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461 records · Page 26Linked to original sources
PubMed2004

A pilot study of calcineurin inhibitors (CNIs) and steroid avoidance immunosuppressive protocol among living donor kidney transplant recipients.

Calcineurin Inhibitors (CNIs) and Corticosteroids have been the main immunosuppressive agents in solid organ transplantation. Many studies have confirmed the positive impacts of withdrawal/avoidance of these agents, separately, on their side effect profiles. A pilot study was performed avoiding both agents among low-immunological-risk living donor kidney transplant recipients at a single center. Seventeen recipients were maintained on the double avoidance protocol during the study period beginning July 2002 through December 2003. Three rejection episodes occurred (out of ten) among related donor kidney recipients and six episodes (out of seven) among unrelated donor kidney recipients. Although most of the rejections were reversed with a short course of corticosteroids, the protocol was revised to exclude the unrelated donor kidney recipients. There were higher incidences of wound complications among recipients who received the initial loading dose of Sirolimus. Double avoidance of CNIs and corticosteroids is possible in living donor kidney transplant recipients with an acceptable incidence of rejection. Proper management of the side effects of Sirolimus could further minimize the incidence of rejection. A multi-center randomized study is recommended in order to recognize the benefits of avoiding CNIs and corticosteroids in renal transplant recipients.

Adrenal Cortex Hormones↗
PubMed2001

[Focus on Islets of Langerhans transplantation].

INDICATIONS: There are two types of indications for Langerhans islets transplantation, patients with type 1 diabetes mellitus who have a functional kidney graft but who cannot be candidates for total pancreas transplantation, and soon, patients without renal failure who develop particularly uncontrollable diabetes mellitus. SEVERAL BASIC CONDITIONS: Several conditions are required for the success of Langerhans islet transplantation: a laboratory with demonstrated skill is isolating islets, a sufficiently large number of islets for injection (600,000 for a 60-kg patient), fresh islets harvested within less than 24 hours before transplantation, effective immunosuppressive treatment with no toxic effect on Langerhans islets. The injection is a simple procedure performed under local anesthesia via transhepatic catheterization of the portal vein. RESULTS: Through 2000, 10% to 20% of implanted grafts were functional at 1 year. Islets survival has exceeded 80% at 1 year. The gold standard for success is withdrawal of insulin therapy and normal glucose control. Islets grafts will undoubtedly become the next important step in the treatment of type 1 diabetes mellitus, but other techniques are also envisaged for the future.

Age Factors↗
PubMed2003

Daclizumab as induction therapy in kidney and simultaneous pancreas-kidney transplantation.

Acute rejection still remains a major problem in organ transplantation and is a significant risk factor for chronic rejection, and chronic rejection is one of the most important causes of late graft loss. Current new immunosuppressive drugs such as tacrolimus, rapamycin and mycophenolate mofetil have been developed to reduce acute rejection and to improve renal allograft survival. More recently, antihuman antibodies, either monoclonal or polyclonal, have been developed to use for induction therapy at the time of transplantation or to treat rejection. Daclizumab, a new engineered human immunoglobulin monoclonal antibody to the interleukin-2 receptor a-subunit was approved to prevent acute rejection after solid organ transplantation. Data from clinical trials show daclizumab to be well tolerated in solid organ transplantation. It does not increase the incidence of infection, including cytomegalovirus infection.

Adrenal Cortex Hormones↗
PubMed2005

Inflammation 2005 - Seventh World Congress. Respiratory inflammation.

In this conference, unlike previous conferences in this series, relatively little time was given to new drug therapy approaches for the treatment of inflammation. Instead, the emphasis was on basic mechanisms with a strong bias toward Australian research. The etiology of chronic obstructive pulmonary disease (COPD) and asthma was discussed in detail with an intensive consideration of mechanisms involved in the development of corticosteroid resistance, particularly the role of histone deacetylase. Various rodent model systems for testing potential inhibitors of COPD and asthma were also presented.

Adrenal Cortex Hormones↗
PubMed2005

[Effect of cyclosporine and simulect mono and combination therapy on cardiac allo-transplantation in rats].

OBJECTIVE: To observe the effect of cyclosporine and simulect mono or combination therapy on cardiac allo-transplantation in rats. METHODS: Recipients with allografts were treated with different doses of cyclosporine and/or simulect after cardiac allo-transplantation. Graft survival time was observed; the histopathological examination of graft tissues was performed; and levels of serum IL-2 and IL-4 were determined. RESULTS: Mono or combination therapy with cyclosporine and/or simulect increased the survival of cardiac allografts. With the prolongation of survival time of the grafts, the rejection of grafts was moderated. The serum IL-2 level increased in acute rejected grafts; the serum IL-4 level increased evidently in long survival grafts. CONCLUSION: Cyclosporine and simulect have an effect in the prolongation of cardiac allograft survival in rats, and the combination therapy shows an evident synergistic effect.

Animals↗
PubMed2006

[Clinical study on haploid HLA-matched hematopoietic stem cell transplantation for treatment of malignant hematological disease].

BACKGROUND & OBJECTIVE: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the most effective method to treat malignant hematological disease. However the human leukocyte antigen (HLA)-matched sibling donors can be found for only 25%-30% patients. The probability of finding an unrelated matched donor is 1/50000-1/100000, or even lower. If we choose haploid HLA-matched hematopoietic stem cell transplantation instead, we may be able to find donors for 90% patients. Our present study was to explore the feasibility of allo-HSCT by using haploid HLA-matched donor in treatment for malignant hematological disease. METHODS: Twenty-five patients with malignant hematological disease received allo-HSCT with HLA 2 or 3 antigen mismatched related donors. All patients were treated with intensive immunosuppression, granulocyte colony stimulating factor (G-CSF) mobilization, antithymocyte globulin (ATG) and combination of bone marrow and peripheral blood stem cell transplantation. The conditioning regimen was intensified and prolonged by using the combination of cyclosporine (Cs) A, MMF, ATG and anti-CD25 antibody for graft-versus-host disease (GVHD) prophylaxis. RESULTS: All patients achieved sustained, full donortype engraftment. Acute GVHD occurred in 21 of 25 patients. Eight of them were grade I aGVHD, six grade II aGVHD, two grade III aGVHD and five grade IV aGVHD. The cumulative incidence of grade II-IV aGVHD was 48%,and grade III-IV aGVHD was 28.57%. Chronic GVHD was observed in 12 of 25 patients and none of them developed extensive cGVHD. Sixteen patients were alive and disease free, with 64.0+/- 2.98% 1 year disease-free survival rate. One year overall survival rate was 64.0+/-3.08%. Nine patients died, 1 from relapse and 8 from transplantation related mortality. CONCLUSIONS: Haploid HLA-matched allo-HSCT is a relatively efficient method for the treatment of patients with malignant hematological disease, who have no related matched donors. Nevertheless, strict administration should be carried out since it's a high risk approach.

Adolescent↗