IVC-CC took less time (1.39 hours) and required less blood transfusion, however a higher dosis of noradrenaline administration was necessary. No sta- tistical differences were observed between the two groups regarding hemodynamic parameters during the surgery, or any impairment of the kidney and liver functions in the early post-operative period. In conclusion, the piggyback with IVC- CC required less surgical time and less units of blood transfusion.
{"title":"Piggyback Technique with and without Inferior Vena Cava Cross- Clamping for Orthotopic Liver Transplant","authors":"M. Sette, E. Lopes, Â. Ferraz, M. Maia, M. Barros, M. Machado, T. Bacchella, R. Cury, H. Sette, E. Ferraz","doi":"10.2174/1874418400903010004","DOIUrl":"https://doi.org/10.2174/1874418400903010004","url":null,"abstract":"This study aimed to compare the piggyback technique with and without inferior vena cava cross-clamping (IVC-CC). Between 2002 and 2005 at two Hospitals in Brazil, 136 patients were submitted to orthotopic liver transplant (OLT), but 36 were excluded due to the employment of different techniques. Depending on the piggyback technique em- ployed, the remaining 100 patients were divided into two groups: Group A (with IVC-CC) = 47 patients; and Group B (without IVC-CC) = 53 patients. The study revealed that the OLT using piggyback with IVC-CC took less time (1.39 hours) and required less blood transfusion, however a higher dosis of noradrenaline administration was necessary. No sta- tistical differences were observed between the two groups regarding hemodynamic parameters during the surgery, or any impairment of the kidney and liver functions in the early post-operative period. In conclusion, the piggyback with IVC- CC required less surgical time and less units of blood transfusion.","PeriodicalId":90368,"journal":{"name":"The open transplantation journal","volume":"3 1","pages":"4-8"},"PeriodicalIF":0.0,"publicationDate":"2009-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68073054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-01-30DOI: 10.2174/1874418400903010001
J. Schwartz, B. Woods, F. Shihab
Cytomegalovirus (CMV) is a known cause of pancreatitis in immunocompromised patients, usually in associa- tion with the human immunodeficiency virus (1). A handful of cases have been reported of CMV pancreatitis occurring in a transplanted pancreas secondary to immunosuppression associated with organ transplantation. Herein, we report a rare case of CMV pancreatitis following deceased-donor renal transplantation in which a patient's native pancreas was in- fected by CMV transmitted by donor renal tissue. After seroconversion from a CMV-positive donor, a 41 year old female with a history of autosomal dominant polycystic kidney disease presented with pancreatitis in her native pancreas follow- ing deceased donor renal transplantation, thus illustrating how a patient's native pancreas can be infected by CMV from donor renal tissue.
{"title":"A Case of Native Cytomegalovirus Pancreatitis Following Deceased-Donor Renal Transplantation","authors":"J. Schwartz, B. Woods, F. Shihab","doi":"10.2174/1874418400903010001","DOIUrl":"https://doi.org/10.2174/1874418400903010001","url":null,"abstract":"Cytomegalovirus (CMV) is a known cause of pancreatitis in immunocompromised patients, usually in associa- tion with the human immunodeficiency virus (1). A handful of cases have been reported of CMV pancreatitis occurring in a transplanted pancreas secondary to immunosuppression associated with organ transplantation. Herein, we report a rare case of CMV pancreatitis following deceased-donor renal transplantation in which a patient's native pancreas was in- fected by CMV transmitted by donor renal tissue. After seroconversion from a CMV-positive donor, a 41 year old female with a history of autosomal dominant polycystic kidney disease presented with pancreatitis in her native pancreas follow- ing deceased donor renal transplantation, thus illustrating how a patient's native pancreas can be infected by CMV from donor renal tissue.","PeriodicalId":90368,"journal":{"name":"The open transplantation journal","volume":"3 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2009-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68073030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-11-06DOI: 10.2174/1874418400802010066
W. Hove, B. D. Rooij, B. Hoek, J. Kuyvenhoven, M. Meijer, M. V. D. Berg, J. J. Reijden, W. Verduyn, J. Dubbeld, D. Hommes, C. Lamers, H. Verspaget
Introduction. Matrix metalloproteinases (MMPs) are involved in connective tissue remodeling processes asso- ciated with chronic liver disease and complications after orthotopic liver transplantation (OLT). Genetic variations in the promoter region of the MMP-2 and MMP-9 genes are thought to contribute not only to their transcription rate but may also have predisposing clinical impact. Methods. MMP-2 and MMP-9 gene promoter polymorphisms were analyzed in 109 patients who underwent an OLT. The relationship between these MMP polymorphisms in the donor and recipient DNA with the development of ische- mia/reperfusion (I/R) injury and rejection after OLT was evaluated. In addition, serum MMP-2 and MMP-9 levels were determined to illustrate potential phenotypical consequences in these patients. Results. The MMP-2 and -9 genotypes of the donor and recipient or a donor/recipient mismatch and chimerism were not associated with the development of late phase I/R injury or rejection in the OLT patients, although serological differences in the MMP levels did occur. The MMP-2 and -9 genotype distribution did also not have a major impact on the respective serum levels in patients that underwent an OLT. Conclusions. MMP-2 and MMP-9 gene polymorphisms do not seem to contribute to late phase I/R injury or rejection after liver transplantation. Serological changes in the MMP-2 and MMP-9 levels appear to occur independent of the MMP genotype after transplantation of the liver.
