Trends in the Use of Immunosuppressive Agents by Outpatients After Renal Transplantation at a Medical Center in Southern Taiwan

2012 ◽  
Vol 44 (1) ◽  
pp. 185-189 ◽  
Author(s):  
P.C.-M. Mao ◽  
E.K.-L. Lee ◽  
P.-L. Tseng
Keyword(s):  
Renal Transplantation ◽  
Medical Center ◽  
Immunosuppressive Agents ◽  
Southern Taiwan

scholarly journals Donor genetic variants in interleukin-6 and interleukin-6 receptor associate with biopsy-proven rejection following kidney transplantation.

2021 ◽  
Author(s):  
Felix Poppelaars ◽  
Mariana Gaya da Costa ◽  
Siawosh K. Eskandari ◽  
Jeffrey Damman ◽  
Marc A. Seelen
Keyword(s):  
Kidney Transplantation ◽  
Renal Transplantation ◽  
Renal Transplant ◽  
Interleukin 6 ◽  
Medical Center ◽  
Organ Donors ◽  
Nucleotide Polymorphisms ◽  
Increased Risk ◽  
Major Player ◽  
The Impact

Rejection after kidney transplantation remains an important cause of allograft failure that markedly impacts morbidity. Cytokines are a major player in rejection, and we, therefore, explored the impact of interleukin-6 (IL6) and IL-6 receptor (IL6R) gene polymorphisms on the occurrence of rejection after renal transplantation. We performed an observational cohort study analyzing both donor and recipient DNA in 1,271 renal transplant-pairs from the University Medical Center Groningen in The Netherlands and associated single nucleotide polymorphisms (SNPs) with biopsy-proven rejection after kidney transplantation. The C-allele of the IL6R SNP (Asp358Ala: rs2228145 A>C, formerly rs8192284) in donor kidneys conferred a reduced risk of rejection following renal transplantation (HR 0.78 per C-allele; 95%-CI 0.67-0.90; P=0.001). On the other hand, the C-allele of the IL6 SNP (at position-174 in the promoter; rs1800795 G>C) in donor kidneys was associated with an increased risk of rejection for male organ donors (HR per C-allele 1.31; 95%-CI 1.08-1.58; P=0.0006), but not female organ donors (P=0.33). In contrast, neither the IL6 nor IL6R SNP in the recipient showed an association with renal transplant rejection. In conclusion, donor IL6 and IL6R genotypes but not recipient genotypes represent an independent prognostic marker for biopsy-proven renal allograft rejection.

P1763TUBERCULOSIS IN RENAL TRANSPLANT RECEPIENTS - DO RITUXIMAB AND OTHER IMMUNOSUPRESSION HAVE A ROLE?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Anupma Kaul ◽  
Dharmendra Bhaduria ◽  
Narayan Prasad ◽  
Amit Gupta
Keyword(s):  
Renal Transplantation ◽  
Renal Transplant ◽  
Immunosuppressive Agents ◽  
Induction Agent ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Transplant Patients ◽  
Significant Difference ◽  
High Prevalence ◽  
Mean Time

Abstract Background and Aims Rituximab is an anti CD 20 agent used widely in renal transplant recipients. Its use is associated with various infections;however, its association with Tuberculosis (TB) is not well established and has not been studied in post renal transplantation patients. Method This is a single centre, retrospective analysis of 56 renal transplant recipients who received rituximab for various reasons and 287 post renal transplant patients who did not receive rituximab during the study period from January 2013 to June 2017. The association between use of rituximab and incidence of TB was studied. Other factors associated with tuberculosis were also investigated. Results Baseline characteristics were similar in both the groups. Mean time for occurrence of TB was 18.4 + 10.6 months after renal transplantation. Rituximab use was not significantly associated with tuberculosis or any other infection. Higher number of rejection episodes (60% vs 32.72%, p=0.029) was the only factor associated with greater incidence of TB. However, no specific type of rejection was associated with tuberculosis. Use of plasmapheresis in post transplant period for treatment of humoral rejections was associated with significantly higher incidence of TB (33.33% vs 13.41%, p=0.031), however when pre- transplant plasmapheresis was also considered, there was no significant difference. The choice of induction agent was not associated with higher incidence of TB. Conclusion Use of rituximab is not associated with higher incidence of TB when compared to other immunosuppressive agents. Routine screening and prophylaxis may not be advisable especially in a country like India with high prevalence of TB; as it will further delay transplantation and may adversely affect the outcome of the patients.

scholarly journals Detection of Plasmid-Mediated β-Lactamase Genes and Emergence of a Novel AmpC (CMH-1) in Enterobacter cloacae at a Medical Center in Southern Taiwan

2018 ◽  
Vol 8 (1) ◽  
pp. 8 ◽  
Author(s):  
Yee-Huang Ku ◽  
Mei-Feng Lee ◽  
Yin-Ching Chuang ◽  
Wen-Liang Yu
Keyword(s):  
Prevalence Rate ◽  
Medical Center ◽  
Genetic Resistance ◽  
Enterobacter Cloacae ◽  
Pcr Analysis ◽  
Genetic Evolution ◽  
Enterobacterial Repetitive Intergenic Consensus ◽  
Antibiotic Resistant ◽  
Resistance Trait ◽  
Southern Taiwan

