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Related Concept Videos

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 II: Surgical Procedure01:26

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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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Kidney Transplant III: Nursing Management01:16

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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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Tissue Transplantation01:24

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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.
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Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
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High Intrapatient Tacrolimus Variability and Increased Cell-Free DNA in Kidney Transplant Recipients.

Miranda Kopfman1,2, Marissa Brokhof1, Shree Patel3

  • 1Department of Pharmacy, Rush University Medical Center, Chicago, IL, USA.

Progress in Transplantation (Aliso Viejo, Calif.)
|October 8, 2024
PubMed
Summary

High variability in tacrolimus levels may increase donor-derived cell-free DNA (dd-cfDNA) in kidney transplant recipients. This suggests tacrolimus variability is a potential biomarker for monitoring transplant health.

Keywords:
biomarkersclinical outcomesdonor-derived cell-free DNAdrug adherenceimmunosuppressionkidney transplantationpharmacology

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Area of Science:

  • Nephrology
  • Transplant Immunology
  • Pharmacogenomics

Background:

  • Tacrolimus is a key immunosuppressant in kidney transplantation.
  • Donor-derived cell-free DNA (dd-cfDNA) is a biomarker for solid organ transplant rejection.
  • Limited data exists on the relationship between tacrolimus variability and dd-cfDNA in kidney transplant recipients.

Purpose of the Study:

  • To investigate the association between high tacrolimus variability and elevated dd-cfDNA levels.
  • To examine this relationship in kidney and simultaneous pancreas-kidney transplant recipients.

Main Methods:

  • Retrospective, single-center study of kidney and pancreas-kidney transplant recipients.
  • Tacrolimus variability assessed by coefficient of variation (%CV) between 1-12 months post-transplant.
  • Longitudinal dd-cfDNA surveillance was utilized.

Main Results:

  • Pancreas-kidney recipients showed higher median dd-cfDNA and were excluded.
  • Ninety-nine kidney transplant recipients were analyzed.
  • Kidney recipients with tacrolimus %CV ≥30% had significantly higher median dd-cfDNA compared to those with %CV <30% (0.22% vs. 0.17%, P=.031).

Conclusions:

  • High intrapatient tacrolimus variability is associated with elevated dd-cfDNA in the first year post-kidney transplant.
  • Tacrolimus variability may serve as a predictive marker for graft health in kidney transplant recipients.