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Article ; Online: Editorial: The cutting edge of donor-specific antibodies in transplantation.

Mandelbrot, Didier A

Current opinion in organ transplantation

2020 Volume 25, Issue 6, Page(s) 527–528

Language	English
Publishing date	2020-10-24
Publishing country	United States
Document type	Editorial
ZDB-ID	1390429-2
ISSN	1531-7013 ; 1087-2418
ISSN (online)	1531-7013
ISSN	1087-2418
DOI	10.1097/MOT.0000000000000824
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Zs.A 5609: Show issues

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Article ; Online: Histopathological Features and Role of Allograft Kidney Biopsy Among Recipients With Prolonged Delayed Graft Function: A Review.

Swanson, Kurtis J / Zhong, Weixiong / Mandelbrot, Didier A / Parajuli, Sandesh

Transplantation

2024

Abstract: Delayed graft function (DGF) is an early posttransplant complication predictive of adverse outcomes. This "acute kidney injury of transplantation" is often defined as allograft dysfunction requiring renal replacement within 7 d posttransplantation. DGF ... ...

Abstract	Delayed graft function (DGF) is an early posttransplant complication predictive of adverse outcomes. This "acute kidney injury of transplantation" is often defined as allograft dysfunction requiring renal replacement within 7 d posttransplantation. DGF is an important area of study because it is emerging with efforts to expand the donor pool and address the supply-demand gap in kidney transplantation. DGF is often caused by severe kidney injury mechanisms because of multiple donors, recipients, and immunologic factors. The role of kidney biopsy, particularly in prolonged DGF, is an ongoing area of research and inquiry for clinicians and researchers alike to better define, manage, and predict outcomes of this early posttransplant event. This review aims to provide an in-depth, comprehensive summary of the literature to date on the histopathology of DGF and the role of kidney transplant biopsies in prolonged DGF.
Language	English
Publishing date	2024-02-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	208424-7
ISSN	1534-6080 ; 0041-1337
ISSN (online)	1534-6080
ISSN	0041-1337
DOI	10.1097/TP.0000000000004928
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Zs.A 488: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: LCP-Tacrolimus Requires a Similar Empiric Dose Adjustment to Immediate-Release Tacrolimus When Given Concomitantly With Letermovir for Cytomegalovirus Primary Prophylaxis.

Descourouez, Jillian L / Mandelbrot, Didier A / Odorico, Jon / Jorgenson, Margaret R

The Annals of pharmacotherapy

2023 , Page(s) 10600280231208430

Language	English
Publishing date	2023-10-27
Publishing country	United States
Document type	Letter
ZDB-ID	1101370-9
ISSN	1542-6270 ; 1060-0280
ISSN (online)	1542-6270
ISSN	1060-0280
DOI	10.1177/10600280231208430
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Zs.A 900: Show issues

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Article ; Online: Transplant Recipient Experience With Belatacept Therapy.

Little, Susan Nelson / Knudsen, Élise N Arsenault / Mandelbrot, Didier A

Transplantation proceedings

2022 Volume 54, Issue 6, Page(s) 1604–1608

Abstract: Although graft and patient outcomes with belatacept have been relatively well documented, the decision to use belatacept for kidney transplant recipients rests in part on the patient experience with a monthly infusion. These details are poorly documented ...

Abstract	Although graft and patient outcomes with belatacept have been relatively well documented, the decision to use belatacept for kidney transplant recipients rests in part on the patient experience with a monthly infusion. These details are poorly documented in the literature. This study describes the personal impact of using belatacept to facilitate shared and informed decision-making regarding the choice of immunosuppression among transplant providers, transplant coordinators, and patients. This study finds that participants are generally satisfied with their experience in receiving belatacept infusions. They report that the potential or actual benefits of belatacept justify possible drawbacks, such as time spent for travel and infusion, limited control over infusion planning, no decrease in insulin requirements, and multiple intravenous attempts. Although this study is limited to one institution and would benefit from replication, these findings begin to fill an important gap in current research.
MeSH term(s)	Abatacept/therapeutic use ; Cyclosporine ; Graft Rejection/prevention & control ; Graft Survival ; Humans ; Immunosuppressive Agents/adverse effects ; Insulins ; Kidney Transplantation/adverse effects ; Transplant Recipients
Chemical Substances	Immunosuppressive Agents ; Insulins ; Abatacept (7D0YB67S97) ; Cyclosporine (83HN0GTJ6D)
Language	English
Publishing date	2022-03-09
Publishing country	United States
Document type	Case Reports
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2021.12.046
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Zs.A 835: Show issues

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Article ; Online: One more time, emphasizing the advantage of simultaneous pancreas and kidney transplantation for patients with type 1 diabetes and end-stage renal disease.

