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  1. Article ; Online: Effect of nirmatrelvir/ritonavir on calcineurin inhibitor levels: Early experience in four SARS-CoV-2 infected kidney transplant recipients.

    Wang, Aileen X / Koff, Alan / Hao, Diana / Tuznik, Natascha M / Huang, Yihung

    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

    2022  Volume 22, Issue 8, Page(s) 2117–2119

    MeSH term(s) Calcineurin Inhibitors/therapeutic use ; Humans ; Kidney Transplantation/adverse effects ; Ritonavir/therapeutic use ; SARS-CoV-2 ; Transplant Recipients ; COVID-19 Drug Treatment
    Chemical Substances Calcineurin Inhibitors ; Ritonavir (O3J8G9O825)
    Language English
    Publishing date 2022-02-23
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2060594-8
    ISSN 1600-6143 ; 1600-6135
    ISSN (online) 1600-6143
    ISSN 1600-6135
    DOI 10.1111/ajt.16997
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    Zs.A 5542: Show issues Location:
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  2. Article ; Online: Parathyroidectomy and Cinacalcet Use in Medicare-Insured Kidney Transplant Recipients.

    Wang, Aileen X / Liu, Sai / Montez-Rath, Maria E / Chertow, Glenn M / Lenihan, Colin R

    American journal of kidney diseases : the official journal of the National Kidney Foundation

    2022  Volume 81, Issue 3, Page(s) 270–280.e1

    Abstract: Rationale & objective: Posttransplant hyperparathyroidism is common, and treatment practices are poorly characterized. The goal of this study was to examine the incidence, associations, and outcomes of posttransplant parathyroidectomy and calcimimetic ... ...

    Abstract Rationale & objective: Posttransplant hyperparathyroidism is common, and treatment practices are poorly characterized. The goal of this study was to examine the incidence, associations, and outcomes of posttransplant parathyroidectomy and calcimimetic use in a cohort of Medicare-insured US kidney transplant recipients.
    Study design: Retrospective observational cohort study.
    Setting & participants: We used the US Renal Data System to extract demographic, clinical, and prescription data from Medicare Parts A, B, and D-insured patients who received their first kidney transplant in 2007-2013. We excluded patients with pretransplant parathyroidectomy.
    Predictors: Calendar year of transplantation and pretransplant patient characteristics.
    Outcome: (1) Incidence of and secular trends in parathyroidectomy and cinacalcet use in the 3 years after transplant; (2) 90-day outcomes after posttransplant parathyroidectomy and cinacalcet initiation.
    Analytical approach: Temporal trends and pretransplant correlates of parathyroidectomy and cinacalcet use were assessed using proportional hazards models and multivariable Poisson regression, respectively.
    Results: The inclusion criteria were met by 30,127 patients, of whom 10,707 used cinacalcet before transplant, 551 underwent posttransplant parathyroidectomy, and 5,413 filled≥1 prescription for cinacalcet. The rate of posttransplant parathyroidectomy was stable over time. By contrast, cinacalcet use increased during the period studied. Long dialysis vintage and pretransplant cinacalcet use were strongly associated with posttransplant parathyroidectomy and cinacalcet use. Roughly 1 in 4 patients were hospitalized within 90 days of posttransplant parathyroidectomy, with hypocalcemia-related diagnoses being the most common complication. Parathyroidectomy (vs cinacalcet initiation) was not associated with an increase in acute kidney injury.
    Limitations: We lacked access to laboratory data to help assess the severity of secondary/tertiary hyperparathyroidism. The cohort was limited to Medicare beneficiaries.
    Conclusions: Almost one-fifth of our study cohort was treated with parathyroidectomy and/or cinacalcet. Further studies are needed to establish the optimal treatment for posttransplant hyperparathyroidism.
    MeSH term(s) Humans ; Aged ; United States ; Cinacalcet/therapeutic use ; Calcimimetic Agents/therapeutic use ; Kidney Transplantation ; Parathyroidectomy ; Retrospective Studies ; Medicare ; Hyperparathyroidism, Secondary/drug therapy ; Parathyroid Hormone ; Calcium ; Kidney Failure, Chronic/complications
    Chemical Substances Cinacalcet (UAZ6V7728S) ; Calcimimetic Agents ; Parathyroid Hormone ; Calcium (SY7Q814VUP)
    Language English
    Publishing date 2022-09-24
    Publishing country United States
    Document type Observational Study ; Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 604539-x
    ISSN 1523-6838 ; 0272-6386
    ISSN (online) 1523-6838
    ISSN 0272-6386
    DOI 10.1053/j.ajkd.2022.07.015
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    Zs.A 1669: Show issues Location:
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    Zs.MO 468: Show issues

