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Incidence and risk factors for rejection after conversion from calcineurin inhibitor to sirolimus-based immunosuppression in orthotopic heart transplant recipients.
J Heart Lung Transplant
December 2024
Van Cleve Cardiac Regenerative Medicine Program, Mayo Clinic, Rochester, Minnesota; Deparment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota. Electronic address:
Background: Although recommended in International Society for Heart and Lung Transplantation (ISHLT) guidelines, transition to mammalian targets of rapamycin (mTOR) inhibitors in heart transplant recipients is not routinely performed, in part due to perceived risk of rejection. This study sought to evaluate the incidence and risk factors for biopsy-proven, clinically relevant rejection following conversion from calcineurin inhibitor (CNI) to sirolimus (SRL) immunosuppression.
Methods: A single center retrospective study was conducted of all consecutive adult patients who underwent orthotopic heart transplantation (OHT) and CNI-free SRL conversion from January 1999 to January 2023.
The Use of Long-Term Monthly Basiliximab Infusions as Rescue Maintenance Immunosuppression in Pancreas Transplant Recipients.
Clin Transplant
December 2024
Department of Surgery, IU Health/Indiana University School of Medicine, Indianapolis, Indiana, USA.
This single-center retrospective study was designed to evaluate the use of basiliximab as an alternative rescue maintenance immunosuppression in situations where standard maintenance immunosuppression is not tolerated after a pancreas transplant. All pancreas transplants performed between January 11, 2006, and January 6, 2022, were reviewed. All recipients received rabbit antithymocyte globulin (rATG) induction with tacrolimus + sirolimus maintenance for simultaneous pancreas and kidney (SPK) and additional low-dose mycophenolic acid for pancreas transplant alone (PTA).
View Article and Find Full Text PDFTreatment With mTOR Inhibitors as Primary Immunosuppression After Combined Heart and Kidney Transplantation.
J Card Fail
December 2024
Department of Cardiovascular Diseases and Health Sciences Research and the William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, Minnesota. Electronic address:
Introduction: Sirolimus (SRL) mitigates cardiac allograft vasculopathy (CAV) progression and confers renal protection after heart transplantation (HT). However, its safety and efficacy in patients undergoing combined heart and kidney transplantation (HKT) are unclear. This study aimed to investigate the impact of conversion from calcineurin inhibitors (CNIs) to SRL on CAV progression, renal function, and outcomes in HKT compared with isolated HT.
View Article and Find Full Text PDFInterventions for BK virus infection in kidney transplant recipients.
Cochrane Database Syst Rev
October 2024
Department of Renal Medicine, The Canberra Hospital, Canberra, Australia.
Article Synopsis
- BK virus-associated nephropathy (BKVAN) is a complication in kidney transplantation due to BK virus infection, requiring careful screening and management primarily through reduced immunosuppression, as no effective antiviral therapy exists.
- This review evaluated the effectiveness and risks of various interventions for treating or preventing BKVAN among kidney transplant recipients, including examining randomized controlled trials and cohort studies.
- The review included 12 RCTs with a total of 2,669 participants, analyzing data through rigorous methods to assess the quality and effectiveness of these interventions.
Effects of two immunosuppression regimens on T-lymphocyte subsets in elderly kidney transplant recipients.
Front Immunol
October 2024
Serviço de Transplante Renal, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Background: Despite the growing number of elderly kidney transplant (Ktx) recipients, few studies have examined the effects of immunosuppression on their lymphocyte profiles.
Methods: We evaluated the early conversion from mycophenolate sodium (MPS) to everolimus (EVL) after rabbit antithymocyte globulin (rATG) 2 mg/kg induction in elderly kidney recipients. Three groups of KTx patients were compared: (a) Young (n=20, 36 ± 7 y) receiving standard immunosuppression (Group A1) (prednisone, tacrolimus, and MPS), (b) Elderly (n=35, 65 ± 3 y) receiving standard immunosuppression (Group B1), and (c) Elderly (n=16, 65 ± 3 y) with early (mean 30 d) conversion from MPS to EVL (Group B2).
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