Search

Background: Hyperlipidemia is a universal adverse effect of proliferation signal inhibitors (PSI). We report our experience with ezetimibe/statin combined therapy in a case of a kidney transplant recipient receiving sirolimus (SRL)-based immunosuppression. We also present our doubts concerning the need for ezetimibe in kidney transplant recipients on PSI-based immunosuppression., Case Report: Results. In the reported patient, ezetimibe/statin combination therapy successfully decreased cholesterol level., Conclusions: Combined therapy with ezetimibe and statin seems to be effective and safe in transplant recipients with SRL-associated hyperlipidemia. However, well-designed clinical trials should be performed to evaluate if there is an impact of such treatment on the frequency of cardiovascular events and patient survival.

Background: Equoral(®) is a generic formulation of Cyclosporine A (CsA), which is significantly cheaper than the original medicine. Our center participated in the clinical trial designed to evaluate the efficacy and safety of Equoral(®) in kidney transplant recipients in the first 9 months after a transplant procedure. The aim of our paper is to present the 5-year follow-up of patients who participated in the study and were monitored in our center., Material/methods: We performed intention-to-treat retrospective analysis of 20 de novo kidney transplant recipients who received Equoral®-based immunosuppressive regimen and were monitored in our department for 5 years after transplantation., Results: The 5-year patient and graft survival was 90%, and the frequency of acute rejection was 15%. In 80% of patients, the initial immunosuppressive regimen had to be changed., Conclusions: In our group of kidney transplant recipients, immunosuppression based on generic formulation of CsA had excellent 5-year patient and graft survival and effectively prevented acute rejection episodes. However, most patients needed modification of the initially administered immunosuppressive regimen.

Background: The use of bioequivalent generic ciclosporin is a cost-effective alternative to non-generic ciclosporin in renal transplant patients. This study aims to explore the efficacy, safety and tolerability of Equoral®, a generic ciclosporin, in adult de novo renal transplant patients., Material/methods: This was a multicentre, open label, phase IV clinical study consisting of a 6-month treatment and 3-month follow-up periods. Patients underwent renal transplantation supported by an immunosupressive regimen of azathioprine (or mofetil mycophenylate [MMF]), prednisolone and Equoral® (10 mg/kg/day, given 12 hours before patients' surgical procedure, and a maintenance ciclosporin dose of 4-6 mg/kg/day thereafter). The primary endpoint was the rate of occurrence of acute graft rejection over the 6-month period after renal transplantation., Results: A total of 54 patients were enrolled and constituted the intention-to-treat/safety population, while 52 patients forming the per-protocol population were assessed for efficacy. There were 13 episodes of acute graft rejection reported in 12 patients, and two of these episodes resulted in withdrawal from the study. The probability of acute rejection in patients was less then 24% for the duration of the study including the observation period which is within the usual range. There were no deaths and one graft loss during the study, and the safety and tolerability profile reported was typical of that of ciclosporin in use in de-novo renal transplant patients., Conclusions: The use of the generic ciclosporin Equoral® is effective and is associated with the usual safety and tolerability profile of ciclosporin when used as the calcineurin-inhibitor component of an immunosuppressive regimen in de novo renal transplant patients.

Autosomal dominant polycystic kidney disease (ADPKD) is an inherited disorder affecting 1 in 1,000 people and responsible for 10% of cases of the end stage renal disease (ESRD). Apart from renal manifestations, changes in other organs may be present. In the absence of contraindications, patients with ADPKD and ESRD should be referred to renal transplantation. The ADPKD patient may also need liver transplantation, or combined liver and kidney transplantation. Also, the patient with ADPKD may become a potential organ donor. The aim of our paper is to review the problems that the physicians deal with in ADPKD patients in pre- and post-transplant period.

Objectives: Antibiotic-associated diarrhea is defined as otherwise unexplained diarrhea which occurs in association with the administration of antibiotics. The incidence of this diagnosis increases worldwide due to augmentative usage of broad spectrum antibiotics. Clostridium difficile is the most common identifiable pathogen, leading to antibiotic-associated diarrhea. The aim of the article was to describe our own experience in diagnostics and treatment of infections caused by C. difficile in solid organs recipients., Methods: In the article, retrospective analysis of infections caused by C. difficile that occurred during first six months of 2003 in the Department of Immunology, Transplant Medicine and Internal Diseases of the Medical University of Warsaw was performed., Results: In this period 18 infections in 16 kidney or/and liver graft recipients were diagnosed. Risk factors are considered and clinical manifestation is described., Conclusions: Proper diagnostics and therapy in this population of patients are proposed and preventive procedures are discussed.