{"title":"MMP-2 and MMP-9 Serum Levels Change but their Gene Promoter Polymorphisms are not Associated with Late Phase I/R Injury or Rejection after Orthotopic Liver Transplantation","authors":"W. Hove, B. D. Rooij, B. Hoek, J. Kuyvenhoven, M. Meijer, M. V. D. Berg, J. J. Reijden, W. Verduyn, J. Dubbeld, D. Hommes, C. Lamers, H. Verspaget","doi":"10.2174/1874418400802010066","DOIUrl":"https://doi.org/10.2174/1874418400802010066","url":null,"abstract":"Introduction. Matrix metalloproteinases (MMPs) are involved in connective tissue remodeling processes asso- ciated with chronic liver disease and complications after orthotopic liver transplantation (OLT). Genetic variations in the promoter region of the MMP-2 and MMP-9 genes are thought to contribute not only to their transcription rate but may also have predisposing clinical impact. Methods. MMP-2 and MMP-9 gene promoter polymorphisms were analyzed in 109 patients who underwent an OLT. The relationship between these MMP polymorphisms in the donor and recipient DNA with the development of ische- mia/reperfusion (I/R) injury and rejection after OLT was evaluated. In addition, serum MMP-2 and MMP-9 levels were determined to illustrate potential phenotypical consequences in these patients. Results. The MMP-2 and -9 genotypes of the donor and recipient or a donor/recipient mismatch and chimerism were not associated with the development of late phase I/R injury or rejection in the OLT patients, although serological differences in the MMP levels did occur. The MMP-2 and -9 genotype distribution did also not have a major impact on the respective serum levels in patients that underwent an OLT. Conclusions. MMP-2 and MMP-9 gene polymorphisms do not seem to contribute to late phase I/R injury or rejection after liver transplantation. Serological changes in the MMP-2 and MMP-9 levels appear to occur independent of the MMP genotype after transplantation of the liver.","PeriodicalId":90368,"journal":{"name":"The open transplantation journal","volume":"2 1","pages":"66-72"},"PeriodicalIF":0.0,"publicationDate":"2008-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68072983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-11-06DOI: 10.2174/1874418400802010073
M. Shimoda, J. Kita, M. Kato, T. Sawada, K. Kubota
Lymphoproliferative disorders following liver transplantation are often Epstein-Barr virus (EBV)-related high- grade B cell lymphomas. EBV-negative and low-grade lymphoma is a very rare condition after cadaveric as well as living donor liver transplantation (LDLT). Herein we report a case of follicular lymphoma with negative EBV viral capsid anti- gen (VCA), IgM, IgG and Epstein-Barr virus-encoded small RNA (EBER), which developed after LDLT, and review the literature pertaining to EBV-negative post-transplantation lymphoproliferative disorder (PTLD) after liver transplantation.