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  3. Article ; Online: Long-term Apheresis in the Management of Patients With Recurrent Focal Segmental Glomerulosclerosis After Kidney Transplantation.

    Uffing, Audrey / Hullekes, Frank / Hesselink, Dennis A / Mansur, Juliana B / Malvezzi, Paolo / de Vries, Aiko P J / Seeger, Harald / Manfro, Roberto C / Nissaisorakarn, Pitchaphon / Wang, Aileen X / Reindl-Schwaighofer, Roman / Sanchez-Russo, Luis / Cravedi, Paolo / Riella, Leonardo V / Berger, Stefan P

    Kidney international reports

    2022  Volume 7, Issue 6, Page(s) 1424–1427

    Language English
    Publishing date 2022-03-11
    Publishing country United States
    Document type Journal Article
    ISSN 2468-0249
    ISSN (online) 2468-0249
    DOI 10.1016/j.ekir.2022.03.002
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  4. Article ; Online: Influence of immunosuppression on seroconversion against SARS-CoV-2 in two kidney transplant recipients.

    Wang, Aileen X / Quintero Cardona, Orlando / Ho, Dora Y / Busque, Stephan / Lenihan, Colin R

    Transplant infectious disease : an official journal of the Transplantation Society

    2020  Volume 23, Issue 1, Page(s) e13423

    Abstract: Solid organ transplant recipients are at risk for infectious complications due to chronic immunosuppression. The outbreak of coronavirus disease 2019 (COVID-19) in the United States has raised growing concerns for the transplant patient population. We ... ...

    Abstract Solid organ transplant recipients are at risk for infectious complications due to chronic immunosuppression. The outbreak of coronavirus disease 2019 (COVID-19) in the United States has raised growing concerns for the transplant patient population. We seek to add to the current limited literature on COVID-19 in transplant recipients by describing the clinical course of two kidney transplant recipients with SARS-CoV-2 infection monitored by both RT-PCR and serology. Through careful adjustment of their immunosuppression regimen, both patients had excellent recovery with intact graft function and development of anti-SARS-CoV-2 antibodies.
    MeSH term(s) Aged ; Female ; Humans ; Immunocompromised Host ; Immunosuppressive Agents/administration & dosage ; Immunosuppressive Agents/therapeutic use ; Kidney Transplantation ; Middle Aged ; SARS-CoV-2 ; Seroconversion ; Transplant Recipients
    Chemical Substances Immunosuppressive Agents
    Keywords covid19
    Language English
    Publishing date 2020-08-08
    Publishing country Denmark
    Document type Case Reports ; Journal Article
    ZDB-ID 1476094-0
    ISSN 1399-3062 ; 1398-2273
    ISSN (online) 1399-3062
    ISSN 1398-2273
    DOI 10.1111/tid.13423
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    Zs.A 5100: Show issues Location:
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  5. Article ; Online: Difficult Patient Behavior in Dialysis Facilities.

    Janosevic, Danielle / Wang, Aileen X / Wish, Jay B

    Blood purification

    2018  Volume 47, Issue 1-3, Page(s) 254–258

    Abstract: Difficult behavior exhibited by dialysis patients is a spectrum that includes nonadherence, verbal or physical abuse, and threatening acts. Such behaviors may lead to harmful consequences to the patient, other patients, the facility, and staff and can ... ...

