Early Conversion to Everolimus Within 180 Days of Living Donor Liver Transplantation.

Background: Early conversion to Everolimus (EVR) post deceased donor liver transplant has been associated with improved renal function but increased rejection. Early EVR conversion has not been evaluated after living donor liver transplant (LDLT). A retrospective cohort study was conducted to compare the rate of rejection and renal function in patients converted to EVR early post-LDLT to patients on calcineurin inhibitors (CNIs).

Using the Pharmacist Interaction Tracking Tool for Capturing Student-Patient Interactions in Direct and Simulated Patient Care Activities.

Objective. To create and implement a standardized data collection tool for capturing student-patient interactions in direct and simulated patient care activities. Design.

Changes in Student Performance and Confidence with a Standardized Patient and Standardized Colleague Interprofessional Activity.

Objective: To assess the impact of a standardized patient and standardized colleague interprofessional activity on student performance and perceived confidence in communicating with patients and physicians.

Methods: Students in the third professional year were presented with a practice and final activity including a standardized patient interaction, SOAP note preparation, and standardized colleague interaction. Student performance was measured by assessment rubrics on practice and final activities.

Promotion of self-directed learning using virtual patient cases.

Objective: To assess the effectiveness of virtual patient cases to promote self-directed learning (SDL) in a required advanced therapeutics course.

Design: Virtual patient software based on a branched-narrative decision-making model was used to create complex patient case simulations to replace lecture-based instruction. Within each simulation, students used SDL principles to learn course objectives, apply their knowledge through clinical recommendations, and assess their progress through patient outcomes and faculty feedback linked to their individual decisions.

Importance of direct patient care in advanced pharmacy practice experiences.

The Accreditation Council for Pharmacy Education issued revised standards (Standards 2007) for professional programs leading to the Doctor of Pharmacy degree in July 2007. The new standards require colleges and schools of pharmacy to provide pharmacy practice experiences that include direct interaction with diverse patient populations. These experiences are to take place in multiple practice environments (e.

Pharmacology of immunosuppressive medications in solid organ transplantation.

The multitude of immunosuppressants available for solid organ transplantation allows for many combinations of immunosuppressive therapies that can be tailored to a patient’s specific lifestyle and immunosuppression needs. Newer agents currently being studied offer even more possibilities for the future to further reduce the incidence of acute rejection and prolong graft and patient survival.

Outcomes of renal transplantation in recipients with peak panel reactive antibody >30% under tacrolimus-based immunosuppression.

Background: Renal transplant recipients with high panel reactive antibodies (PRA) have worse outcomes than those with lower PRA. High PRA re-transplant recipients are thought to have worse outcomes than high PRA first transplant recipients. In this study, we examined outcomes of renal transplantation recipients with a peak PRA >30% and compared the outcomes of first and re-transplanted recipients.

A critical appraisal of and recommendations for faculty development.

The 2009-2010 American Association of Colleges of Pharmacy (AACP) Council of Faculties Faculty Affairs Committee reviewed published literature assessing the scope and outcomes of faculty development for tenure and promotion. Relevant articles were identified via a PubMed search, review of pharmacy education journals, and identification of position papers from major healthcare professions academic organizations. While programs intended to enhance faculty development were described by some healthcare professions, relatively little specific to pharmacy has been published and none of the healthcare professions have adequately evaluated the impact of various faculty-development programs on associated outcomes.

Patient simulation software to augment an advanced pharmaceutics course.

Objective: To implement and assess the effectiveness of adding a pharmaceutical care simulation program to an advanced therapeutics course.

Design: PharmaCAL (University of Pittsburgh), a software program that uses a branched-outcome decision making model, was used to create patient simulations to augment lectures given in the course. In each simulation, students were presented with a challenge, given choices, and then provided with consequences specific to their choices.

Early risk factors for persistent anemia after kidney transplantation.

Study Objective: To identify predictors of persistent posttransplant anemia that appear within the first week after kidney transplantation in order to determine the high-risk patients who might receive the most benefit from erythropoiesis-stimulating agents.

Study Design: Retrospective cohort study.

Setting: University-affiliated hospital and outpatient clinic.

Determination of cidofovir in human plasma after low dose drug administration using high-performance liquid chromatography-tandem mass spectrometry.

A sensitive and specific method for the determination of cidofovir (CDV) in human plasma using high-performance liquid chromatography with tandem mass spectrometry (LC-MS/MS) was developed and validated. Plasma samples were processed by a solid phase extraction (SPE) procedure using Varian SAX extraction cartridges prior to chromatography. The internal standard was (13)C5-Folic acid ((13)C5-FA).

Polyomavirus BK neutralizing activity in human immunoglobulin preparations.

Background: Polyomavirus BK (BKV) infection can cause nephropathy in the allograft kidney. No well-established drug treatment is available at this time. Human intravenous immunoglobulins (IVIG) have been used as an empiric therapy without proof of effectiveness.

Adverse effects of immunosuppression in pediatric solid organ transplantation.

Solid organ transplantation is a life-saving treatment for end-stage organ failure in children. Immunosuppressant medications are used to prevent rejection of the organ transplant. However, these medications are associated with significant adverse effects that impact growth and development, quality of life (QOL), and sometimes long-term survival after transplantation.

Effect of long-term tacrolimus immunosuppression on renal function in liver transplant recipients.

Study Objectives: To describe changes in renal function occurring after long-term treatment with tacrolimus in clinically stable liver transplant recipients, and to identify risk factors for a clinically significant decline in renal function in these patients.

Design: Retrospective cohort study. Setting.

Retrospective analysis of hyperlipidemia management in a transplant population.

Study Objectives: To determine the prevalence of hyperlipidemia and the effectiveness of hyperlipidemia management in a large population of transplant recipients. A secondary objective was to assess the effect of the National Cholesterol Education Program (NCEP) Adult Treatment Panel III guidelines on hyperlipidemia management compared with the effect from earlier guidelines.

Design: Retrospective review of computerized records.

Colesevelam: potential uses for the newest bile resin.

Colesevelam is the newest bile resin with a unique chemical structure. It binds to bile acids with higher affinity than traditional bile acid sequestrants and has fewer gastrointestinal side effects and drug interactions. Colesevelam is safe and efficacious alone or in combination with HMG-CoA reductase inhibitors (statins) in reducing low-density lipoprotein cholesterol (LDL-C) levels.

Terbutaline for chronotropic support in heart transplantation.

Objective: To report the use of oral terbutaline for chronotropic support in a patient who had undergone heart transplantation.

Case Summary: A 54-year-old white man received a heart transplant secondary to ischemic dilated cardiomyopathy. His clinical course was uncomplicated until postoperative day 10, when he became hemodynamically compromised despite inotropic therapy (BP 88/53 mm Hg, mean HR 80 beats/min) secondary to stage IIIa rejection.

Tacrolimus and lopinavir/ritonavir interaction in liver transplantation.

Objective: To report an interaction between tacrolimus and the protease inhibitor combination lopinavir/ritonavir in a liver transplant patient.

Case Summary: A 48-year-old white male liver transplant recipient receiving tacrolimus 5 mg twice daily for immunosuppression started highly active antiretroviral therapy for his HIV-positive status. Three days after initiation of lopinavir/ritonavir, the tacrolimus concentration rose sharply to toxic levels.