scholarly journals Recent options in drug therapy after solid organ transplantation

2012 ◽  
Vol 153 (33) ◽  
pp. 1294-1301
Author(s):  
Balázs Pőcze ◽  
Péter Németh ◽  
Róbert Langer
Keyword(s):  
Immune Response ◽  
Organ Transplantation ◽  
Survival Rates ◽  
Solid Organ Transplantation ◽  
Tolerance Induction ◽  
Calcineurin Inhibitors ◽  
Immunosuppressive Drugs ◽  
Solid Organ ◽  
Patient And Graft Survival

Solid organ transplantation has shown improvement in patient and graft survival rates due to the development of immunosuppression in the last fifty years; however only the last two decades led to the development of new, baseline immunosuppressive drugs that avoid the unlikely side effects of calcineurin inhibitors, especially nephrotoxicity. The transplanted organ is foreign to the host and, therefore, it induces a complex immune response of the recipient. In this review, a brief outline of immune response is given, followed by the introduction of new immunosuppressive drugs acting via variant pathways. These are compounds which are already in use or becoming shortly available and are potential future alternatives for the calcineurin inhibitors. This paper highlights the role of co-stimulation blockade with belatacept and the recently even more intensively studied field of tolerance induction. Orv. Hetil., 2012, 153, 1294–1301.

scholarly journals Calcineurin Inhibitor-Based Immunosuppression and COVID-19: Results from a Multidisciplinary Cohort of Patients in Northern Italy

2020 ◽  
Vol 8 (7) ◽  
pp. 977 ◽  
Author(s):  
Lorenzo Cavagna ◽  
Elena Seminari ◽  
Giovanni Zanframundo ◽  
Marilena Gregorini ◽  
Angela Di Matteo ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Calcineurin Inhibitor ◽  
Clinical Course ◽  
Solid Organ Transplantation ◽  
Calcineurin Inhibitors ◽  
Infectious Complications ◽  
Study Data ◽  
Solid Organ ◽  
The North

The role of immunosuppression in SARS-CoV-2-related disease (COVID-19) is a matter of debate. We here describe the course and the outcome of COVID-19 in a cohort of patients undergoing treatment with calcineurin inhibitors. In this monocentric cohort study, data were collected from the COVID-19 outbreak in Italy up to 28 April 2020. Patients were followed at our hospital for solid organ transplantation or systemic rheumatic disorders (RMDs) and were on calcineurin inhibitor (CNI)-based therapy. Selected patients were referred from the North of Italy. The aim of our study was to evaluate the clinical course of COVID-19 in this setting. We evaluated 385 consecutive patients (220 males, 57%; median age 61 years, IQR 48–69); 331 (86%) received solid organ transplantation and 54 (14%) had a RMD. CNIs were the only immunosuppressant administered in 47 patients (12%). We identified 14 (4%) COVID-19 patients, all transplanted, mainly presenting with fever (86%) and diarrhea (71%). Twelve patients were hospitalized and two of them died, both with severe comorbidities. No patients developed acute respiratory distress syndrome or infectious complications. The surviving 10 patients are now fully recovered. The clinical course of COVID-19 patients on CNIs is generally mild, and the risk of superinfection seems low.

The role of radiotherapy in patients with solid tumours after solid organ transplantation: a systematic review

2021 ◽  
Vol 22 (3) ◽  
pp. e93-e104
Author(s):  
Rosario Mazzola ◽  
Francesco Cuccia ◽  
Alessandro Bertani ◽  
Slavisa Tubin ◽  
Pier Giulio Conaldi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Solid Tumours ◽  
Solid Organ

Barcelona Consensus on Biomarker-Based Immunosuppressive Drugs Management in Solid Organ Transplantation

2016 ◽  
Vol 38 ◽  
pp. S1-S20 ◽  
Author(s):  
Mercè Brunet ◽  
Maria Shipkova ◽  
Teun van Gelder ◽  
Eberhard Wieland ◽  
Claudia Sommerer ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Immunosuppressive Drugs ◽  
Solid Organ

Living Organ Donation Role of Ethics for Improved Clinical Practice

2018 ◽  
pp. 242-259
Author(s):  
Pierpaolo Di Cocco
Keyword(s):  
Organ Donation ◽  
Organ Transplantation ◽  
Financial Incentives ◽  
Ethical Issues ◽  
Supply And Demand ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Live Donor ◽  
Live Donation

Solid organ transplantation represents one of the most important achievements in history of medicine. Over the last decades, the increasing number of transplants has not been of the same extent of the number of patients in the waiting lists. Live donation has been implemented in order to reduce the gap between supply and demand. From an ethical standpoint, the donation process from a live donor seems to violate the traditional first rule of medicine—primum non nocere because inevitably exposes healthy persons to a risk in order to benefit another person. In the chapter will be presented the crucial role of ethics and specific ethical issues in the different forms of live donation, such as financial incentives for living donation, reimbursement in unrelated live donation, minor sibling-to-sibling organ donation. The ethical aspects of live donor organ transplantation are continuously evolving; in order to make this strategy more beneficial and lifesaving, everyone involved in the process should make every possible effort with in mind the best interests of the patients.

scholarly journals Deciphering the role of eosinophils in solid organ transplantation

2019 ◽  
Vol 20 (4) ◽  
pp. 924-930
Author(s):  
Oscar Okwudiri Onyema ◽  
Yizhan Guo ◽  
Atsushi Hata ◽  
Daniel Kreisel ◽  
Andrew E. Gelman ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Solid Organ

scholarly journals Macrophages in Organ Transplantation

2020 ◽  
Vol 11 ◽  
Author(s):  
Farideh Ordikhani ◽  
Venu Pothula ◽  
Rodrigo Sanchez-Tarjuelo ◽  
Stefan Jordan ◽  
Jordi Ochando
Keyword(s):  
Immune Response ◽  
Organ Transplantation ◽  
Survival Rates ◽  
Adaptive Immune Response ◽  
Phagocytic Cells ◽  
Term Survival ◽  
Vast Number ◽  
Monocytes And Macrophages

Current immunosuppressive therapy has led to excellent short-term survival rates in organ transplantation. However, long-term graft survival rates are suboptimal, and a vast number of allografts are gradually lost in the clinic. An increasing number of animal and clinical studies have demonstrated that monocytes and macrophages play a pivotal role in graft rejection, as these mononuclear phagocytic cells recognize alloantigens and trigger an inflammatory cascade that activate the adaptive immune response. Moreover, recent studies suggest that monocytes acquire a feature of memory recall response that is associated with a potent immune response. This form of memory is called “trained immunity,” and it is retained by mechanisms of epigenetic and metabolic changes in innate immune cells after exposure to particular ligands, which have a direct impact in allograft rejection. In this review article, we highlight the role of monocytes and macrophages in organ transplantation and summarize therapeutic approaches to promote tolerance through manipulation of monocytes and macrophages. These strategies may open new therapeutic opportunities to increase long-term transplant survival rates in the clinic.

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