October 25, 2013
Renal transplantation for carefully selected HIV-positive patients has become well-accepted over the last decade. There remain concerns about the risk of overimmunosuppression in this group, due to their pre-existing immunodeficiency due to HIV infection. In this US registry study, HIV-positive patients actually had a higher risk of acute rejection than HIV-negative recipients, but this increased […]
October 6, 2013
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The 30th adult heart transplant ISHLT report is based on data submitted on 110,486 heart transplants in recipients of all ages (including 99,008 adults) by 407 centers worldwide since 1982 through June 30, 2012, with follow-up until June 30, 2012.
June 21, 2013
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This multicenter trial randomized de novo heart transplant recipients to everolimus 1.5 mg or 3.0 mg with reduced-dose cyclosporine, or mycophenolate mofetil (MMF) 3 g/day with standard-dose cyclosporine (plus corticosteroids ± induction). Primary efficacy endpoint was the 12-month composite incidence of biopsy-proven acute rejection, acute rejection associated with hemodynamic compromise, graft loss/retransplant, death or loss […]
June 21, 2013
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New immunosuppressant agents face a high standard: theymust show comparable or superior results as current treatments with less side effects. Sotrastaurin is an oral medication that blocks protein kinase C to prevent T cell activation. In this randomized controlled trial, sotrastaurin combined with tacrolimus, steroids and basiliximab showed similar rates of acute rejection and graft […]
June 21, 2013
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There have been several trials evaluating a strategy of adjusting mycophenolic acid dose early post-transplant based on pharmacokinetic studies early post-transplant as opposed to prescribing a fixed dose to all patients. This meta-analysis of available trials showed no reduction in acute rejection or graft loss with such a practice. There were also no differences in […]
January 28, 2013
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Advagraf, a once-daily extended-release tacrolimus formulation was released several years ago. Another once daily formulation of tacrolimus called LCPT, has now been developed. In this non-inferiority RCT, the LCPT formulation showed similar outcomes to standard twice-daily tacrolimus with a lower daily dose. The availability of multiple once-daily tacrolimus formulations, as well as several generic versions […]
January 28, 2013
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Advagraf, a once-daily extended-release tacrolimus formulation was released several years ago. Another once daily formulation of tacrolimus called LCPT, has now been developed. In this non-inferiority RCT, the LCPT formulation showed similar outcomes to standard twice-daily tacrolimus with a lower daily dose. The availability of multiple once-daily tacrolimus formulations, as well as several generic versions […]
October 30, 2012
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The best strategy to manage patients with a failed renal allograft is unknown. It is unknown whether the allograft acts a “sponge” for DSA, and removal may lead to higher levels of anti-HLA antibodies. This study compared patients whose immunosuppression stopped, and who either underwent a graft nephrectomy or not. Allograft nephrectomy resulted in a […]
October 30, 2012
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Chronic kidney disease is a significant complication after liver transplantation. A common strategy is to add mycophenolic acid (MPA) in order to reduce or eliminate calcineurin inhibitors (CnI). Although this is a common practice, the authors were only able to find 8 randomized controlled trials assessing its effects. Use of MPA does improve renal function, […]
August 17, 2012
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Immunosuppression regimens after lung transplantation are typically based on calcineurin inhibitors. Tacrolimus is widely used as an alternative to cyclosporine, and it has been proposed that tacrolimus may reduce the development of bronchiolitis obliterans (BOS) when compared to cyclosporine. This randomized, open-label, multicenter trial compared cyclosporine to tacrolimus (both plus prednisolone and mycophenolate mofetil) for […]
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