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6. Evaluation of medication-related problems in liver transplant recipients with and without an outpatient medication consultation by a clinical pharmacist:a cohort study

Author

Mulder, Midas B., Doga, B., Borgsteede, S. D., van den Burg, A. M., Metselaar, H. J., den Hoed, C. M., Hunfeld, N. G. M., Mulder, Midas B., Doga, B., Borgsteede, S. D., van den Burg, A. M., Metselaar, H. J., den Hoed, C. M., and Hunfeld, N. G. M.

Abstract

Background: Transplant recipients undergo significant changes in their medication regimen during follow-up and are at an increased risk for medication-related problems (MRPs). Aim: This study aimed to compare the prevalence and types of MRPs and interventions in liver transplant recipients with and without an outpatient medication consultation by a clinical pharmacist as well as the satisfaction with information about medicines and medication adherence. Method: We performed a single-center, observational cohort study. A retro- and prospective cohort were used and subdivided in a group that did and did not receive a medication consultation. The prevalence and types of MRPs and interventions were identified and categorized. The satisfaction parameters were evaluated using validated questionnaires. Results: Included were 291 patients. In total, 368 MRPs were identified in 197 patients in the non-medication consultation cohort (median 1; range 1–3 per patient) and 248 MRPs in 94 patients in the medication consultation cohort (median 2; range 1–4 per patient). In the medication consultation cohort, significantly fewer MRPs as unnecessary drugs (17.3% versus 58.7%, p < 0.001), suboptimal therapy (2.4% versus 9.5%, p < 0.001), untreated indication (2.8% versus 6.8%, p = 0.040) and underdosed drugs (0.4% versus 6.3%, p < 0.001) were identified. In the non-medication consultation cohort significantly more patients used unnecessary drugs (72.1% versus 39.4%, p < 0.001) compared to the medication consultation cohort. Patients in both cohorts are satisfied with the information about medicines and reported a high medication adherence. Conclusion: Patients in the medication consultation cohort had significantly fewer MRPs and used significantly less unnecessary drugs. Including a clinical pharmacist to the post-transplant care has an added value.

Published
2022

8. Acute Hepatic Failure

Author

Schalm, S. W., de Knegt, R. J., Metselaar, H. J., van den Berg, B., Prieto, Jesús, editor, Rodés, Joan, editor, and Shafritz, David A., editor

Published
1992
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29. Protective role of tacrolimus, deleterious role of age and comorbidities in liver transplant recipients with Covid-19: results from the ELITA/ELTR multi-center European study

Author

Belli LS, Fondevila C, Cortesi PA, Conti S, Karam V, Adam R, Coilly A, Ericzon BG, Loinaz C, Cuervas-Mons V, Zambelli M, Llado L, Diaz F, Invernizzi F, Patrono D, Faitot F, Bhooori S, Pirenne J, Perricone G, Magini G, Castells L, Detry O, Cruchaga PM, Colmenero J, Berrevoet F, Rodriguez G, Ysebaert D, Radenne S, Metselaar H, Morelli C, De Carlis L, Polak WG, Duvoux C, and ELITA-ELTR COVID-19 Registry

Subjects
Liver transplantation, COVID-19, Tacrolimus, Outcome
Abstract

BACKGROUND AND AIMS: Despite concerns that liver transplant (LT) recipients may be at increased risk of unfavorable outcomes from COVID-19 due the high prevalence of co-morbidities, immunosuppression and ageing, a detailed analysis of their effects in large studies is lacking. METHODS: Data from adult LT recipients with laboratory confirmed SARS-CoV2 infection were collected across Europe. All consecutive patients with symptoms were included in the analysis. RESULTS: Between March 1st and June 27th2020, data from 243 adult symptomatic cases from 36 centers and 9 countries were collected. Thirty-nine (16%) were managed as outpatients while 204 (84%) required hospitalization including admission to the ICU (39/204, 19.1%). Forty-nine (20.2%) patients died after a median of 13.5 (10-23) days, respiratory failure was the major cause. After multivariable Cox regression analysis, age >70 (HR, 4.16; 95% CI, 1.78-9.73) had a negative effect and tacrolimus (TAC) use (HR, 0.55; 95% CI, 0.31-0.99) had a positive independent effect on survival. The role of co-morbidities was strongly influenced by the dominant effect of age where comorbidities increased with the increasing age of the recipients. In a second model excluding age, both diabetes (HR, 1.95; 95% CI, 1.06-3.58) and chronic kidney disease (HR, 1.97; 95% CI, 1.05-3.67) emerged as associated with death CONCLUSIONS: Twenty-five per cent of patients requiring hospitalization for Covid-19 died, the risk being higher in patients older than 70 and with medical co-morbidities, such as impaired renal function and diabetes. Conversely, the use of TAC was associated with a better survival thus encouraging clinicians to keep TAC at the usual dose.

