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  • 1
    Online Resource
    Online Resource
    Comparison of Alemtuzumab Versus Basiliximab Induction Therapy in Elderly Kidney Transplant Recipients: A Single-Center Experience
    SAGE Publications ; 2021
    In:  Journal of Pharmacy Practice Vol. 34, No. 2 ( 2021-04), p. 199-206
    Details
    In: Journal of Pharmacy Practice, SAGE Publications, Vol. 34, No. 2 ( 2021-04), p. 199-206
    Abstract: The optimal choice of induction immunosuppression for elderly kidney transplant recipients remains unclear. Although alemtuzumab has been associated with escalating risk of death and graft loss in this population, this risk has not been adequately explored. The purpose of this study was to compare the safety and efficacy of alemtuzumab with basiliximab induction in this population. Methods: This is a retrospective matched cohort study of kidney transplant recipients aged ≥65 years. Patients who received alemtuzumab induction were matched (1:2) to a basiliximab control. The primary outcome was allograft survival. The incidence of acute rejection, infection, and all-cause mortality was measured. Results: Fifty-one and 102 patients were included in the alemtuzumab and basiliximab groups, respectively. Baseline demographics were similar between groups, except for more living donor transplant recipients in the alemtuzumab group (26/51 [51%] vs 31/102 [30.4%] , P = .02). Acute cellular rejection occurred more frequently within the first year in the basiliximab group ( P = .02). There was no difference in rates of infection within the first year. Graft and patient survival rates were similar over the follow-up period. Patients receiving basiliximab had a higher glomerular filtration rate at 2 years posttransplant (59 mL/min/1.73 m 2 vs 49 mL/min/1.73 m 2 , P = .03). Conclusions: Alemtuzumab induction is associated with similar outcomes to basiliximab in elderly kidney transplant recipients.
    Type of Medium: Online Resource
    ISSN: 0897-1900 , 1531-1937
    URL: Article
    DOI: 10.1177/0897190019850934
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2131091-9
    SSG: 15,3
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  • 2
    Online Resource
    Online Resource
    Treatment of Renin-Angiotensin-Aldosterone System Dysfunction With Angiotensin II in High-Renin Septic Shock
    SAGE Publications ; 2021
    In:  Seminars in Cardiothoracic and Vascular Anesthesia Vol. 25, No. 1 ( 2021-03), p. 67-73
    Details
    In: Seminars in Cardiothoracic and Vascular Anesthesia, SAGE Publications, Vol. 25, No. 1 ( 2021-03), p. 67-73
    Abstract: Endothelial dysfunction is common in septic shock and has been shown to impair angiotensin converting enzyme and the renin-angiotensin-aldosterone system (RAAS). Dysregulation of this pathway, which can be measured with plasma renin activity (PRA), is important not only because RAAS dysfunction is associated with increased mortality but also because treatment with angiotensin II (Ang-2) has been shown to decrease mortality. In this case series of 2 patients, serial PRA levels identified septic shock patients with RAAS dysfunction. The patients were treated with Ang-2, an angiotensin type 1 receptor agonist, which resulted in significant improvements in hemodynamics and PRA levels during treatment.
    Type of Medium: Online Resource
    ISSN: 1089-2532 , 1940-5596
    URL: Article
    DOI: 10.1177/1089253220949070
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2233047-1
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  • 3
    Online Resource
    Online Resource
    Impact of Steroid Only Induction on Rejection in Simultaneous Liver-Kidney Transplantation
    SAGE Publications ; 2022
    In:  Progress in Transplantation Vol. 32, No. 4 ( 2022-12), p. 363-369
    Details
    In: Progress in Transplantation, SAGE Publications, Vol. 32, No. 4 ( 2022-12), p. 363-369
    Abstract: Introduction: The occurrence of simultaneous liver kidney transplantation has greatly increased; however, the ideal induction and maintenance immunosuppression remains unknown. Question: This evaluation aimed to determine if corticosteroid only induction in simultaneous liver kidney transplant recipients provided adequate prophylaxis against rejection when compared to basiliximab. Design: This was a single center, retrospective, cohort study of adult simultaneous liver kidney transplant recipients from June 2010 to June 2019 receiving corticosteroid only (N = 41) or basiliximab (N = 42) induction. Results: Liver or kidney biopsy proven acute rejection at 3 months was comparable between the corticosteroid only and basiliximab groups (10% vs 7%, P = .67), which persisted through 12 months posttransplant (15% vs 21%, P = .42). The occurrence of any infection at 3 months was increased in the corticosteroid only group relative to the basiliximab group (41% vs 21%, P = .049). Graft and patient survival at 12 months were similar between groups. Maintenance immunosuppression was overall minimized with a tacrolimus goal of 6-8 ng/mL, mycophenolate mofetil dose reduction to 1000 mg/day by 3 months, and early steroid withdrawal in both groups. Conclusion: Our findings suggested that corticosteroid only induction was an effective strategy for preventing rejection in simultaneous liver kidney transplant recipients, even in combination with reduced maintenance immunosuppression.
