Introduction: The presence of hepatitis C virus (HCV) in renal transplant recipients is an independent risk factor for death and graft failure. Chronic allograft nephropathy (CAN) favored by the use of calcineurin inhibitors (CNI) is one of the main causes of graft loss, whereas sirolimus (SRL) has proven to maintain better graft function with lower rates of CAN.
Objectives And Methods: We developed a protocol to evaluate the safety of SRL in transplant recipients with respect to HCV. We studied 5 patients (3 men) of mean age 52 +/- 9.2 years with HCV who had not received antiviral treatment. The viral genotypes were 1b in 4 cases and 2a/2c in 1 case. Basic immunosuppression was mycophenolate mofetil (MMF) and corticosteroids in all patients, cyclosporine (CsA) in 4 cases, and tacrolimus (Tac) in 1 case. Before the switch, a renal biopsy was performed and viral replication and cryoglobulins determined.
Results: Biopsy provided a diagnosis of CAN in 1 case, CNI toxicity-associated CAN in 2 cases, CNI toxicity in 1 case, and no renal damage in the remaining case. We observed a nonsignificant decrease in the number (log) of viral copies with a stabilization of renal function but with a slight to moderate increase in proteinuria.
Conclusions: The switch seemed to be safe with no increase in viral copies. Graft renal function remained stable with increased proteinuria that must be supervised, even though it did not reach statistical significance.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.transproceed.2009.06.064 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Retrospective claims data analysis of ASCT characteristics and costs for working-age, multiple myeloma patients in the US, 2017-2019.
Leuk Res Rep
December 2024
Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, United States.
Multiple myeloma (MM) is a rare hematologic malignancy with a 5-year survival rate of 52 %. For transplant-eligible MM patients, high-dose chemotherapy followed by autologous stem cell transplant (ASCT) is recommended. Given the complexities of the ASCT procedure, understanding patient-specific factors and their impact on treatment decisions is essential.
View Article and Find Full Text PDFMuscle Mass, Muscle Strength, and Health-Related Quality of Life in Kidney Transplant Recipients: Results of the TransplantLines Biobank and Cohort Study.
Kidney Int Rep
January 2025
Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Introduction: Muscles are crucial for daily activities, and kidney transplant recipients (KTRs) often have reduced muscle mass and strength. We aimed to investigate the potential relationship of muscle mass and strength with physical health-related quality of life (HRQoL) in KTRs.
Methods: Data from the TransplantLines Biobank and Cohort Studies were used.
Efficacy and Safety of Pegcetacoplan in Kidney Transplant Recipients With Recurrent Complement 3 Glomerulopathy or Primary Immune Complex Membranoproliferative Glomerulonephritis.
Kidney Int Rep
January 2025
Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Introduction: Complement 3 glomerulopathy (C3G) and primary immune complex membranoproliferative glomerulonephritis (IC-MPGN) have high risks for disease recurrence and allograft loss in transplant kidneys. Pegcetacoplan (targeted complement 3 [C3]/C3b inhibitor) may prevent excessive deposition of C3 and complement 5 [C5] breakdown products and associated renal damage.
Methods: NOBLE (NCT04572854) is a prospective, phase 2, multicenter, open-label, randomized controlled trial evaluating the efficacy and safety of pegcetacoplan in posttransplant patients with recurrent C3G or IC-MPGN.
Direct Oral Anticoagulants in Patients With ESRD and Kidney Transplantation.
Kidney Int Rep
January 2025
Department of Pharmacy, NewYork-Presbyterian Hospital, New York, USA.
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).
View Article and Find Full Text PDFOutcome of Patients Transplanted for C3 Glomerulopathy and Primary Immune Complex-Mediated Membranoproliferative Glomerulonephritis.
Kidney Int Rep
January 2025
Transplantation Center, Departments of Medicine and Surgery, Lausanne University Hospital and University of Lausanne, Switzerland.
Introduction: Approximately 50% of patients with C3 glomerulopathy (C3G) and primary immune complex-mediated membranoproliferative glomerulonephritis (IC-MPGN) reach kidney failure 10 years after diagnosis. Because these patients are generally young, the majority will be listed for kidney transplantation (KTx). However, reported outcomes in patients transplanted for C3G and IC-MPGN are heterogeneous and conflicting, because they are mainly based on retrospective monocentric studies.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!