Posts Tagged ‘Immunosuppression’

July 9, 2012

Randomized Phase 2b Trial of Tofacitinib (CP-690,550) in De Novo Kidney Transplant Patients: Efficacy, Renal Function and Safety at 1 Year


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Tofacitinib is the first in a new class of immunosuppressive agents that inhibit janus kinase, an important transcription factor. This randomized-controlled trial compared tofacitinib to cyclosporine in renal transplant patients. Tofacitinib showed lower rates of acute rejection and chronic changes on biopsy, with better renal function compared to a cyclosporine-based regimen. On the other hand, […]

No Comments Posted in Renal Transplantation
July 9, 2012

Post-transplant malignancy: reducing the risk in kidney transplant recipients


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Post-transplant malignancy, one of the most common causes of death following transplantation, is linked to both modifiable and non-modifiable risk factors. This publication reviews the scope of the problem of post-transplant malignancy, its pathogenesis, and strategies for prevention, with attention to the impact of various immunosuppressive strategies. The systematic review included a Medline search of […]

No Comments Posted in Renal Transplantation
April 14, 2012

Randomized Controlled Trial of Sirolimus for Renal Transplant Recipients at High Risk for Nonmelanoma Skin Cancer

Several randomized controlled trials have shown lower rates of non-melanoma skin cancer among patients who receive sirolimus from the time of transplant. This study randomized previously transplanted patients who had previously had at least one skin cancer to either continue on their usual immunosuppression or change their calcineurin inhibitor to sirolimus. There were fewer new […]

No Comments Posted in Renal Transplantation
April 14, 2012

Conversion from Cyclosporine to Everolimus at 4.5 Months Posttransplant: 3-Year Results from the Randomized ZEUS Study

This paper prevents further results from a randomized controlled trial of mandatory conversion from cyclosporine to everolimus. There remains a higher acute rejection rate in the everolimus-treated patients. However, renal function remained better in the everolimus arm. As in many such trials, a significant number of patients treated with everolimus had to change to other […]

No Comments Posted in Renal Transplantation
April 14, 2012

Can Immune Cell Function Assay Identify Patients at Risk of Infection or Rejection? A Meta-Analysis


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An assay to quantify how immunosuppressed an individual is would be a great asset in clinical practice. The Cylex ImmuKnow assay measures ATP-release from CD4+ T cells and is used in some transplant centers to guide management of immunosuppression. In this study, the authors performed a meta-analysis to determine whether this assay could identify the […]

No Comments Posted in Transplant Infectious Disease
February 23, 2012

Use of sublingual tacrolimus in lung transplant recipients


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Oral administration of tacrolimus in lung transplant recipients is preferred over intravenous administration for reasons of cost, side effects, and predictability of blood concentrations.  Sublingual tacrolimus has been used as an alternative to intravenous drug in patients when oral tacrolimus cannot be administered.  Using a retrospective analysis of a cohort of 34 lung transplant patients […]

No Comments Posted in Lung Transplantation
February 23, 2012

Calcineurin inhibitor minimization using sirolimus leads to improved renal function in pediatric heart transplant recipients.


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The use of calcineurin inhibitors (CNI) as part of the immunosuppressive regime following transplantation is associated with an increased risk of renal dysfunction. There are a limited number of reports on the role CNI minimization for renal recovery following pediatric heart transplant. These authors describe their experience with sirolimus and low dose cyclosporine in those […]

No Comments Posted in Cardiac Transplantation
February 23, 2012

Penny Wise, Pound Foolish? Coverage Limits on Immunosuppression after Kidney Transplantation


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This commentary discusses the current policy in the United States for Medicare patients who receive a renal transplant. Immunosuppressive drug costs are only covered for the first three years post-transplant, at which point patients must pay for the drugs out-of-pocket, or obtain private health insurance. The authors point out that the difficulties many patients face […]

No Comments Posted in Renal Transplantation
February 23, 2012

Three-Year Outcomes from BENEFIT, a Randomized, Active-Controlled, Parallel-Group Study in Adult Kidney Transplant Recipients


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BENEFIT is a randomized controlled trial comparing two different doses of belatacept, a costimulatory blocker, to standard therapy with cyclosporine in de novo kidney transplant patients. Earlier results from this study showed a higher acute rejection rate with belatacept. Nonetheless, at three years, renal function was significantly better in belatacept-treated patents.

No Comments Posted in Renal Transplantation
February 23, 2012

Generic Immunosuppression in Solid Organ Transplantation: A Canadian Perspective


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Over the next few years, patents on all of the currently used oral immunosuppressive medications will expire. There is concern within the transplant community as to whether generic immunosuppressive medications are truly as safe and effective as the original, brand-name versions. In this paper, the evidence comparing brand-name to generic immunosuppressants in transplantation is reviewed, […]

No Comments Posted in Cardiac Transplantation, Liver Transplantation, Lung Transplantation, Renal Transplantation