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Luis Veloza Cristina Teixido Natalia Castrejon Fina Climent Ana Carri Marta Marginet Davide Soldini Blanca Gonzlez‐Farr Inmaculada Ribera‐Cortada Armando Lopez‐Guillermo Eva Gonzlez‐Barca Adriana Sierra Mileyka Herrera Cndida Gmez Adriana Garcia Olga Balagu Elias Campo Antonio Martinez 《Histopathology》2019,75(6):799-812
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《Nefrología : publicación oficial de la Sociedad Espa?ola Nefrologia》2019,39(5):506-512
The aim of this study was to evaluate the trough concentrations (Cptrough) and the tacrolimus dosage regimen after the conversion of Prograf or Advagraf to Envarsus (new pharmaceutical form with MeltDose technology that improves the absorption of fat-soluble drugs) in patients with stable renal transplantation, and their renal function.We selected stable renal transplant patients who were converted to Envarsus. Two periods were defined: Baseline and Conversion (Envarsus) and they were stratified according to the pharmaceutical form used in the Baseline period. Sixty-one patients were included (24 with Advagraf and 37 with Prograf), with an average age of 52 years. The mean post-transplant time at the time of conversion to Envarsus was 76.3 months and the mean follow-up in the Baseline and Conversion period was 10.1 months and 11.6 months, respectively.In the Prograf and Envarsus group, the Cptrough medians were 6.6 vs 6.4 ng/mL (P = .636), with a mean daily dose that decreased significantly from 3 mg to 2 mg (P < .001), respectively, maintaining the filtration rate.The median Cptrough values in the Advagraf and Envarsus groups were 5.7 ng/mL and 6.3 ng/mL (P = .07), with a median daily dose of 7 mg and 4 mg (P < .001), respectively, and the same renal function.In stable renal transplant patients, the conversion from Advagraf to Envarsus has allowed the dose of tacrolimus to be reduced by 42.9% and, in the case of Prograf, by 33.3%, maintaining similar Cptrough values, without renal function being altered. 相似文献
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Erik C. von Rosenvinge Francis Palumbo Jacques Ravel Virginia Rowthorn Diane Hoffmann 《Gut microbes》2019,10(2):113-114
This is a reply to the commentary of Ossorio and Zhou. 相似文献
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Erik L. Frandsen Jessica Otero Joe C. Rutledge Mariska S. Kemna Erin L. Albers Borah J. Hong Yuk M. Law Joshua M. Friedland‐Little 《Pediatric transplantation》2020,24(1)
Bortezomib is approved for the treatment of multiple myeloma but increasingly used in heart transplant (HTx) recipients with antibody‐mediated rejection (AMR). Severe pulmonary toxicity is a rare complication in multiple myeloma patients treated with bortezomib, but has not been described in a solid organ transplant recipient. A 20‐year‐old man 7 years post‐HTx presented with acute rejection with hemodynamic compromise. Endomyocardial biopsy showed mixed rejection (ISHLT grade 2R‐3R acute cellular rejection (ACR) and pAMR 1 (I+) with diffuse C4d staining). Two new high MFI circulating MHC class‐II donor‐specific antibodies (DSA) were detected. Treatment included corticosteroids, antithymocyte globulin, plasmapheresis, IVIG, rituximab, and bortezomib (1.3 mg/m2). Due to rebound in DSA, a second course of bortezomib was started. Thrombocytopenia and peripheral neuropathy prompted a 50% dose reduction during the 2nd course. Shortly after the 3rd reduced dose, the patient developed hypoxemic respiratory failure. Bronchoscopy revealed pulmonary hemorrhage with negative infectious studies. Chest CT showed bilateral parenchymal disease with bronchiectasis and alveolar bleeding. Despite treatment with high‐dose steroids, severe ARDS ensued with multisystem organ failure. The patient expired 23 days after the final dose of bortezomib. Post‐mortem lung histology revealed diffuse alveolar damage, pulmonary fibrosis, and hemorrhage. Cardiac histology showed resolving/residual ACR 1R and pAMR 1 (I+). While rare, bortezomib‐induced lung toxicity (BILT) can occur in HTx recipients and can carry a high risk of mortality. Drug reaction and immediate drug withdrawal should be considered in patients who develop respiratory symptoms, though optimal management of BILT is unclear. 相似文献
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Anand Srinivasan Chibuzo C Ilonze Stephen R. Travis David Crawford 《Pediatric blood & cancer》2020,67(1)
Systemic mastocytosis is a rare entity in pediatrics, usually associated with mutations in the c‐KIT gene. We describe a Caucasian female who presented with severe systemic mastocytosis with food allergies requiring prolonged total parenteral nutrition. Her course was further complicated by the onset of hemophagocytic lymphohistiocytosis, which responded poorly to conventional chemotherapy. She underwent an allogeneic hematopoietic stem cell transplant that resulted in resolution of all symptoms related to systemic mastocytosis and hemophagocytic lymphohistiocytosis. She is now disease‐free and without any complications two years after the transplant. 相似文献
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Meghan L. Good Parisa Malekzadeh Isaac R. Kriley Nirali N. Shah David E. Kleiner Katherine Calvo Jonathan M. Hernandez Jeremy L. Davis 《Pediatric transplantation》2020,24(2)
Secondary malignancies are a significant cause of non‐relapse mortality in patients who undergo allogeneic HCT. However, secondary liver cancer is rare, and ICC following HCT has never been reported in the literature. Secondary solid cancers typically have a long latency period, and cholangiocarcinoma is classically a malignancy occurring in older individuals. Here, we report the first case of secondary ICC, which presented just 3 years after HCT in a young adult with a history of childhood ALL. A 26‐year‐old male with history of precursor B‐cell ALL presented with asymptomatic elevated liver function tests 3 years after HCT. Laboratories were indicative of biliary obstruction. ERCP showed focal biliary stricturing of the common and left hepatic ducts. MRCP revealed left intrahepatic duct dilatation, suggestive of intrahepatic obstructing mass. Additional workup lead to a clinical diagnosis of ICC. The patient underwent left hepatectomy with extrahepatic bile duct resection and portal lymphadenectomy. Surgical pathology was consistent with moderately differentiated cholangiocarcinoma. Our case illustrates a rare SMN following HCT for ALL. It is the first case report of ICC occurring as a secondary cancer in this patient population. Although cholangiocarcinoma is characteristically diagnosed in the older population, it must remain on the differential for biliary obstruction in post‐HCT patients. 相似文献