Everolimus and Advagraf Ab Initio in Combined Liver and Kidney Transplant With Donor-Specific Antibodies: A Case Report
| Autor: | Laura Tariciotti, Daniele Sforza, T.M. Manzia, Alessandro Anselmo, Giuseppe Tisone |
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| Rok vydání: | 2016 |
| Předmět: |
Graft Rejection
Male medicine.medical_specialty medicine.medical_treatment Calcineurin Inhibitors Urology Delayed Graft Function Pharmacology Liver transplantation Kidney Antibodies Tacrolimus Drug Therapy HLA Antigens Transplantation Immunology medicine Humans Everolimus Kidney transplantation Antilymphocyte Serum Transplantation business.industry Immunosuppression Middle Aged medicine.disease Drug Therapy Combination Immunosuppressive Agents Kidney Transplantation Liver Liver Transplantation Tissue Donors Transplant Recipients Settore MED/18 Calcineurin Regimen surgical procedures operative Combination Surgery business medicine.drug |
| Zdroj: | Transplantation Proceedings. 48:3109-3111 |
| ISSN: | 0041-1345 |
| Popis: | Although donor-specific antibodies are regarded as a contraindication for kidney transplantation, the data available for combined liver and kidney transplantation (cLKTx) are scarce, and there is no established therapeutic approach for this category of transplant recipients. De novo use of everolimus and a reduced dose of calcineurin inhibitor reportedly provides excellent kidney function compared with a standard regimen containing a calcineurin inhibitor. This strategy, however, has been applied in only some recipient categories. Here we report a case of A highly sensitized male patient who underwent a cLKTx and received everolimus with low-dose tacrolimus (once-daily prolonged-release formulation) as ab initio immunosuppressive treatment. The pretransplant panel-reactive antibody estimate was 97%, and multiple anti-HLA antibodies were detected at the time of transplantation. Thus far, patient and allograft survival have reached 2 years, with the recipient remaining on a regimen of immunosuppression with everolimus and low-dose tacrolimus, with no episodes of rejection. |
| Databáze: | OpenAIRE |
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