    Abstract Difficult behavior exhibited by dialysis patients is a spectrum that includes nonadherence, verbal or physical abuse, and threatening acts. Such behaviors may lead to harmful consequences to the patient, other patients, the facility, and staff and can culminate in involuntary discharge. It is important to recognize that these "difficult behaviors" may be due to underlying psychosocial or medical issues, which places an onus on care providers to explore further. According to the Conditions for Coverage (CfC) for dialysis facilities, it falls upon the medical director to coordinate and oversee policies for patient satisfaction, patient safety and rights, involuntary discharges, and adverse events and outcomes. Thus, medical directors are liable for their own actions, and their staff for which they have oversight, for harm or perceived harm to patients in response to difficult behaviors. Guidelines to deal with specific patient behavior scenarios have been published by the Decreasing Dialysis Patient Conflict National Task Force of the Forum of end-stage renal disease (ESRD) Networks. The common denominator for these difficult scenarios is impaired communication, and the majority of patient concerns involve issues with staff, policies, treatments, and diet. Involuntary discharge of a patient should always be viewed as a last resort, and there is a structured process described in the CfC that requires the involvement of the respective ESRD Network and the facility medical director. As physicians, we are bound by ethical and growing legal obligations to act in an appropriate, ethical, and fair manner to patients who are considered to be "difficult."
    MeSH term(s) Humans ; Medication Adherence ; Patient Safety ; Patient Satisfaction ; Physician-Patient Relations ; Practice Guidelines as Topic ; Renal Dialysis
    Language English
    Publishing date 2018-12-06
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 605548-5
    ISSN 1421-9735 ; 0253-5068
    ISSN (online) 1421-9735
    ISSN 0253-5068
    DOI 10.1159/000494592
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  6. Article ; Online: Influence of immunosuppression on seroconversion against SARS‐CoV‐2 in two kidney transplant recipients

    Wang, Aileen X. / Quintero Cardona, Orlando / Ho, Dora Y. / Busque, Stephan / Lenihan, Colin R.

    Transplant Infectious Disease ; ISSN 1398-2273 1399-3062

    2020  

    Keywords Transplantation ; Infectious Diseases ; covid19
    Language English
    Publisher Wiley
    Publishing country us
    Document type Article ; Online
    DOI 10.1111/tid.13423
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  7. Article ; Online: What solid organ transplant healthcare providers should know about renin‐angiotensin‐aldosterone system inhibitors and COVID‐19

    Wong, Sunnie Y. / Brubaker, Aleah L. / Wang, Aileen X. / Taiwo, Adetokunbo A. / Melcher, Marc L.

    Clinical Transplantation

    2020  Volume 34, Issue 7

    Keywords Transplantation ; covid19
    Language English
    Publisher Wiley
    Publishing country us
    Document type Article ; Online
    ZDB-ID 639001-8
    ISSN 1399-0012 ; 0902-0063
    ISSN (online) 1399-0012
    ISSN 0902-0063
    DOI 10.1111/ctr.13991
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    Zs.A 2204: Show issues Location:
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  8. Article ; Online: What solid organ transplant healthcare providers should know about renin-angiotensin-aldosterone system inhibitors and COVID-19.

    Wong, Sunnie Y / Brubaker, Aleah L / Wang, Aileen X / Taiwo, Adetokunbo A / Melcher, Marc L

    Clinical transplantation

    2020  Volume 34, Issue 7, Page(s) e13991

    Abstract: The data on the outcomes of solid organ transplant recipients who have contracted coronavirus disease 2019 (COVID-19) are still emerging. Kidney transplant recipients are commonly prescribed renin-angiotensin-aldosterone system (AAS) inhibitors given the ...