    Type of Medium: Online Resource
    ISSN: 1526-9248 , 2164-6708
    URL: Article
    DOI: 10.1177/15269248221122883
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2864264-8
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  • 4
    Online Resource
    Online Resource
    The Impact of Treatment Delay on Hepatitis C Liver Transplant Outcomes
    SAGE Publications ; 2023
    In:  Journal of Pharmacy Practice Vol. 36, No. 2 ( 2023-04), p. 264-270
    Details
    In: Journal of Pharmacy Practice, SAGE Publications, Vol. 36, No. 2 ( 2023-04), p. 264-270
    Abstract: Background: Direct-acting antivirals for the treatment of hepatitis C virus (HCV) have improved outcomes in liver transplant recipients (LTRs). However, the timing of HCV treatment and approach to treating rejection have not been well described. Additionally, pharmacists’ roles in these comprehensive areas have not been investigated. Methods: This single-center, retrospective, cohort review compared 1-year graft and patient survival between HCV-positive and HCV-negative LTRs. Secondary endpoints included 1-year rejection rates, HCV sustained virologic response and time to HCV treatment. Results: Ninety-two HCV Nucleic Acid Amplification Test (NAT)-positive LTRs were matched 1:1 to HCV-seronegative LTRs. One-year graft and patient survival were similar between groups. HCV-positive LTRs were more likely to experience biopsy-proven acute rejection (BPAR), and despite treatment with pulse steroids, there was no impact on graft survival or occurrence of fibrosing cholestatic hepatitis (FCH). Time to HCV treatment was 5.4–6.4 months post-transplant, with no treatment failures or impact on graft or patient survival. Conclusions: No difference was seen in graft survival at 1 year between HCV-positive and HCV-seronegative LTRs. Delayed time to treatment of HCV and treatment of rejections in the HCV-positive cohort did not impact outcomes. However, pharmacist-driven protocols could ensure more efficient initiation of HCV treatment in the future.
    Type of Medium: Online Resource
    ISSN: 0897-1900 , 1531-1937
    URL: Article
    DOI: 10.1177/08971900211034261
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2131091-9
    SSG: 15,3
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  • 5
    Online Resource
    Online Resource
    Polymerase chain reaction–based method for the typing of F18 fimbriae and distribution of F18 fimbrial subtypes among porcine Shiga toxin–encoding Escherichia coli in Germany
    SAGE Publications ; 2011
    In:  Journal of Veterinary Diagnostic Investigation Vol. 23, No. 3 ( 2011-05), p. 454-464
    Details
    In: Journal of Veterinary Diagnostic Investigation, SAGE Publications, Vol. 23, No. 3 ( 2011-05), p. 454-464
    Abstract: Edema disease is an enterotoxemic disorder of weaned piglets that represents a significant threat to pig husbandry worldwide. The causative Escherichia coli strains are highly adapted to the porcine host and characterized by the production of Shiga toxin type 2e (Stx2e) and adhesive F18 fimbria. The current study assessed the occurrence of F18 fimbrial subtypes in 241 porcine stx2e + fedA + E. coli strains in Germany, including 116 Shiga toxin–encoding E. coli (STEC) and 125 Shiga toxin E. coli/enterotoxigenic E. coli (STEC/ETEC) isolates. In addition, a novel multiplex polymerase chain reaction (PCR) was developed in order to improve the typing system in terms of costs, time, and discriminative power. Utilizing the novel F18 typing PCR, 93 E. coli strains (38.5%) tested positive for the F18ab fimbrial subtype and 147 strains (61.0%) for the F18ac fimbrial subtype, while 1 strain remained nontypeable. Six strains were classified as F18ac using the F18 typing PCR, but were classified as F18ab using the F18-restriction fragment length polymorphism assay. Nucleotide sequencing of the FedA gene revealed that 5 of these strains encoded F18ac fimbriae, while the FedA of 1 strain did not cluster with F18ab or with F18ac amino acid sequences. The F18 fimbrial subtype was significantly associated with the pathovar of the E. coli strains, as 73.2% of the STEC isolates harbored F18ab genes whereas 93.6% of the STEC/ETEC isolates proved F18ac positive. In conclusion, the novel F18 typing PCR allows a specific identification of the F18 fimbrial subtype. The genetic and phenotypic heterogeneity of F18 fimbriae in porcine E. coli strains should be considered in the development of new vaccines and diagnostic tools.
    Type of Medium: Online Resource
    ISSN: 1040-6387 , 1943-4936
    URL: Article
    DOI: 10.1177/1040638711403417
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2011
    detail.hit.zdb_id: 2265211-5
    SSG: 22
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