{"title":"Epstein-Barr Virus-Negative Lymphoproliferative Disorders after Liver Transplantation","authors":"M. Shimoda, J. Kita, M. Kato, T. Sawada, K. Kubota","doi":"10.2174/1874418400802010073","DOIUrl":"https://doi.org/10.2174/1874418400802010073","url":null,"abstract":"Lymphoproliferative disorders following liver transplantation are often Epstein-Barr virus (EBV)-related high- grade B cell lymphomas. EBV-negative and low-grade lymphoma is a very rare condition after cadaveric as well as living donor liver transplantation (LDLT). Herein we report a case of follicular lymphoma with negative EBV viral capsid anti- gen (VCA), IgM, IgG and Epstein-Barr virus-encoded small RNA (EBER), which developed after LDLT, and review the literature pertaining to EBV-negative post-transplantation lymphoproliferative disorder (PTLD) after liver transplantation.","PeriodicalId":90368,"journal":{"name":"The open transplantation journal","volume":"2 1","pages":"73-76"},"PeriodicalIF":0.0,"publicationDate":"2008-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68072995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-10-30DOI: 10.2174/1874418400802010062
I. Morard, G. Mentha, L. Rubbia, S. Terraz, L. Spahr, A. Hadengue, P. Majno, P. Morel, E. Giostra
After adult liver transplantation (LT), post-transplant lymphoproliferative disorder (PTLD) is an uncommon but serious complication of immunosuppression (IMS) in presence of an acute or latent EBV infection. The clinical pres- entation of this disease is aspecific, and, after LT, it may mimic anastomotic bile duct stricture. We report the cases of 2 adult patients who developed, 3 months and 8 years after OLT, an EBV-associated PTLD with diffuse intrinsic infiltration of bile duct mimicking anastomotic biliary stricture. In the absence of liver or hilar nodes in- volvement, percutaneous biopsies were non contributive and the diagnosis were made by surgical biopsy. After reduction of IMS and Rituximab treatment, both patients are alive without recurrence 5 and 6 years after diagnosis. In conclusion, PTLD is one of the differential diagnosis of biliary tree obstruction after OLT. Diagnosis requires surgical biopsies and treatment consists in IMS reduction and Rituximab.
{"title":"Post Transplantation Lymphoproliferative Disorder (PTLD) Presenting as Biliary Duct Obstruction","authors":"I. Morard, G. Mentha, L. Rubbia, S. Terraz, L. Spahr, A. Hadengue, P. Majno, P. Morel, E. Giostra","doi":"10.2174/1874418400802010062","DOIUrl":"https://doi.org/10.2174/1874418400802010062","url":null,"abstract":"After adult liver transplantation (LT), post-transplant lymphoproliferative disorder (PTLD) is an uncommon but serious complication of immunosuppression (IMS) in presence of an acute or latent EBV infection. The clinical pres- entation of this disease is aspecific, and, after LT, it may mimic anastomotic bile duct stricture. We report the cases of 2 adult patients who developed, 3 months and 8 years after OLT, an EBV-associated PTLD with diffuse intrinsic infiltration of bile duct mimicking anastomotic biliary stricture. In the absence of liver or hilar nodes in- volvement, percutaneous biopsies were non contributive and the diagnosis were made by surgical biopsy. After reduction of IMS and Rituximab treatment, both patients are alive without recurrence 5 and 6 years after diagnosis. In conclusion, PTLD is one of the differential diagnosis of biliary tree obstruction after OLT. Diagnosis requires surgical biopsies and treatment consists in IMS reduction and Rituximab.","PeriodicalId":90368,"journal":{"name":"The open transplantation journal","volume":"2 1","pages":"62-65"},"PeriodicalIF":0.0,"publicationDate":"2008-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68072140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-10-24DOI: 10.2174/1874418400802010058
A. Dosanjh, J. Koziol
Background: Alaska Native and Native American populations (AN/NA) are prone to respiratory tract infections, due to genetic predisposition and environmental factors. Since community acquired respiratory tract infections are associated with higher rates of bron- chiolitis obliterans syndrome (BOS), it was hypothesized that AN/NA lung transplant recipients may experience a higher rate of BOS. Methods: The UNOS database was searched from 1995-2005 to identify adult AN/NA patients undergoing lung transplantation in the U.S. Among 11,103 patients, 33 AN/NA (13M/20F) patients were identified for further analysis. Among this population rates of: i) initial hospital stay, ii) first year hospitalizations, iii) hospitalization for infection, iv) subsequent BOS in years 1-5, were compared. Statistical analysis was performed using the fisher exact test, and a p value of <0.05 was considered significant. Results: AN/NA recipients did not have a higher incidence of BOS in years 1-5 following lung transplantation. They did have a higher rate of first year complications, reflected by higher hospitalization rates. AN/NA patients had a higher rate of first year hospitalizations for non-CMV infection (p < 0.03). Conclusions: AN/NA patients despite being at risk for community acquired respiratory infections did not have a higher rate of trans- plantation BOS in subsequent years.
