Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

01 January 2008

Association between pharmacodynamic parameters and clinical events under therapy with EC-MPS in the early phase after kidney transplantation (KTx)

E. Wieland, M. Shipkova, Y. Martius, G. Hasche, C. Klett, R. Bolley, C. Olbricht

Ann Transplant 2008; 13(1): 41-41 :: ID: 880206

Abstract

Background: Strategies based on monitoring pharmacodynamic effects are increasingly evaluated to optimize immunosuppressive therapy. Pharmacodynamic monitoring is either specific for the particular drug or aimed at a general estimation of the immunosuppression. We have monitored both drug specific and general phramacodynamic parameters and looked on their association with clinical events early after KTx.
Material/Methods: 35 patients receiving basiliximab, EC-MPS (2-720 mg/day), steroids, and tacrolimus (target: 6-8 μg/L) were included. Blood was drawn on days 7(±1) and 21(±2) at C0 h and C2 h. Mononuclear leucocytes were isolated and the following parameters were investigated: IMPDH activity (HPLC-DAD), cell proliferation (BRdU test), CD25[sup]+/[/sup]CD3[sup]+[/sup]- CD71[sup]+[/sup]/CD3[sup]+[/sup]-, and CD26[sup]+[/sup] /CD3[sup]+[/sup] -expression by flow cytometry. Acute rejection, gastrointestinal side effects, leucopenia, and infections were monitored over three month. Results were statistically evaluated by the Mann-Whitney test and odds ratios.
Results: There was no association between events and IMPDH activity apart that patients with diarrhea showed a significantly higher IMPDH activity 2 h after drug intake (p<0.05). Cell proliferation (0h) was significantly reduced in patients with leucopenia (p<0.01). CD71[sup]+[/sup] /CD3[sup]+[/sup]-expression was less inducible in patients with infections  (p<0.05). CD26[sup]+[/sup] /CD3[sup]+[/sup]-expression was highly and significantly associated with rejection particularly on day 7 after KTx (p=0.01; odds-ratio: 16.3). No assotiations were found for the CD25[sup]+[/sup] /CD3[sup]+[/sup] -expression.
Conclusions: A potential of pharmacodynamic monitoring to optimize immunosuppressive combination therapy has been demonstrated. Particularly CD26[sup]+[/sup] /CD3[sup]+[/sup] expression seems to be a promising parameter to predict acute rejection. The lack of association between IMPDH activity and events should be proven in further trials with more
patients.

Keywords: catherer, Tacrolimus, leucopenia

Add Comment 0 Comments

In Press

07 Mar 2024 : Original article  

Outcomes of Renal Transplantation in ANCA-Associated Vasculitis

Ann Transplant In Press; DOI: 10.12659/AOT.943433  

08 Mar 2024 : Original article  

Association of Coronary Calcium Score on Cardiac PET During Pre-Kidney Transplant Assessment with Persisten...

Ann Transplant In Press; DOI: 10.12659/AOT.943532  

14 Mar 2024 : Original article  

Impact of Blood Products Transfusion on Patients in the Immediate Post-Lung Transplant Period: A Cohort Study

Ann Transplant In Press; DOI: 10.12659/AOT.943652  

14 Mar 2024 : Case report  

Treatment of Cavernous Transformation of Portal Vein Caused by Hepatic Cystic Echinococcosis Using Ex Vivo ...

Ann Transplant In Press; DOI: 10.12659/AOT.942358  

Most Viewed Current Articles

05 Apr 2022 : Original article  

Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver Transplantation

DOI :10.12659/AOT.935604

Ann Transplant 2022; 27:e935604

12 Jan 2022 : Original article  

Risk Factors for Developing BK Virus-Associated Nephropathy: A Single-Center Retrospective Cohort Study of ...

DOI :10.12659/AOT.934738

Ann Transplant 2022; 27:e934738

22 Nov 2022 : Original article  

Long-Term Effects of Everolimus-Facilitated Tacrolimus Reduction in Living-Donor Liver Transplant Recipient...

DOI :10.12659/AOT.937988

Ann Transplant 2022; 27:e937988

15 Mar 2022 : Case report  

Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...

DOI :10.12659/AOT.935860

Ann Transplant 2022; 27:e935860

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358