Practical Recommendations for Long-term Management of Modifiable Risks in Kidney and Liver Transplant Recipients: A Guidance Report and Clinical Checklist by the Consensus on Managing Modifiable Risk in Transplantation (COMMIT) Group.
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Citations
Class II Eplet Mismatch Modulates Tacrolimus Trough Levels Required to Prevent Donor-Specific Antibody Development
Analyses of the short- and long-term graft survival after kidney transplantation in Europe between 1986 and 2015
Understanding Medication Nonadherence after Kidney Transplant.
HLA‐DR/DQ molecular mismatch: A prognostic biomarker for primary alloimmunity
Pharmacokinetic considerations related to therapeutic drug monitoring of tacrolimus in kidney transplant patients
References
Psychological functioning, nonadherence and health outcomes after pediatric liver transplantation.
The role of donor-specific HLA alloantibodies in liver transplantation.
Reduced exposure to calcineurin inhibitors early after liver transplantation prevents recurrence of hepatocellular carcinoma
Long‐Term Belatacept Exposure Maintains Efficacy and Safety at 5 Years: Results From the Long‐Term Extension of the BENEFIT Study
Renin Angiotensin System Blockade in Kidney Transplantation: A Systematic Review of the Evidence
Related Papers (5)
Frequently Asked Questions (15)
Q2. What have the authors stated for future works in "University of birmingham practical recommendations for long-term management of modifiable risks in kidney and liver transplant recipients" ?
Although the future looks promising for the field of transplantation, recipients and HCPs must not lose sight of those factors that can be modified today, so leading to the best possible future outcomes for the recipients, and giving consolation to the donor family.
Q3. What are the factors that affect the long-term outcomes of a kidney transplant?
perioperative, and postoperative factorsmay impact long-term outcomes; these include donor and organ factors as well as logistic factors.
Q4. What is the risk factor for poor long-term graft survival?
Ischemia-reperfusion injury (IRI) is considered an unavoidable, but potentially modifiable, risk factor for poor long-term graft survival in solid organ transplantation.
Q5. What are the main factors that may interfere with the metabolism and elimination of tacrolimus?
In liver transplantation, graft dysfunction and/or biliary complications may interfere with metabolism and elimination of tacrolimus.
Q6. What is the effect of tacrolimus on trough concentrations?
The conversion from twice-daily to prolonged-release tacrolimus (capsules), both in kidney and liver transplant recipients, leads to lower blood trough concentrations and a reduced IPVof tacrolimus.
Q7. What are some of the risk factors that can be modified after a transplant?
8,9 However, some risk factors have the potential to be modified or mitigated posttransplantation to improve outcomes, including behavioral risk factors, such as medication adherence.
Q8. What is the cytolex ImmuKnow Cell Function Assay?
The Cylex ImmuKnow Cell Function Assay measures T-cell function by the release of adenosine triphosphate from CD4-positive lymphocytes in culture after a mitogenic stimulus.
Q9. What is the role of CNIs and steroids in the development of hypertension in kidney transplant?
CNIs and steroids play a major role in the development of hypertension in kidney transplant patients; therefore, modifications of immunosuppressive regimen may be considered for lowering BP in these patients.
Q10. What is the importance of maximizing long-term graft survival?
maximizing long-term graft survival and reducing the need for retransplantation is paramount, not only in improving outcomes for the recipients but also for those awaiting a graft.
Q11. What is the average blood concentration in the liver and kidney transplant recipients?
During subsequent maintenance therapy, blood concentrations have generally been in the range of 5-15 ng/mL in liver and kidney transplant recipients.
Q12. What is the reason for the large intrapatient and inter-subject exposure variability of tacrol?
the intrinsic pharmacokinetic and pharmacodynamic properties of tacrolimus, including erratic absorption, a variable first-pass effect, and unpredictable metabolism, may be responsible for its large intrapatient and inter-subject exposure variability.
Q13. What was considered to be the advantages of having a lower burden?
161 For liver transplantation, historically, it was considered that there might be advantages to having a lower immunosuppressive burden.
Q14. What is the reason for the increase in the use of CNI-based immunosuppressive?
Over the last 10 years, there has been a strong move in the renal transplant community to minimize CNI-based immunosuppressive regimens, largely based on reports of longterm nephrotoxicity.
Q15. What is the evidence to support the conclusion that generics are safe?
There appears to be insufficient evidence to provide reassurance that, in transplanted patients, generics are therapeutically equivalent to innovator immunosuppressants.