Publications by authors named "N Isbel"
Background: Therapeutic monitoring is routinely performed to ensure tacrolimus whole-blood concentrations fall within a predefined target. Despite this, patients still experience inefficacy and toxicity that could be related to variability in free (unbound) tacrolimus exposure. Therefore, the aim of this study was to compare tacrolimus-free plasma (C u ), total plasma (C p ), and whole-blood (C wb ) concentrations in adult kidney transplant recipients and to characterize tacrolimus disposition across different matrices.
View Article and Find Full Text PDFBackground: The numbers of Māori and Pasifika peoples with kidney failure living in Australia are rising. However, data describing outcomes of those proceeding to transplantation are limited. This study describes clinical outcomes of Māori and Pasifika peoples who received a kidney transplant in Australia.
View Article and Find Full Text PDFAdoptive T-cell immunotherapy holds great promise for the treatment of viral complications in immunocompromised patients resistant to standard anti-viral strategies. We present a retrospective analysis of 78 patients from 19 hospitals across Australia and New Zealand, treated over the last 15 years with "off-the-shelf" allogeneic T cells directed to a combination of Epstein-Barr virus (EBV), cytomegalovirus (CMV), BK polyomavirus (BKV), John Cunningham virus (JCV) and/or adenovirus (AdV) under the Australian Therapeutic Goods Administration's Special Access Scheme. Most patients had severe post-transplant viral complications, including drug-resistant end-organ CMV disease, BKV-associated haemorrhagic cystitis and EBV-driven post-transplant lymphoproliferative disorder.
View Article and Find Full Text PDFArticle Synopsis
- Keratinocyte carcinomas, like basal and squamous cell carcinomas, are common and serious issues for solid organ transplant recipients, necessitating early detection and effective treatment strategies.
- A Phase III clinical trial, called the SiroSkin trial, will assess the effectiveness of topical sirolimus in reducing skin cancer incidence among these patients compared to a placebo, involving 146 participants over 24 weeks of treatment and 18 months of follow-up.
- The trial's results aim to enhance management approaches for skin cancers in solid organ transplant recipients and gather evidence on the cost-effectiveness of using topical sirolimus.
Does Age Influence Immunosuppressant Drug Pharmacokinetics in Kidney Transplant Recipients?
Eur J Drug Metab Pharmacokinet
November 2024
Background: The pharmacokinetics of immunosuppressant drugs may change with advancing age, potentially affecting patient outcomes.
Objective: To characterise the effects of age on the pharmacokinetic and exposure parameters of tacrolimus, mycophenolate, and prednisolone.
Methods: Pharmacokinetic profiling, involving whole blood tacrolimus, total and free plasma mycophenolic acid (MPA), total plasma mycophenolic acid glucuronide (MPAG), and total and free plasma prednisolone, was performed in an older and younger adult cohort.