Published
2021

30. Resveratrol And Pterostilbene Potently Inhibit SARS-CoV-2 Replication In Vitro

Author

Dinesh Kumar N, Ellen M Bouma, Ende van der-Metselaar H, Berit Troost, Jolanda M. Smit, Pol van de D, Jill Moser, Martijn C. Nawijn, Izabela A. Rodenhuis-Zybert, Berge van den M, Voort van der P, Ellen ter B, Gosliga van D, and Leonie Apperloo

Subjects
Kidney, Pterostilbene, Resveratrol, Pharmacology, Biology, In vitro, Virus, chemistry.chemical_compound, medicine.anatomical_structure, chemistry, Viral replication, medicine, African Green Monkey, Structural analog
Abstract

The current COVID-19 pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has an enormous impact on human health and economy. In search for therapeutic options, researchers have proposed resveratrol, a food supplement with known antiviral, anti-inflammatory and anti-oxidant properties as an advantageous antiviral therapy for SARS-CoV-2 infection. Here, we provide evidence that both resveratrol and its metabolically more stable structural analog, pterostilbene, exhibit potent antiviral properties against SARS-CoV-2 in vitro. Resveratrol and pterostilbene showed antiviral activity in African green monkey kidney cells and in human primary bronchial epithelial cells cultured in an air-liquid interface system. Both compounds actively inhibit virus replication within infected cells as reduced virus progeny production was observed when the compound was added at post-inoculation conditions. Without replenishment of the compound, antiviral activity was observed up to roughly 5 rounds of replication, demonstrating the long-lasting effect of these compounds. Collectively, our data indicate that resveratrol and pterostilbene are promising antiviral compounds to treat SARS-CoV-2 infection. Because these results represent laboratory findings in cells, we advocate evaluation of these compounds in clinical trials before statements are made whether or not these drugs are advantageous for COVID-19 treatment.

Published
2020
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31. Protective role of tacrolimus, deleterious role of age and comorbidities in liver transplant recipients with Covid-19: results from the ELITA/ELTR multi-center European study

