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
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 ï¬‚ow 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
Keywords: catherer, Tacrolimus, leucopenia
20 Jan 2022 : Original articleImpact on Waitlist Outcomes from Changes in the Medical Eligibility of Candidates for Simultaneous Liver-Ki...
Ann Transplant In Press; DOI: 10.12659/AOT.934850
19 Jan 2022 : Original articleCarbohydrate Metabolism Disorders in Relation to Cardiac Allograft Vasculopathy (CAV) Intensification in He...
Ann Transplant In Press; DOI: 10.12659/AOT.933420
18 Jan 2022 : Original articlePLGA+Fe₃O₄+PFP Nanoparticles Drug-Delivery Demonstrates Potential Anti-Tumor Effects on Tumor Cells
Ann Transplant In Press; DOI: 10.12659/AOT.933246
Most Viewed Current Articles
29 Dec 2021 : Original articleEfficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...
Ann Transplant 2021; 26:e933588
22 Dec 2021 : Original articleComparison of Coronary Artery Calcium Scoring with Dobutamine Stress Echo for Detection of Coronary Artery ...
Ann Transplant 2021; 26:e934163
12 Jan 2022 : Original articleRisk Factors for Developing BK Virus-Associated Nephropathy: A Single-Center Retrospective Cohort Study of ...
Ann Transplant 2022; 27:e934738