{"title":"Infection and Bronchiolitis Obliterans among Native American Lung Transplant Recipients","authors":"A. Dosanjh, J. Koziol","doi":"10.2174/1874418400802010058","DOIUrl":"https://doi.org/10.2174/1874418400802010058","url":null,"abstract":"Background: Alaska Native and Native American populations (AN/NA) are prone to respiratory tract infections, due to genetic predisposition and environmental factors. Since community acquired respiratory tract infections are associated with higher rates of bron- chiolitis obliterans syndrome (BOS), it was hypothesized that AN/NA lung transplant recipients may experience a higher rate of BOS. Methods: The UNOS database was searched from 1995-2005 to identify adult AN/NA patients undergoing lung transplantation in the U.S. Among 11,103 patients, 33 AN/NA (13M/20F) patients were identified for further analysis. Among this population rates of: i) initial hospital stay, ii) first year hospitalizations, iii) hospitalization for infection, iv) subsequent BOS in years 1-5, were compared. Statistical analysis was performed using the fisher exact test, and a p value of <0.05 was considered significant. Results: AN/NA recipients did not have a higher incidence of BOS in years 1-5 following lung transplantation. They did have a higher rate of first year complications, reflected by higher hospitalization rates. AN/NA patients had a higher rate of first year hospitalizations for non-CMV infection (p < 0.03). Conclusions: AN/NA patients despite being at risk for community acquired respiratory infections did not have a higher rate of trans- plantation BOS in subsequent years.","PeriodicalId":90368,"journal":{"name":"The open transplantation journal","volume":"2 1","pages":"58-61"},"PeriodicalIF":0.0,"publicationDate":"2008-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68072086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-09-02DOI: 10.2174/1874418400802010040
D. Gray
Complex areas of scientific endeavor may sometimes benefit from a theoretical and/or reductionist approach to guide the direction of future experiments, perhaps best illustrated by the field of cosmology. The field of immunology in general, and transplantation immunology in particular, is certainly complex. This commentary draws attention to a theory that proposes an alternative role for MHC molecules, placing them central to the process of tolerance induction, with ma- jor implications for transplantation and all fields of immunology.
{"title":"The MHC-Based Suppression (MBS) Theory: Implications for Transplantation","authors":"D. Gray","doi":"10.2174/1874418400802010040","DOIUrl":"https://doi.org/10.2174/1874418400802010040","url":null,"abstract":"Complex areas of scientific endeavor may sometimes benefit from a theoretical and/or reductionist approach to guide the direction of future experiments, perhaps best illustrated by the field of cosmology. The field of immunology in general, and transplantation immunology in particular, is certainly complex. This commentary draws attention to a theory that proposes an alternative role for MHC molecules, placing them central to the process of tolerance induction, with ma- jor implications for transplantation and all fields of immunology.","PeriodicalId":90368,"journal":{"name":"The open transplantation journal","volume":"2 1","pages":"40-53"},"PeriodicalIF":0.0,"publicationDate":"2008-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68072039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-09-02DOI: 10.2174/1874418400802010054
J. Akoh, P. Caton
With the aid of a professional developer, the South West Transplant Centre designed and launched a website in September 2006 to provide patient friendly information in all aspects of renal transplantation and health professionals with transplant related e-book protocols alongside research materials, printable referral forms and statistical data including survival figures. The aim of this paper is to report on our experience of the first year of operating such a website. The website consists of approximately 500 pages covering subjects ranging from transplant related procedures to the transplant procedure itself. During the first year the total number of hits on SWTC website were 70,971 with April 2007 having a peak of 10,357 hits. There was sustained interest in the website throughout the year and the amount of information (kilo- bytes) downloaded was highest during the first three months. Regular visitors to the website come from several countries across the globe including the United Kingdom, New Zealand, Seychelles, Canada, France and the US. A well-designed website is a useful tool for increasing awareness of Unit activities, increasing organ donation, providing information and in some instances training people in geographically remote areas. To maintain relevance transplant websites require to be upgraded on a regular basis by transplant clinicians and relevant sections expanded to meet the needs of the public.
