Association of medication non-adherence with short-term allograft loss after the treatment of severe acute kidney transplant rejection

Al-Sheyyab, Ahmed; Binari, Laura A.; Shwetar, Mohammed; Ramos, Everly; Kapp, Meghan E.; Bala, Stefanie; Wilson, Nikita S.; Forbes, Rachel C.; Helderman, J. Harold; Abdel-Kader, Khaled; Concepcion, Beatrice P.

doi:10.1186/s12882-019-1563-z

Cited by 10 publications

(11 citation statements)

References 21 publications

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“…Treatment adherence is crucial to ensure favorable outcomes in transplanted patients, and nonadherence is associated with an increased risk of allograft loss. 58 Continuous treatment adherence to antiretrovirals to prevent virological failure and resistance of HIV is a challenge in many PLWHIV. The added burden of IS therapy conceivably represents an additional barrier to treatment adherence.…”

Section: Discussionmentioning

confidence: 99%

Pharmacotherapeutic Interventions in People Living With HIV Undergoing Solid Organ Transplantation: A Scoping Review

Lam

Moussa

Sakr

et al. 2023

Transplantation Direct

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Background. The pharmacotherapeutic management of people living with HIV (PLWHIV) undergoing solid organ transplantation (SOT) is clinically challenging, mainly due to the frequent occurrence of complex drug–drug interactions. Although various strategies have been proposed to improve treatment outcomes in these patients, several uncertainties remain, and consensus practice guidelines are just beginning to emerge. The main objective of this scoping review was to map the extent of the literature on the pharmacotherapeutic interventions performed by healthcare professionals for PLWHIV undergoing SOT. Methods. We searched Medline, Embase, and the Cochrane databases as well as gray literature for articles published between January 2010 and February 2020. Study selection was performed by at least 2 independent reviewers. Articles describing pharmacotherapeutic interventions in PLWHIV considered for or undergoing SOT were included in the study. Results. Of the 12 599 references identified through our search strategy, 209 articles met the inclusion criteria. Results showed that the vast majority of reported pharmacotherapeutic interventions concerned the management of immunosuppressive and antimicrobial therapy, including antiretrovirals. Analysis of the data demonstrated that for several aspects of the pharmacotherapeutic management of PLWHIV undergoing SOT, there were differing practices, such as the choice of immunosuppressive induction and maintenance therapy. Other important aspects of patient management, such as patient counseling, were rarely reported. Conclusions. Our results constitute an extensive overview of current practices in the pharmacotherapeutic management of SOT in PLWHIV and identify knowledge gaps that should be addressed to help improve patient care in this specific population.

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Section: Discussionmentioning

confidence: 99%

Pharmacotherapeutic Interventions in People Living With HIV Undergoing Solid Organ Transplantation: A Scoping Review

Lam

Moussa

Sakr

et al. 2023

Transplantation Direct

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“…In our data, AIM2 attained a significant SMD in the TCMR subgroup, in accordance with our individualdataset heatmap, suggesting a probable confident non-random Frontiers in Immunology frontiersin.org finding. Since demographic information is usually incompletely available either in the GEO platform or in published transcriptome papers, our analyzed microarrays could have embraced grafts from different donor types, distinct ischemia periods, and immunosuppressive schemes, which are conditions that affect acute rejection development, potentially modifying our measured effect (66)(67)(68). In spite of diagnostic heterogeneity, expression profiling by array has intrinsic variations that may also contribute to this observation.…”

Section: Discussionmentioning

confidence: 99%

AIM2 as a putative target in acute kidney graft rejection

et al. 2022

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Acute rejection (AR) is a process triggered via the recognition of grafted organ-derived antigens by the immune system, which could present as a life-threatening condition. In the context of a kidney transplant, despite improvement with immunosuppressive therapies, AR maintains a significant incidence of 10%, and currently available drugs generally act in similar and canonical pathways of lymphocyte activation. This prompted the research for different approaches to identify potential novel targets that could improve therapeutic interventions. Here, we conducted a transcriptome analysis comparing groups of acute rejection (including T cell-mediated rejection and antibody-mediated rejection) to stable grafts that included differentially expressed genes, transcription factor and kinase enrichment, and Gene Set Enrichment Analysis. These analyses revealed inflammasome enhancement in rejected grafts and AIM2 as a potential component linked to acute rejection, presenting a positive correlation to T-cell activation and a negative correlation to oxidative phosphorylation metabolism. Also, the AIM2 expression showed a global accuracy in discerning acute rejection grafts (area under the curve (AUC) = 0.755 and 0.894, p < 0.0001), and meta-analysis comprising different studies indicated a considerable enhancement of AIM2 in rejection (standardized mean difference (SMD) = 1.45, [CI 95%, 1.18 to 1.71]), especially for T cell-mediated rejection (TCMR) (SMD = 2.01, [CI 95%, 1.58 to 2.45]). These findings could guide future studies of AIM2 as either an adjuvant target for immunosuppression or a potential biomarker for acute rejection and graft survival.

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“…Rates of nonadherence to immunosuppression are highest among KT recipients, increasing the risk for acute KT rejection (Al-Sheyyab et al, 2019;Dew et al, 2007). Posttransplant nonadherence is associated with higher rates of hospital readmissions and acute rejection among KT recipients (Mohamed et al, 2021).…”

Section: Adherencementioning

confidence: 99%

Solid organ transplant.

Balliet¹,

Haver²,

Maurer³

et al. 2023

Psychological Assessment of Surgical Candidates: Evidence-Based Procedures and Practices.

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Although solid organ transplantation (SOT) is considered one of the exceptional medical victories of the 20th century, there is a widening gap between available organs and potential recipients. In the United States, every 9 minutes, another person is added to the transplant waitlist, and on average, 17 people die per day while waiting to receive SOT (Health Resources and Services Administration, 2021). As a result, transplant teams are often considered custodians of this limited and valued resource for patients with advanced or end-stage organ disease (ESOD). This chapter focuses on areas most applicable to the presurgical psychosocial assessment of adult SOT candidates (PPA-TC), incorporating a brief review of the distinct domains across the four most common organ transplants and associated disease states. Pretransplant psychosocial, behavioral, and cognitive factors that have been empirically linked to posttransplant outcomes are reviewed to help guide why and how to best assess adult patients being considered for liver, heart, lung, or kidney transplantation (LT, HT, LGT, KT, respectively). Guidelines for evaluating

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Association of medication non-adherence with short-term allograft loss after the treatment of severe acute kidney transplant rejection

Cited by 10 publications

References 21 publications

Pharmacotherapeutic Interventions in People Living With HIV Undergoing Solid Organ Transplantation: A Scoping Review

Pharmacotherapeutic Interventions in People Living With HIV Undergoing Solid Organ Transplantation: A Scoping Review

AIM2 as a putative target in acute kidney graft rejection

Solid organ transplant.

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