Search results for "tacrolimus"
showing 9 items of 89 documents
Combining Three Different Pretransplantation Scores Improves Predictive Value in Patients after Haploidentical Stem Cell Transplantation with Thiotep…
2021
ABSTRACT One hundred and sixty-one patients underwent haploidentical stem cell transplantation (haploSCT) with thiotepa, busulfan, and fludarabine conditioning followed by post-transplantation cyclophosphamide (PTCy) (on days +3 and +4) and tacrolimus as graft-versus-host disease prophylaxis. Forty-two percent of patients had a high or very high revised Disease Risk Index (rDRI), 55% had an European Society for Blood and Marrow Transplantation risk score (EBMT-RS) ≥4, and 36% had an age-adjusted Hematopoietic Cell Transplant Comorbidity Index (HCT-CI-age) score ≥3. Each of these was considered an unfavorable score. Using the pretransplantation unfavorable scores that had an independent impa…
Update on the principles and novel local and systemic therapies for the treatment of non-infectious uveitis.
2012
Ocular inflammatory disorders constitute a sight-threatening group of diseases that might be managed according to their severity. Their treatment guidelines experience constant changes with new agents that improve the results obtained with former drugs. Nowadays we can make use of a five step protocol in which topical, periocular and systemic corticosteroids remain as the main therapy for non-infectious uveitis. In addition, immunosuppresive drugs can be added in order to enhance the anti-inflammatory effects and to play the role of corticosteroid-sparing agents. These can be organized in four other steps: cyclosporine and methotrexate in a second one; azathioprine, mycophenolate and tacrol…
Rapid Steroid Withdrawal after Renal Transplantation Reduces Mortality: Five Year Follow-Up of a Randomized Controlled Trial (Harmony Study) Confirms…
2021
Background: We previously reported excellent efficacy and improved safety aspects of rapid steroid withdrawal (RSWD) in the randomized controlled one year “Harmony” trial, in which 587 predominantly deceased-donor kidney transplant recipients were randomized either to basiliximab or rabbit ATG induction therapy and compared to standard immunosuppressive therapy consisting of basiliximab, low tacrolimus once daily, mycophenolate mofetil, and corticosteroids. Methods: Following the end of the original one-year study period, patients were asked to participate in the observational follow-up (FU) study examining most of the end points of the original study. Hereby, de novo incidences between yea…
Predicting risk of acute rejection in patients with kidney transplants
2009
Objective: Create a model to predict the risk of acute rejection of kidney transplant considering variables related to the immunosuppressant agent used, the receiver, the donor, and the transplanted organ. Methods: Cohort study in a population of 68 patients with kidney transplants being treated with tacrolimus triple therapy. Predicting the risk of acute rejection was carried out with a logistic regression analysis using age, sex, retransplant status, number of HLA incompatibilities, cold ischaemia time, acute tubular necrosis, induction with basiliximab or thymoglobulin, and treatment type as explanatory variables. The contribution of variables associated with determining the blood concen…
Clinical implications ofCYP3Apolymorphisms
2006
Due to their enormous substrate spectrum CYP3A4, -3A5 and -3A7 constitute the most important drug-metabolising enzyme subfamily in humans. CYP3As are expressed predominantly, but not exclusively, in the liver and intestine, where they participate in the metabolism of 45 - 60% of currently used drugs and many other compounds such as steroids and carcinogens. CYP3A expression and activity vary interindividually due to a combination of genetic and nongenetic factors such as hormone and health status, and the impact of environmental stimuli. Over the past several years, genetic determinants have been identified for much of the variable expression of CYP3A5 and -3A7, but not for CYP3A4. Using th…
Guillain-Barré syndrome after orthotopic liver transplantation: A clinical manifestation of immune reconstitution inflammatory syndrome?
2018
Guillain-Barrè Syndrome, as part of the spectrum of dysimmune neuropathies, is unexpected to occur in immunocompromised hosts. We describe a clinical case of Guillain-Barrè syndrome, occurred a few weeks after a liver transplant, and we postulate that our case would satisfy all requirements to explain this peripheral nervous system complication as a clinical manifestation of an Immune reconstitution inflammatory syndrome. In this setting of liver transplantation, complicated by potentially multiple infective triggers, reduction of immunosuppression and reversal of pathogen-induced immunosuppression, through antimicrobial therapy, may have led to pro-inflammatory response. The pro-inflammato…
Isolated lip dermatitis (atopic cheilitis), successfully treated with topical tacrolimus 0.03%
2020
Background Exfoliative and erosive cheilitis, may be a source of speech and chewing discomfort, but may also be an aesthetic issue for the patients affected. Such a clinical presentation may implicate a variety of inflammatory conditions, including atopic (eczematous) cheilitis. Topical and systemic agents, e.g. corticosteroids, have been used to treat inflammatory lip conditions. Topical tacrolimus has also been used in some inflammatory lip conditions. Material and Methods We performed a retrospective clinical analysis of atopic cheilitis patients. Results Between 2015 and 2020, we addressed 7 (seven) patients with atopic dermatitis affecting only lips and were diagnosed as atopic-eczemat…
Topic tacrolimus, alternative treatment for oral erosive lichen planus resistant to steroids : a case report
2006
The lichen planus is a mucocutaneous disease with unknown etiology and auto-immune pathogenia. There have been three variants of lichen planus: the reticular, the plaque-like and the atrophic-erosive lesions. It?s a chronic disease with acute relapses that generally affects more frecuently to women from the fourties. The diagnostic is based on the clinic identification of the lesions joined with the histopathologic study (basal cells hidropic degeneration, linfoplasmocitic infiltration and absence of displasy signs). The great number of therapeutic options are explained for its high prevalency (0.5-2%), its recurrence and its risk for malignant transformation. We present a case of oral eros…
Fertility and immunosuppression in allogeneic uterus transplantation
2015
A pesar de los avances en medicina reproductiva alcanzados durante las últimas tres décadas, la esterilidad absoluta de origen uterino (AUFI, por sus siglas en inglés), a día de hoy, carece de tratamiento. Ésta, puede ser causada tanto por la ausencia del útero (congénita o adquirida) o la no funcionalidad del mismo [1, 2]. Cálculos en el Reino Unido han demostrado que hay alrededor de 12000 a 15000 mujeres en edad reproductiva con infertilidad uterina en dicho país [3]. No hay cálculos correspondientes a España, pero extrapolando datos sobre prevalencia de causas de AUFI, se estima que puede haber alrededor de 2000-3000 mujeres en edad fértil que no tienen ninguna oportunidad de ser biológ…