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Related Concept Videos

Pharmacogenetics of Phase II Enzymes: N-acetyltransferase, Thiopurine S-methyltransferase, UDP-glucuronosyltransferase01:27

Pharmacogenetics of Phase II Enzymes: N-acetyltransferase, Thiopurine S-methyltransferase, UDP-glucuronosyltransferase

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Phase II biotransformation reactions are essential for detoxifying and eliminating xenobiotics, including many pharmaceutical compounds. These reactions typically involve conjugation, the covalent attachment of polar endogenous groups such as glucuronic acid, sulfate, methyl, or acetyl moieties to functional groups introduced during Phase I metabolism. The resulting conjugates are more water-soluble, enabling efficient renal or biliary excretion.The major classes of Phase II enzymes include...
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Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Kidney Transplant III: Nursing Management01:16

Kidney Transplant III: Nursing Management

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Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
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Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Tissue Transplantation01:24

Tissue Transplantation

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Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
The Biology of Tissue Transplantation
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Bone Marrow Sampling and Transplants01:22

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Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
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Analysis of Rejection, Infection and Surgical Outcomes in Type I Versus Type II Diabetic Recipients After Simultaneous Pancreas-Kidney Transplantation.

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Surgical Angiogenesis in Porcine Tibial Allotransplantation: A New Large Animal Bone Vascularized Composite Allotransplantation Model
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Mycophenolates in transplantation.

Hans W Sollinger1

  • 1Department of Surgery, University of Wisconsin School of Medicine, Madison, WI 53792, USA. hans@tx.surgery.wisc.edu

Clinical Transplantation
|September 4, 2004
PubMed
Summary

Enteric-coated mycophenolate sodium (EC-MPS) offers an effective alternative to mycophenolate mofetil (MMF) for transplant patients, reducing gastrointestinal side effects while maintaining immunosuppressive efficacy.

Area of Science:

  • Immunology
  • Pharmacology
  • Transplantation Medicine

Background:

  • Mycophenolic acid (MPA) is a potent immunosuppressant inhibiting lymphocyte proliferation.
  • Mycophenolate mofetil (MMF) is an effective prodrug used in transplantation to prevent organ rejection.
  • Gastrointestinal toxicity is a significant side effect of MMF, potentially impacting therapeutic outcomes.

Purpose of the Study:

  • To evaluate the efficacy and safety of enteric-coated mycophenolate sodium (EC-MPS) compared to MMF.
  • To assess the impact of EC-MPS on gastrointestinal adverse events in transplant recipients.

Main Methods:

  • Clinical trials were conducted in renal, heart, and liver transplant recipients.
  • Patients received MMF or EC-MPS in combination with standard immunosuppressants (cyclosporine and steroids).

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  • Outcomes measured included acute rejection episodes, graft survival, patient survival, graft function, and adverse events, particularly gastrointestinal toxicity.

    • Main Results:

    • MMF demonstrated efficacy in reducing rejection and improving survival in transplant patients.
    • Over 40% of patients experienced gastrointestinal toxicity with MMF, sometimes necessitating dose adjustments.
    • EC-MPS showed comparable efficacy and safety to MMF in de novo and maintenance renal transplant patients, with improved upper GI tolerability.

    Conclusions:

    • EC-MPS provides an effective and safer alternative to MMF for immunosuppression in renal transplantation.
    • The enteric-coated formulation of MPA may mitigate gastrointestinal side effects, potentially improving patient adherence and long-term outcomes.
    • EC-MPS represents a valuable therapeutic option for improving the management of transplant recipients.