The plasmid-mediated extended-spectrum β-lactamases (ESBLs) and AmpC β-lactamases in Enterobacter spp. have increasingly been reported. In this study, we investigated the prevalence of the plasmid-mediated β-lactamases in Enterobacter cloacae from bloodstream isolates at a medical center in southern Taiwan. ESBL and ampC genes were detected by PCRs and DNA sequencing. Conjugation experiments were conducted to confirm the transferability of the genetic resistance trait. Among 41 non-repetitive blood isolates of cefuroxime-resistant E. cloacae, eight isolates exhibited ESBL phenotype confirmed by double-disk synergistic tests. Nearly all the strains were susceptible to carbapenems. The prevalence rate of the plasmid-mediated blaampC genes was 73% (30/41), including one blaDHA-1, one blaMIR-6, two novel blaCMH-1 genes and other blaACT-like genes. Coexistence of plasmid-mediated blaACT and ESBL genes (10 with blaSHV-12 and one with blaCTX-M-3) was observed. Successful transmissions of the blaACT and blaCMH-1 were demonstrated in some transconjugants. The inducible or derepressed CMH-1 had expanded activity of isolates versus ceftazidime. Enterobacterial repetitive intergenic consensus (ERIC)-PCR analysis and pulsotype showed distinct patterns suggesting non-clonal relationship. In conclusion, plasmid-mediated blaACT-like ampC genes in E. cloacae isolates have been highly prevalent in southern Taiwan and may continue genetic evolution, contributing to the complexities in antibiotic-resistant mechanisms.

scholarly journals La terapia immunosoppressiva nel trapianto di rene

2019 ◽  
Vol 31 (3) ◽  
pp. 192-196
Author(s):  
Aris Tsalouchos ◽  
Maurizio Salvadori
Keyword(s):  
Kidney Transplantation ◽  
Renal Transplantation ◽  
Acute Rejection ◽  
Immunosuppressive Therapy ◽  
Kidney Transplant ◽  
Induction Therapy ◽  
Immunosuppressive Agents ◽  
Oral Prednisone ◽  
Kidney Transplant Recipients ◽  
Optimal Maintenance

Immunosuppressive therapy in renal transplantation Immunosuppressive therapy in renal transplantation can be distinguished in induction therapy and maintenance therapy. Induction therapy is an intense immunosuppressive therapy administered at the time of kidney transplantation to reduce the risk of acute allograft rejection. In general, the induction immunosuppressive strategies used at kidney transplant centers fall into one of these two categories. One strategy relies upon high doses of conventional immunosuppressive agents, while the other utilizes antibodies directed against T-cell antigens in combination with lower doses of conventional agents. Maintenance immunosuppressive therapy is administered to almost all kidney transplant recipients to help prevent acute rejection and loss of the renal allograft. Although an adequate level of immunosuppression is required to dampen the immune response to the allograft, the level of chronic immunosuppression is decreased over time (as the risk of acute rejection decreases) to help lower the overall risk of infection and malignancy; these risks directly correlate with the degree of overall immunosuppression. The optimal maintenance immunosuppressive therapy in kidney transplantation is not established. The major immunosuppressive agents that are available in various combination regimens are glucocorticoids (primarily oral prednisone), azathioprine, mycophenolate mofetil (MMF), enteric-coated mycophenolate sodium (EC-MPS), cyclosporine (in non-modified or modified [microemulsion] form), Tacrolimus, everolimus, rapamycin (sirolimus), and Belatacept.

scholarly journals Legionnaires' disease at a medical center in southern Taiwan

2018 ◽  
Vol 51 (3) ◽  
pp. 352-358 ◽  
Author(s):  
Tzu-Lun Hung ◽  
Ming-Chi Li ◽  
Li-Rong Wang ◽  
Ching-Chuan Liu ◽  
Chia-Wen Li ◽  
...  
Keyword(s):  
Medical Center ◽  
Legionnaires Disease ◽  
Southern Taiwan

scholarly journals The trend of macrolide resistance and emm types of group A streptococci from children at a medical center in southern Taiwan

2015 ◽  
Vol 48 (2) ◽  
pp. 160-167 ◽  
Author(s):  
Po-Kai Chuang ◽  
Shih-Min Wang ◽  
Hui-Chen Lin ◽  
Yu-Hao Cho ◽  
Yun-Ju Ma ◽  
...  
Keyword(s):  
Medical Center ◽  
Macrolide Resistance ◽  
Group A Streptococci ◽  
Group A ◽  
Southern Taiwan

scholarly journals Community-onset Clostridium difficile infection at a tertiary medical center in southern Taiwan, 2007–2015

2018 ◽  
Vol 51 (2) ◽  
pp. 243-250 ◽  
Author(s):  
Chin-Shiang Tsai ◽  
Yuan-Pin Hung ◽  
Jen-Chieh Lee ◽  
Nan-Yao Lee ◽  
Po-Lin Chen ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Medical Center ◽  
Southern Taiwan ◽  
Community Onset
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