Lung transplantation acute rejection

B6. Blankenberg, F. G., and Strauss, H. W, Non-invasive diagnosis of acute heart- or lung-transplant rejection using radiolabeled annexin V. Pediatr. Radiol. 29, 299-305 (1999). 

G. Other applications Other possible uses of Orthoclone OKT3 are for prophylaxis and treatment of acute graft-versus-host disease (as an adjunct with allogeneic bone marrow transplantation) treatment of rejection after lung transplantation prophylaxis and treatment of rejection... 

Pinderski LJ, Kirklin JK, McGiffin D, Brown R, et al. 2005. Multi-organ transplantation Is there a protective effect against acute and chronic rejection J Heart Lung Transplant. 24 1828-1833. 

De Geest S, Abraham I, Moons P, Vandeputte M, Van Cleemput J, Evers G, Daenen W, Vanhaecke J. 1998. Late acute rejection and subclinical noncompliance with cyclosporine therapy in heart transplant recipients . J. Heart Lung Transplant 17 854-863. 

Acute and chronic rejection are major problems compromising transplant and patient survival. Many studies indicate that aerosolized cyclosporin A is useful for reducing the risk of acute rejection. The lung concentrates and retains cyclosporin A better after inhalation [152,153]. A number in investigators have found that aerosolized cyclosporin reduces acute rejection in animals [154-157], and some studies suggest efficacy in treating acute [158] and chronic [159,160] rejection in human transplant recipients. 

Currently, since the safety and efficacy of SRL has not been established in liver or lung transplants, it is recommended that its use be avoided in these populations immediately following transplant. In contrast, limited data on the use of SRL in heart transplantation indicate benefit in reversing acute rejection in patients who do not respond to antilymphocyte therapy. Furthermore, SRL may slow the progression of vasculopathy, which may have an impact on chronic rejection and long-term patient survival after heart transplantation. ... 

Kobashigawa JA, Kirklin JK, Naftel DC, et al. Pretransplantation risk factors for acute rejection after heart transplantation A multiinstitutional smdy. The Transplant Cardiologists Research Database Group. J Heart Lung Transplant 1993 12 355-366. 

Reams BD, Davis RD, Curl J, Palmer SM. Treatment of refractory acute rejection in a lung transplant recipient with campath IH. Transplanation 2002 74 903. 

Alio- / xenogeneic transplantation graft rejection cyclosporine A, but not tacrolimus, has strong additive effect wilh calcitriol on acute rat lung allograft survival and xenogeneic islets in nonobese diabetic mice [148, 213]... 

IL-10 Adult lung Transplant patients Acute persistent rejection Increased IL-10 production genotype has lower rejection rate 58... 

Figure 14 Spirometry over time from two groups of patients who have received lung transplants. Both groups are suffering from persistent acute rejection. The filled circles represent patients who were started on aerosolized cyclosporine at day 0 of observation.

Moudgil A, Bagga A, Toyoda M, Nicolaidou E, Jordan SC, Ross D. Expression of gamma-IFN mRNA in bronchoalveolar lavage fluid correlates with early acute allograft rejection in lung transplant recipients. Clin Transplant 1999 13 201-207. 

Winter JB, CleUand C, Gouw AS, Prop J. Distinct phenotypes of infiltrating cells during acute and chronic lung rejection in human heart-lung transplants. Transplantation 1995 59 63-69. 

Bowdish, M.F., Barr, M.L., Quardt, S.M., Medina, J., Collins, T., Johnson, M., Tonn, G., Newland, D. et al. (2003) Fvaluation of an oral CXCR3 antagonist in a rat model of acute cardiac allograft rejection. The Journal of Heart and Lung Transplantation, 22, S162. 

Because it is easy to administer and has satisfactory pharmacokinetics, sublingual tacrolimus is an attractive option when the oral route is prohibited. In a retrospective analysis of 17 lung and heart transplant patients, tacrolimus was administered sublingually and 90% of blood concentrations were within the target range [153 ]. Acute rejection episodes, renal toxicity, and drug interactions were not observed. 

During allograft acute rejection, the production of NO as measured nitrite/nitrate levels, has been demonstrated in several experimental models and inhibition of inducible nitric oxide synthase (rNOS) activity in a rat lung transplant model dramatically improved the survival rate of allografts (Shiraishi etal. 1995, Worrall etal. 1997). Studies carried out on transplant samples from patients with end-stage obliterative bronchioHfis have shown that in... 

Tc-HYMC annexin V Acute heart- or lung-transplant rejection Blankenberg and Strauss (24)... 

Blankenberg FG, Robbins RC, Stoot JH, Vriens PW, Berry GJ, Tait JF, Strauss HW. Radionuclide imaging of acute lung transplant rejection with annexin V. Chest 2000 ... 

Gerbase MW, Spiliopoulos A, Fathi M, et al. Low doses of mycophenolate mofetil with low doses of tacrolimus prevent acute rejection and long-term function loss after lung transplantation. Transplant Proc 2001 33 2146-2147. 

Homing NR, Lynch JP, Sundaresan SR, et al. Tacrolimus therapy for persistent or recurrent acute rejection after lung transplantation. J Heart Lung Transplant 1998 17 761-767. 

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