Author

Belli, L, Fondevila, C, Cortesi, P, Conti, S, Karam, V, Adam, R, Coilly, A, Ericzon, B, Loinaz, C, Cuervas-Mons, V, Zambelli, M, Llado, L, Diaz, F, Invernizzi, F, Patrono, D, Faitot, F, Bhooori, S, Pirenne, J, Perricone, G, Magini, G, Castells, L, Detry, O, Cruchaga, P, Colmenero, J, Berrevoet, F, Rodriguez, G, Ysebaert, D, Radenne, S, Metselaar, H, Morelli, C, De Carlis, L, Polak, W, Duvoux, C, Belli, Luca S, Fondevila, Constantino, Cortesi, Paolo A, Conti, Sara, Karam, Vincent, Adam, Rene, Coilly, Audrey, Ericzon, Bo Goran, Loinaz, Carmelo, Cuervas-Mons, Valentin, Zambelli, Marco, Llado, Laura, Diaz, Fernando, Invernizzi, Federica, Patrono, Damiano, Faitot, Francois, Bhooori, Sherrie, Pirenne, Jacques, Perricone, Giovanni, Magini, Giulia, Castells, Lluis, Detry, Oliver, Cruchaga, Pablo Mart, Colmenero, Jordi, Berrevoet, Frederick, Rodriguez, Gonzalo, Ysebaert, Dirk, Radenne, Sylvie, Metselaar, Herold, Morelli, Cristina, De Carlis, Luciano, Polak, Wojciech G, Duvoux, Christophe, Belli, L, Fondevila, C, Cortesi, P, Conti, S, Karam, V, Adam, R, Coilly, A, Ericzon, B, Loinaz, C, Cuervas-Mons, V, Zambelli, M, Llado, L, Diaz, F, Invernizzi, F, Patrono, D, Faitot, F, Bhooori, S, Pirenne, J, Perricone, G, Magini, G, Castells, L, Detry, O, Cruchaga, P, Colmenero, J, Berrevoet, F, Rodriguez, G, Ysebaert, D, Radenne, S, Metselaar, H, Morelli, C, De Carlis, L, Polak, W, Duvoux, C, Belli, Luca S, Fondevila, Constantino, Cortesi, Paolo A, Conti, Sara, Karam, Vincent, Adam, Rene, Coilly, Audrey, Ericzon, Bo Goran, Loinaz, Carmelo, Cuervas-Mons, Valentin, Zambelli, Marco, Llado, Laura, Diaz, Fernando, Invernizzi, Federica, Patrono, Damiano, Faitot, Francois, Bhooori, Sherrie, Pirenne, Jacques, Perricone, Giovanni, Magini, Giulia, Castells, Lluis, Detry, Oliver, Cruchaga, Pablo Mart, Colmenero, Jordi, Berrevoet, Frederick, Rodriguez, Gonzalo, Ysebaert, Dirk, Radenne, Sylvie, Metselaar, Herold, Morelli, Cristina, De Carlis, Luciano, Polak, Wojciech G, and Duvoux, Christophe

Abstract

BACKGROUND AND AIMS: Despite concerns that liver transplant (LT) recipients may be at increased risk of unfavorable outcomes from COVID-19 due the high prevalence of co-morbidities, immunosuppression and ageing, a detailed analysis of their effects in large studies is lacking.METHODS: Data from adult LT recipients with laboratory confirmed SARS-CoV2 infection were collected across Europe. All consecutive patients with symptoms were included in the analysis.RESULTS: Between March 1st and June 27th2020, data from 243 adult symptomatic cases from 36 centers and 9 countries were collected. Thirty-nine (16%) were managed as outpatients while 204 (84%) required hospitalization including admission to the ICU (39/204, 19.1%). Forty-nine (20.2%) patients died after a median of 13.5 (10-23) days, respiratory failure was the major cause. After multivariable Cox regression analysis, age >70 (HR, 4.16; 95% CI, 1.78-9.73) had a negative effect and tacrolimus (TAC) use (HR, 0.55; 95% CI, 0.31-0.99) had a positive independent effect on survival. The role of co-morbidities was strongly influenced by the dominant effect of age where comorbidities increased with the increasing age of the recipients. In a second model excluding age, both diabetes (HR, 1.95; 95% CI, 1.06-3.58) and chronic kidney disease (HR, 1.97; 95% CI, 1.05-3.67) emerged as associated with death CONCLUSIONS: Twenty-five per cent of patients requiring hospitalization for Covid-19 died, the risk being higher in patients older than 70 and with medical co-morbidities, such as impaired renal function and diabetes. Conversely, the use of TAC was associated with a better survival thus encouraging clinicians to keep TAC at the usual dose.

Published
2021

42. A Randomized, Controlled Study to Assess the Conversion From Calcineurin-Inhibitors to Everolimus After Liver Transplantation—PROTECT

Author

Fischer, L., Klempnauer, J., Beckebaum, S., Metselaar, H. J., Neuhaus, P., Schemmer, P., Settmacher, U., Heyne, N., Clavien, P-A., Muehlbacher, F., Morard, I., Wolters, H., Vogel, W., Becker, T., Sterneck, M., Lehner, F., Klein, C., Kazemier, G., Pascher, A., Schmidt, J., Rauchfuss, F., Schnitzbauer, A., Nadalin, S., Hack, M., Ladenburger, S., and Schlitt, H. J.

Published
2012
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