Conversion from Prograft to Advagraf among kidney transplant récipients results in sustained decrease in tacrolimus exposure

info:eu-repo/semantics/nonPublishe

A case-control study of the impact of Ticlopidine and Clopidogrel on surgical risk in renal transplantation

info:eu-repo/semantics/publishe

Does Loss to Follow‐Up Affects Outcomes of Renal Transplantation? A Retrospective Study of 849 Patients

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Conversion from Prograf to Advagraf among kidney transplant recipients results in sustained decrease in tacrolimus exposure.

Advagraf is a slow release form of tacrolimus with once-daily formulation. The potential advantages of Advagraf are better adherence and a safer profile by avoiding toxic peak concentrations. In this study, we evaluated the required daily doses of tacrolimus and subsequent blood levels on conversion from Prograf to Advagraf among kidney transplant recipients.Comparative StudyJournal ArticleSCOPUS: ar.jinfo:eu-repo/semantics/publishe

COMBINED INTRODUCTION OF ANTI-IL2 RECEPTOR ANTIBODIES, MYCOPHENOLIC ACID AND TACROLIMUS: EFFECT ON MALIGNANCIES IN A SINGLE CENTRE RETROSPECTIVE CO-HORT STUDY OF 929 RENAL TRANSPLANT RECIPIENTS

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Ticlopidine and clopidogrel, sometimes combined with aspirin, only minimally increase the surgical risk in renal transplantation: a case-control study.

Patients undergoing kidney transplantation are sometimes being treated with antiplatelet agents such as ticlopidine or clopidogrel. Some teams refuse to wait-list these patients for fear of bleeding during transplant surgery.Journal ArticleSCOPUS: ar.jinfo:eu-repo/semantics/publishe

The Bacteriuria In Renal Transplantation (BIRT) study: A prospective, randomized, parallel-group, multicenter, open-label, superiority trial comparing antibiotics versus no treatment in the prevention of symptomatic urinary tract infection in kidney transplant recipients with asymptomatic bacteriuria (protocol).

http://www.thelancet.com/protocol-reviews/14PRT-5447info:eu-repo/semantics/publishe

Antibiotics versus no therapy in kidney transplant recipients with asymptomatic bacteriuria (BiRT): a pragmatic, multicentre, randomised controlled trial.

Many transplant physicians screen for and treat asymptomatic bacteriuria (ASB) during post-kidney transplant surveillance. We investigated whether antibiotics are effective in reducing the occurrence of symptomatic urinary tract infection (UTI) in kidney transplant recipients with ASB. We performed this multicentre, randomised, open-label trial in kidney transplant recipients who had ASB and were ≥2 months post-transplantation. We randomly assigned participants to receive antibiotics or no therapy. The primary outcome was the incidence of symptomatic UTI over the subsequent 12 months. 199 kidney transplant recipients with ASB were randomly assigned to antibiotics (100 participants) or no therapy (99 participants). There was no significant difference in the occurrence of symptomatic UTI between the antibiotic and no-therapy groups (27% [27/100] versus 31% [31/99], univariate Cox model: hazard ratio 0.83 [95% CI: 0.50-1.40], log-rank test: p=0.49). Over the one-year study period, antibiotic use was five times higher in the antibiotic group than in the no-therapy group (30 antibiotic days/participant [interquartile range, 20-41] versus 6 [interquartile range, 0-15], p<0.001). Overall, 155/199 participants (78%) had at least one further episode of bacteriuria during the follow-up. Compared with the participant's baseline episode of ASB, the second episode of bacteriuria was more frequently caused by a bacteria resistant to clinically relevant antibiotics (ciprofloxacin, cotrimoxazole, 3-generation cephalosporin) in the antibiotic group than in the no-therapy group (18% [13/72] versus 4% [3/83], p=0.003). Applying a screen-and-treat strategy for ASB does not reduce the occurrence of symptomatic UTI in kidney transplant recipients who are more than two months post-transplantation. Furthermore, this strategy increases antibiotic use and promotes the emergence of resistant organisms

Safety of Everolimus With Reduced Calcineurin Inhibitor Exposure in De Novo Kidney Transplants: An Analysis From the Randomized TRANSFORM Study

BACKGROUND: The safety profiles of standard therapy versus everolimus with reduced-exposure calcineurin inhibitor (CNI) therapy using contemporary protocols in de novo kidney transplant recipients have not been compared in detail. METHODS: TRANSFORM was a randomized, international trial in which de novo kidney transplant patients were randomized to everolimus with reduced-exposure CNI (N = 1014) or mycophenolic acid (MPA) with standard-exposure CNI (N = 1012), both with induction and corticosteroids. RESULTS: Within the safety population (everolimus 1014, MPA 1012), adverse events with a suspected relation to study drug occurred in 62.9% versus 59.2% of patients given everolimus or MPA, respectively (P = 0.085). Hyperlipidemia, interstitial lung disease, peripheral edema, proteinuria, stomatitis/mouth ulceration, thrombocytopenia, and wound healing complications were more frequent with everolimus, whereas diarrhea, nausea, vomiting, leukopenia, tremor, and insomnia were more frequent in the MPA group. The incidence of viral infections (17.2% versus 29.2%; P < 0.001), cytomegalovirus (CMV) infections (8.1% versus 20.1%; P < 0.001), CMV syndrome (13.6% versus 23.0%, P = 0.044), and BK virus (BKV) infections (4.3% versus 8.0%, P < 0.001) were less frequent with everolimus. CMV infection was less common with everolimus versus MPA after adjusting for prophylaxis therapy in the D+/R- subgroup (P < 0.001). Study drug was discontinued more frequently due to rejection or impaired healing with everolimus, and more often due to BKV infection or BKV nephropathy with MPA. CONCLUSIONS: De novo everolimus with reduced-exposure CNI yielded a comparable incidence, though a distinctly different pattern, of adverse events versus current standard of care. Both regimens are safe and effective, yet their distinct profiles may enable tailoring for individual kidney transplant recipients.status: publishe