Parajuli, Sandesh / Mandelbrot, Didier A

Transplant international : official journal of the European Society for Organ Transplantation

2020 Volume 33, Issue 11, Page(s) 1384–1386

MeSH term(s)	Diabetes Mellitus, Type 1/complications ; Diabetes Mellitus, Type 1/surgery ; Humans ; Kidney Failure, Chronic/surgery ; Kidney Transplantation ; Pancreas ; Pancreas Transplantation ; Quality of Life ; Renal Dialysis
Language	English
Publishing date	2020-06-30
Publishing country	England
Document type	Journal Article ; Comment
ZDB-ID	639435-8
ISSN	1432-2277 ; 0934-0874
ISSN (online)	1432-2277
ISSN	0934-0874
DOI	10.1111/tri.13686
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Zs.A 2358: Show issues

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Article: Sodium-glucose cotransporter-2 inhibitor use in kidney transplant recipients.

Ramakrishnan, Pavithra / Garg, Neetika / Pabich, Samantha / Mandelbrot, Didier A / Swanson, Kurtis J

World journal of transplantation

2023 Volume 13, Issue 5, Page(s) 239–249

Abstract: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are novel oral hypoglycemic agents garnering much attention for their substantial benefits. These recent data have positioned SGLT2i at the forefront of diabetic chronic kidney disease (CKD) and heart ... ...

Abstract	Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are novel oral hypoglycemic agents garnering much attention for their substantial benefits. These recent data have positioned SGLT2i at the forefront of diabetic chronic kidney disease (CKD) and heart failure management. SGLT2i use post-kidney transplant is an emerging area of research. Highlights from this mini review include the following: Empagliflozin is the most prescribed SGLT2i in kidney transplant recipients (KTRs), median time from transplant to initiation was 3 years (range: 0.88-9.6 years). Median baseline estimated glomerular filtration rate (eGFR) was 66.7 mL/min/1.73 m
Language	English
Publishing date	2023-09-08
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2220-3230
ISSN	2220-3230
DOI	10.5500/wjt.v13.i5.239
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Article ; Online: Resource Use and Financial Impact of Oral Step-Down Therapy for Resistant Cytomegalovirus in Solid Organ Transplant Recipients.

Kleiboeker, Hanna / Descourouez, Jillian L / Schulz, Lucas T / Mandelbrot, Didier A / Odorico, Jon S / Saddler, Christopher M / Smith, Jeannina A / Jorgenson, Margaret R

Transplantation proceedings

2024 Volume 56, Issue 2, Page(s) 434–439

Abstract: Background: Cytomegalovirus (CMV) infections are common opportunistic infections in solid organ transplants (SOT) with increased health care resource USE and costs. Costs are further increased with ganciclovir-resistance (GR). This study aimed to ... ...

