Although donor-specific antibodies are regarded as a contraindication for kidney transplantation, the data available for combined liver and kidney transplantation (cLKTx) are scarce, and there is no established therapeutic approach for this category of transplant recipients. De novo use of everolimus and a reduced dose of calcineurin inhibitor reportedly provides excellent kidney function compared with a standard regimen containing a calcineurin inhibitor. This strategy, however, has been applied in only some recipient categories. Here we report a case of A highly sensitized male patient who underwent a cLKTx and received everolimus with low-dose tacrolimus (once-daily prolonged-release formulation) as ab initio immunosuppressive treatment. The pretransplant panel-reactive antibody estimate was 97%, and multiple anti-HLA antibodies were detected at the time of transplantation. Thus far, patient and allograft survival have reached 2 years, with the recipient remaining on a regimen of immunosuppression with everolimus and low-dose tacrolimus, with no episodes of rejection.

Tariciotti, L., Manzia, T.m., Sforza, D., Anselmo, A., Tisone, G. (2016). Everolimus and Advagraf Ab Initio in Combined Liver and Kidney Transplant With Donor-Specific Antibodies: A Case Report. TRANSPLANTATION PROCEEDINGS, 48(9), 3109-3111 [10.1016/j.transproceed.2016.07.021].

Everolimus and Advagraf Ab Initio in Combined Liver and Kidney Transplant With Donor-Specific Antibodies: A Case Report

Manzia T. M.;Sforza D.;Anselmo A.;Tisone G.
2016-01-01

Abstract

Although donor-specific antibodies are regarded as a contraindication for kidney transplantation, the data available for combined liver and kidney transplantation (cLKTx) are scarce, and there is no established therapeutic approach for this category of transplant recipients. De novo use of everolimus and a reduced dose of calcineurin inhibitor reportedly provides excellent kidney function compared with a standard regimen containing a calcineurin inhibitor. This strategy, however, has been applied in only some recipient categories. Here we report a case of A highly sensitized male patient who underwent a cLKTx and received everolimus with low-dose tacrolimus (once-daily prolonged-release formulation) as ab initio immunosuppressive treatment. The pretransplant panel-reactive antibody estimate was 97%, and multiple anti-HLA antibodies were detected at the time of transplantation. Thus far, patient and allograft survival have reached 2 years, with the recipient remaining on a regimen of immunosuppression with everolimus and low-dose tacrolimus, with no episodes of rejection.
2016
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/18 - CHIRURGIA GENERALE
English
Antibodies; Antilymphocyte Serum; Calcineurin Inhibitors; Delayed Graft Function; Drug Therapy, Combination; Everolimus; Graft Rejection; HLA Antigens; Humans; Immunosuppressive Agents; Kidney; Kidney Transplantation; Liver; Liver Transplantation; Male; Middle Aged; Tacrolimus; Tissue Donors; Transplant Recipients; Transplantation Immunology
Tariciotti, L., Manzia, T.m., Sforza, D., Anselmo, A., Tisone, G. (2016). Everolimus and Advagraf Ab Initio in Combined Liver and Kidney Transplant With Donor-Specific Antibodies: A Case Report. TRANSPLANTATION PROCEEDINGS, 48(9), 3109-3111 [10.1016/j.transproceed.2016.07.021].
Tariciotti, L; Manzia, Tm; Sforza, D; Anselmo, A; Tisone, G
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/240856
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