    Abstract The data on the outcomes of solid organ transplant recipients who have contracted coronavirus disease 2019 (COVID-19) are still emerging. Kidney transplant recipients are commonly prescribed renin-angiotensin-aldosterone system (AAS) inhibitors given the prevalence of hypertension, diabetes, and cardiovascular disease. As the angiotensin-converting enzyme 2 (ACE2) facilitates the entry of coronaviruses into target cells, there have been hypotheses that preexisting use of renin-angiotensin-aldosterone system (RAAS) inhibitors may increase the risk of developing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Given the common use of RAAS inhibitors among solid organ transplant recipients, we sought to review the RAAS cascade, the mechanism of SARS-CoV-2 entry, and pertinent data related to the effect of RAAS inhibitors on ACE2 to guide management of solid organ transplant recipients during the COVID-19 pandemic. At present, there is no clear evidence to support the discontinuation of RAAS inhibitors in solid organ transplant recipients during the COVID-19 pandemic.
    MeSH term(s) Angiotensin Receptor Antagonists/therapeutic use ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Betacoronavirus ; COVID-19 ; Cardiovascular Diseases/complications ; Cardiovascular Diseases/therapy ; Coronavirus Infections/complications ; Coronavirus Infections/diagnosis ; Coronavirus Infections/therapy ; Humans ; Organ Transplantation ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/therapy ; Renin-Angiotensin System/physiology ; SARS-CoV-2
    Chemical Substances Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors
    Keywords covid19
    Language English
    Publishing date 2020-06-15
    Publishing country Denmark
    Document type Journal Article ; Review
    ZDB-ID 639001-8
    ISSN 1399-0012 ; 0902-0063
    ISSN (online) 1399-0012
    ISSN 0902-0063
    DOI 10.1111/ctr.13991
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  9. Article: Influence of immunosuppression on seroconversion against SARS-CoV-2 in two kidney transplant recipients

    Wang, Aileen X / Quintero Cardona, Orlando / Ho, Dora Y / Busque, Stephan / Lenihan, Colin R

    Transpl Infect Dis

    Abstract: Solid organ transplant recipients are at risk for infectious complications due to chronic immunosuppression. The outbreak of coronavirus disease 2019 (COVID-19) in the United States has raised growing concerns for the transplant patient population. We ... ...

    Abstract Solid organ transplant recipients are at risk for infectious complications due to chronic immunosuppression. The outbreak of coronavirus disease 2019 (COVID-19) in the United States has raised growing concerns for the transplant patient population. We seek to add to the current limited literature on COVID-19 in transplant recipients by describing the clinical course of two kidney transplant recipients with SARS-CoV-2 infection monitored by both RT-PCR and serology. Through careful adjustment of their immunosuppression regimen, both patients had excellent recovery with intact graft function and development of anti-SARS-CoV-2 antibodies.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #671848
    Database COVID19

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  10. Article: What solid organ transplant healthcare providers should know about renin-angiotensin-aldosterone system inhibitors and COVID-19

    Wong, Sunnie Y / Brubaker, Aleah L / Wang, Aileen X / Taiwo, Adetokunbo A / Melcher, Marc L

    Clin Transplant

    Abstract: The data on the outcomes of solid organ transplant recipients who have contracted coronavirus disease 2019 (COVID-19) are still emerging. Kidney transplant recipients are commonly prescribed renin-angiotensin-aldosterone system (AAS) inhibitors given the ...

    Abstract The data on the outcomes of solid organ transplant recipients who have contracted coronavirus disease 2019 (COVID-19) are still emerging. Kidney transplant recipients are commonly prescribed renin-angiotensin-aldosterone system (AAS) inhibitors given the prevalence of hypertension, diabetes, and cardiovascular disease. As the angiotensin-converting enzyme 2 (ACE2) facilitates the entry of coronaviruses into target cells, there have been hypotheses that preexisting use of renin-angiotensin-aldosterone system (RAAS) inhibitors may increase the risk of developing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Given the common use of RAAS inhibitors among solid organ transplant recipients, we sought to review the RAAS cascade, the mechanism of SARS-CoV-2 entry, and pertinent data related to the effect of RAAS inhibitors on ACE2 to guide management of solid organ transplant recipients during the COVID-19 pandemic. At present, there is no clear evidence to support the discontinuation of RAAS inhibitors in solid organ transplant recipients during the COVID-19 pandemic.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #342700
    Database COVID19

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