Abstract	Background: Cytomegalovirus (CMV) infections are common opportunistic infections in solid organ transplants (SOT) with increased health care resource USE and costs. Costs are further increased with ganciclovir-resistance (GR). This study aimed to evaluate the real-world impact of conversion to oral step-down therapy on duration of foscarnet and hospital length of stay (LOS) for treatment of GR-CMV infections in SOT. Methods: This study included adult recipients of kidney or lung transplants who received foscarnet for genotypically documented GR-CMV while admitted at the University of Wisconsin Hospital from October 1, 2015, to January 31, 2022. Patients in the oral step-down group were converted from standard of care (SOC; foscarnet) to maribavir or letermovir; patients in the historical control group were treated with SOC. Results: Twenty-six patients met the inclusion criteria: 5 in the intervention group and 21 in the SOC group. The median viral load at foscarnet initiation was 11,435 IU/mL. Patients who received oral step-down conversion had shorter mean foscarnet duration than those who received SOC (7 ± 4 vs 37 ± 25 days, P = .017). Mean hospital LOS in the oral step-down group (16 ± 3 days) was shorter than the SOC group (33 ± 21 days; P < .001). In the SOC group, 9 patients lost their graft, and 9 patients died; 2 deaths were attributed to CMV. There were 2 deaths in the oral step-down group, neither of which was attributed to CMV. Conclusion and relevance: In this real-world case series of patients receiving treatment for GR-CMV infection, oral step-down conversion decreased foscarnet therapy duration and hospital LOS. Future studies are needed to evaluate better the effect of oral step-down in treating GR-CMV infection on treatment duration and cost-savings.
MeSH term(s)	Adult ; Humans ; Cytomegalovirus ; Foscarnet/therapeutic use ; Antiviral Agents/therapeutic use ; Ganciclovir/therapeutic use ; Cytomegalovirus Infections/diagnosis ; Cytomegalovirus Infections/drug therapy ; Cytomegalovirus Infections/etiology ; Organ Transplantation/adverse effects ; Transplant Recipients
Chemical Substances	Foscarnet (364P9RVW4X) ; Antiviral Agents ; Ganciclovir (P9G3CKZ4P5)
Language	English
Publishing date	2024-02-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2024.01.052
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Zs.A 835: Show issues

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Article ; Online: Potassium-lowering effects of sodium zirconium cyclosilicate in the early post-transplant period.

Shockey, William / Wiegel, Joshua J / Parajuli, Sandesh / Garg, Neetika / Swanson, Kurtis J / Mandelbrot, Didier A

Clinical transplantation

2023 Volume 38, Issue 1, Page(s) e15156

Abstract: Problem: Hyperkalemia is a serious condition among intra-abdominal transplant recipients, and the safety and efficacy of sodium zirconium cyclosilicate (SZC) for its management during the early post-transplant period are not well-established.: Methods! ...

Abstract	Problem: Hyperkalemia is a serious condition among intra-abdominal transplant recipients, and the safety and efficacy of sodium zirconium cyclosilicate (SZC) for its management during the early post-transplant period are not well-established. Methods: Adults who received at least one 10-g dose of SZC within 14 days after an intra-abdominal transplant between January 2020 and July 2022 were included in our study. The primary outcome was the change in potassium (K+) levels following the first SZC dose. Other analyses explored adjunctive potassium-lowering therapies, potential gastrointestinal complications, and patient subgroups based on therapy and transplant type. Results: Among the recipients (n = 46), 11 were kidney recipients, 26 were liver recipients, seven were simultaneous liver/kidney recipients, and two were simultaneous pancreas/kidney recipients. The mean time to first dose post-transplant was 7.6 (±4) days, and the mean change in serum K+ after the initial SZC dose was -.27 mEq (p = .001). No gastrointestinal complications were observed following the SZC dose. The mean increase in serum bicarbonate was .58 mEq (p = .41) following the first dose of SZC. Four kidney recipients required dialysis following the SZC dose. Conclusion: This study represents the largest investigation on the use of SZC in transplant recipients. A single 10-g dose of SZC reduced serum K+ levels in all subgroups, while the use of adjunctive K+-lowering therapies did not provide additional reduction beyond the effects of SZC. Importantly, no gastrointestinal complications were observed. These findings suggest that SZC may be a safe and promising therapeutic option for hyperkalemia management following solid organ transplantation.
MeSH term(s)	Adult ; Humans ; Potassium/therapeutic use ; Hyperkalemia/etiology ; Hyperkalemia/drug therapy ; Silicates/therapeutic use ; Renal Dialysis/adverse effects
Chemical Substances	Potassium (RWP5GA015D) ; sodium zirconium cyclosilicate (D652ZWF066) ; Silicates
Language	English
Publishing date	2023-10-09
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	639001-8
ISSN	1399-0012 ; 0902-0063
ISSN (online)	1399-0012
ISSN	0902-0063
DOI	10.1111/ctr.15156
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Article ; Online: Graft Function Variability and Slope and Kidney Transplantation Outcomes.

Lyu, Beini / Mandelbrot, Didier A / Djamali, Arjang / Astor, Brad C

Kidney international reports

2021 Volume 6, Issue 6, Page(s) 1642–1652

Abstract: Introduction: It is critical to identify kidney transplant recipients (KTRs) at higher risk for adverse outcomes, to focus on monitoring and interventions to improve outcomes. We examined the associations between graft function variability and long-term ...

