Complications of Solid Organ Transplantation

Sen, Ayan; Callisen, Hannelisa; Libricz, Stacy; Patel, B. M.

doi:10.1016/j.ccc.2018.08.011

Cited by 51 publications

(17 citation statements)

References 100 publications

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“…With introduction of modern immunosuppressive regimens, severe rejection of allografts is nowadays rare and thereby fatal immunological organ failures are uncommon. Meanwhile, other complications prevail, notably infections, tumors and cardiovascular diseases[ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Chances and risks of sodium-glucose cotransporter 2 inhibitors in solid organ transplantation: A review of literatures

Schwarzenbach¹,

Bernhard²,

Czerlau³

et al. 2021

WJT

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Solid organ transplantation offers life-saving treatment for patients with end-organ dysfunction. Patient survival and quality of life have improved over the past few decades as a result of pharmacological development, expansion of the donor pool, technological advances and standardization of practices related to transplantation. Still, transplantation is associated with cardiovascular complications, of which post-transplant diabetes mellitus (PTDM) is one of the most important. PTDM increases mortality, which is best documented in patients who have received kidney and heart transplants. PTDM results from traditional risk factors seen in patients with type 2 diabetes mellitus, but also from specific post-transplant risk factors such as metabolic side effects of immunosuppressive drugs, post-transplant viral infections and hypomagnesemia. Oral hypoglycaemic agents are the first choice for the treatment of type 2 diabetes mellitus in non-transplanted patients. However, the evidence on the safety and efficacy of oral hypoglycaemic agents in transplant recipients is limited. The favourable risk/benefit ratio, which is suggested by large-scale and long-term studies on new glucose-lowering drug classes such as glucagon-like peptide 1 receptor agonists and sodium-glucose cotransporter 2 inhibitors, makes studies warranted to assess the potential role of these agents in the management of PTDM.

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Section: Introductionmentioning

confidence: 99%

Chances and risks of sodium-glucose cotransporter 2 inhibitors in solid organ transplantation: A review of literatures

Schwarzenbach¹,

Bernhard²,

Czerlau³

et al. 2021

WJT

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“…Despite the higher rates of survival, pediatric SOT is also associated with clinical complexities, including the chronic use of immunosuppressants, frequent hospitalization, the need for multiple surgical interventions, and nutrition and growth concerns 5,6 . Thus, with improved survival rates comes increased risk for longer‐term morbidity and subsequent impact on QoL.…”

Section: Introductionmentioning

confidence: 99%

“…2,4 Despite the higher rates of survival, pediatric SOT is also associated with clinical complexities, including the chronic use of immunosuppressants, frequent hospitalization, the need for multiple surgical interventions, and nutrition and growth concerns. 5,6 Thus, with improved survival rates comes increased risk for longer-term morbidity and subsequent impact on QoL. As a result, outcome metrics should also consider the broader concepts of health that reflect overall QoL and well-being, and incorporate self-reported evaluations to adequately capture the patient experience and optimize functioning.…”

mentioning

confidence: 99%

Quality of life and psychosocial outcomes of adults who were pediatric solid organ transplant recipients: A systematic review

Durish

Lin

Pol

et al. 2022

Pediatric Transplantation

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Background The number of pediatric SOT recipients surviving into adulthood is increasing. Thus, understanding their psychosocial and QoL outcomes is important. We conducted a systematic review to collate existing literature examining QoL outcomes (physical functioning, psychological functioning, social functioning), as well as risk and protective factors associated with QoL, among adults who underwent SOT during childhood. Methods A systematic search of five databases, from inception to January 6, 2021, was conducted to identify articles that reported on QoL outcomes for adults (≥18‐year of age) who received a SOT during childhood (<19‐year of age). Results Twenty‐five articles met inclusion criteria. Studies examined QoL across a range of SOT populations (liver, kidney, heart). QoL and psychosocial outcomes were variable; however, the majority of studies indicated QoL in this population to be similar to the general population, or at least similar to other chronic illness groups, with the exception of physical and social functioning. Factors related to a more optimal medical course, younger age at transplant and follow‐up, and positive psychosocial functioning, were found to be predictive of better QoL outcomes. Conclusions While several studies indicated QoL to be similar to the general population, the literature is limited in both quantity and quality. No study employed prospective, longitudinal methodologies to systematically evaluate QoL over time and few studies utilized normative‐based measures of QoL. Furthermore, several SOT groups were under‐represented in the literature (e.g., lung, intestine, multi‐visceral). Nonetheless, findings have implications for intervention and clinical decision‐making.

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“…Omeprazole increased tacrolimus concentration through inhibiting CYP3A5 of patients with variant CYP2C19 alleles in one drug interaction study ( Bosó et al, 2013 ). The most commonly used antihypertensive drugs in renal transplant recipients are dihydropyridine calcium channel blockers (CCBs) ( Moes et al, 2017 ; Rao and Coates, 2018 ; Sen et al, 2019 ). The interaction between tacrolimus and CCBs varies widely in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

CYP3A5 Genotype-Dependent Drug-Drug Interaction Between Tacrolimus and Nifedipine in Chinese Renal Transplant Patients

et al. 2021

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Purpose: The drug-drug interactions (DDIs) of tacrolimus greatly contributed to pharmacokinetic variability. Nifedipine, frequently prescribed for hypertension, is a competitive CYP3A5 inhibitor which can inhibit tacrolimus metabolism. The objective of this study was to investigate whether CYP3A5 genotype could influence tacrolimus-nifedipine DDI in Chinese renal transplant patients.Method: All renal transplant patients were divided into CYP3A5*3/*3 homozygotes (group I) and CYP3A5*1 allele carriers (CYP3A5*1/*1 + CYP3A5*1/*3) (group II). Each group was subdivided into patients taking tacrolimus co-administered with nifedipine (CONF) and that administrated with tacrolimus alone (Controls). Tacrolimus trough concentrations (C0) were measured using high performance liquid chromatography. A retrospective analysis compared tacrolimus dose (D)-corrected trough concentrations (C0) (C0/D) between CONF and Controls in group I and II, respectively. At the same time, a multivariate line regression analysis was made to evaluate the effect of variates on C0/D.Results: In this study, a significant DDI between tacrolimus and nifedipine with respect to the CYP3A5*3 polymorphism was confirmed. In group I (n = 43), the C0/D of CONF was significantly higher than in Controls [225.2 ± 66.3 vs. 155.1 ± 34.6 ng/ml/(mg/kg); p = 0.002]. However, this difference was not detected in group II (n = 27) (p = 0.216). The co-administrated nifedipine and CYP3A5*3/*3 homozygotes significantly increased tacrolimus concentrations in multivariate line regression analysis.Discussion: A CYP3A5 genotype-dependent DDI was found between tacrolimus and nifedipine. Therefore, personalized therapy accounting for CYP3A5 genotype detection as well as therapeutic drug monitoring are necessary for renal transplant patients when treating with tacrolimus and nifedipine.

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Complications of Solid Organ Transplantation

Cited by 51 publications

References 100 publications

Chances and risks of sodium-glucose cotransporter 2 inhibitors in solid organ transplantation: A review of literatures

Chances and risks of sodium-glucose cotransporter 2 inhibitors in solid organ transplantation: A review of literatures

Quality of life and psychosocial outcomes of adults who were pediatric solid organ transplant recipients: A systematic review

CYP3A5 Genotype-Dependent Drug-Drug Interaction Between Tacrolimus and Nifedipine in Chinese Renal Transplant Patients

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