{"title":"A Transplant Website in Today’s World","authors":"J. Akoh, P. Caton","doi":"10.2174/1874418400802010054","DOIUrl":"https://doi.org/10.2174/1874418400802010054","url":null,"abstract":"With the aid of a professional developer, the South West Transplant Centre designed and launched a website in September 2006 to provide patient friendly information in all aspects of renal transplantation and health professionals with transplant related e-book protocols alongside research materials, printable referral forms and statistical data including survival figures. The aim of this paper is to report on our experience of the first year of operating such a website. The website consists of approximately 500 pages covering subjects ranging from transplant related procedures to the transplant procedure itself. During the first year the total number of hits on SWTC website were 70,971 with April 2007 having a peak of 10,357 hits. There was sustained interest in the website throughout the year and the amount of information (kilo- bytes) downloaded was highest during the first three months. Regular visitors to the website come from several countries across the globe including the United Kingdom, New Zealand, Seychelles, Canada, France and the US. A well-designed website is a useful tool for increasing awareness of Unit activities, increasing organ donation, providing information and in some instances training people in geographically remote areas. To maintain relevance transplant websites require to be upgraded on a regular basis by transplant clinicians and relevant sections expanded to meet the needs of the public.","PeriodicalId":90368,"journal":{"name":"The open transplantation journal","volume":"2 1","pages":"54-57"},"PeriodicalIF":0.0,"publicationDate":"2008-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68072074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-08-29DOI: 10.2174/1874418400802010035
A. Mathis, D. Schiller
Ciprofloxacin, a fluoroquinolone antibiotic, has been linked to an increased risk of acute cellular rejection and drug interactions with the calcineurin inhibitors in renal transplant recipients. Little is known about the effects of levofloxacin. We report our evaluation for pharmacokinetic and pharmacodynamic interaction between levofloxacin and the calcineurin inhibitors. A retrospective review was conducted of renal transplant recipients with known or suspected community acquired pneumonia who received levofloxacin. Patients were assessed for rejection at 90-day follow-up, and compared to a historical ciprofloxacin cohort. Assessment of the drug-drug interaction between levofloxacin and the cal- cineurin inhibitors required stable dose of the immunosuppressants, a baseline trough level, and follow-up levels. Rejec- tion occurred in 1 of the 26 included patients (3.8%), less than the rate in the historical ciprofloxacin group at 4 weeks (28.6%; p=0.012) and 12 weeks (45.2%; p<0.001). There was no significant drug-drug interaction between levofloxacin and cyclosporine (n=8) or tacrolimus (n=6) when trough levels were evaluated. In summary, renal transplant patients re- ceiving levofloxacin for pneumonia did not appear to have a temporally-related elevated risk of ACR or a pharmacoki- netic drug-drug interaction with the calcineurin inhibitors.
{"title":"Pharmacokinetic and Pharmacodynamic Interactions with Levofloxacin in Renal Transplant Patients with Suspected Pneumonia","authors":"A. Mathis, D. Schiller","doi":"10.2174/1874418400802010035","DOIUrl":"https://doi.org/10.2174/1874418400802010035","url":null,"abstract":"Ciprofloxacin, a fluoroquinolone antibiotic, has been linked to an increased risk of acute cellular rejection and drug interactions with the calcineurin inhibitors in renal transplant recipients. Little is known about the effects of levofloxacin. We report our evaluation for pharmacokinetic and pharmacodynamic interaction between levofloxacin and the calcineurin inhibitors. A retrospective review was conducted of renal transplant recipients with known or suspected community acquired pneumonia who received levofloxacin. Patients were assessed for rejection at 90-day follow-up, and compared to a historical ciprofloxacin cohort. Assessment of the drug-drug interaction between levofloxacin and the cal- cineurin inhibitors required stable dose of the immunosuppressants, a baseline trough level, and follow-up levels. Rejec- tion occurred in 1 of the 26 included patients (3.8%), less than the rate in the historical ciprofloxacin group at 4 weeks (28.6%; p=0.012) and 12 weeks (45.2%; p<0.001). There was no significant drug-drug interaction between levofloxacin and cyclosporine (n=8) or tacrolimus (n=6) when trough levels were evaluated. In summary, renal transplant patients re- ceiving levofloxacin for pneumonia did not appear to have a temporally-related elevated risk of ACR or a pharmacoki- netic drug-drug interaction with the calcineurin inhibitors.","PeriodicalId":90368,"journal":{"name":"The open transplantation journal","volume":"2 1","pages":"35-39"},"PeriodicalIF":0.0,"publicationDate":"2008-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68072029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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