Abstract	Introduction: It is critical to identify kidney transplant recipients (KTRs) at higher risk for adverse outcomes, to focus on monitoring and interventions to improve outcomes. We examined the associations between graft function variability and long-term outcomes in KTRs in an observational study. Methods: We identified 2919 KTRs in the Wisconsin Allograft Recipient Database (WisARD) who had a functioning allograft 2 years posttransplantation and at least 3 outpatient measurements of estimated glomerular filtration rate (eGFR) from 1 to 2 years posttransplantation. Graft function slope was calculated from a linear regression of eGFR, and variability was defined as the coefficient of variation around this regression line. Associations of eGFR variability and slope with death, graft failure, cardiovascular events, and acute rejection were estimated. Results: Compared to the lowest quartile, the highest quartile of eGFR variability was associated with a higher risk of death (adjusted hazard ratio [HR] = 1.85; 95% CI = 1.23-2.76), but not with a higher risk of graft failure (subhazard ratio = 1.16; 95% CI = 0.85-1.58), independent of eGFR and slope of eGFR. Greater eGFR variability was associated with higher risk of cardiovascular- and infection-related death and cardiovascular events but not malignancy-related death or allograft rejection. Including variability of eGFR significantly improved prediction of mortality but not prediction of graft failure. Conclusion: Variability of eGFR is independently associated with risk of death, especially cardiovascular disease-related death and cardiovascular events, but not graft failure. Variability of eGFR may help identify KTRs at higher risk for death and cardiovascular events.
Language	English
Publishing date	2021-03-30
Publishing country	United States
Document type	Journal Article
ISSN	2468-0249
ISSN (online)	2468-0249
DOI	10.1016/j.ekir.2021.03.880
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Article ; Online: Early Increases in Posttransplant Pancreatic Enzymes Are Associated With Surgical Complications But Not Graft Failure Among Pancreas Transplant Recipients.

Parajuli, Sandesh / Leverson, Glen E / Kaufman, Dixon B / Djamali, Arjang / Welch, Bridget M / Sollinger, Hans W / Mandelbrot, Didier A / Odorico, Jon S

Pancreas

2023 Volume 51, Issue 10, Page(s) 1381–1387

Abstract: Objectives: This study aimed to find the association between immediate postoperative increases in pancreatic enzymes and posttransplant complications among pancreas transplant recipients (PTRs).: Methods: We analyzed all PTRs transplanted at the ... ...

Abstract	Objectives: This study aimed to find the association between immediate postoperative increases in pancreatic enzymes and posttransplant complications among pancreas transplant recipients (PTRs). Methods: We analyzed all PTRs transplanted at the University of Wisconsin between June 2009 and September 2018. Enzyme levels were presented as a ratio of absolute numbers to the upper limit of normal value, with value >1 considered as abnormal. We specifically evaluated bleeding, fluid collections, and thrombosis complications based on the amylase or lipase ratios on day 1 (Amylase1, Lipase1) and maximum ratios within 5 days of transplant (Amylasemax, Lipasemax). For early complications, we focused on technical complications that occurred within 90 days of transplant. For long-term outcomes, we assessed patient and graft survival, and rejections. Results: There were a total of 443 PTRs, 287 were simultaneous pancreas and kidney recipients, and 156 were solitary pancreas recipients. Higher Amylase1, Liplase1, Amylasemax, and Lipasemax were associated with an increase in early complications, mainly need for pancreatectomy, fluid collections, bleeding complications, or graft thrombosis, particularly in the solitary pancreas group. Conclusions: Our finding suggests that cases of early perioperative enzyme increase merit consideration for early imaging investigation to mitigate detrimental outcomes.
MeSH term(s)	Humans ; Pancreas Transplantation/adverse effects ; Pancreas Transplantation/methods ; Transplant Recipients ; Kidney Transplantation/adverse effects ; Kidney Transplantation/methods ; Pancreas/surgery ; Thrombosis/etiology ; Graft Survival ; Postoperative Complications/etiology ; Graft Rejection
Language	English
Publishing date	2023-04-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632831-3
ISSN	1536-4828 ; 0885-3177
ISSN (online)	1536-4828
ISSN	0885-3177
DOI	10.1097/MPA.0000000000002187
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