Direct Oral Anticoagulants in Patients With ESRD and Kidney Transplantation.

Direct oral anticoagulant (DOAC) use has significantly increased because major medical organizations endorse their role for conditions in which anticoagulation is indicated. Owing to important pharmacokinetic properties, the use of apixaban and rivaroxaban requires careful consideration in at-risk populations such as those with kidney disease. Both apixaban and rivaroxaban undergo some degree of renal elimination, and thus total drug exposure is increased in patients with renal insufficiency and/or those undergoing renal replacement therapy (RRT).

Nanoparticle shape is the game-changer for blood-brain barrier crossing and delivery through tunneling nanotubes among glioblastoma cells.

Tunneling nanotubes (TNTs) are thin, dynamic, long membrane protrusions that allow intercellular exchanges of signaling clues, molecules and organelles. The presence of TNTs and their involvement as drug delivery channels have been observed in several types of cancer, including glioblastoma. Recently, increased attention has been directed toward nanoparticles (NPs) that can be transported in TNTs.

Contemporary Immunosuppression Management and 1-Year Outcomes in Dual Organ Heart Transplantation.

Background: There have been limited reports on immunosuppression strategies and outcomes in dual organ heart transplant populations, primarily from before the 2018 United Network for Organ Sharing (UNOS) heart allocation policy change. Recent data suggested that outcomes with heart-lung and heart-liver transplants remained comparable in the new allocation era, yet heart-kidney recipients have worse 1-year survival.

Methods: This single-center retrospective study evaluated adult heart-kidney, heart-liver, and heart-lung transplant recipients from September 2019 to May 2023.

Mycophenolate Metabolite Trough Concentrations Are Not Well Correlated With Dosing or Adverse Outcomes in Pediatric Heart Transplant Recipients.

Objective: Although mycophenolate metabolite trough concentrations in serum are routinely obtained for pediatric orthotopic heart transplant (OHT) recipients, limited data support this practice. We sought to investigate the relationship of mycophenolic acid (MPA) and MPA glucuronide (MPAG) serum concentrations to dosing and adverse outcomes among pediatric OHT patients.

Methods: This retrospective study included OHT recipients ages 0 to 21 years who received mycophenolate mofetil (MMF) with MPA and MPAG serum trough concentration monitoring.