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Two Case Reports of Successful Withdrawal of Mycofenolate Mofetil After Living Donor Lobar Lung Transplantation
http://hdl.handle.net/10069/31486
http://hdl.handle.net/10069/314868e0cbe8a-3190-4cf8-a974-82d80a776ec8
名前 / ファイル | ライセンス | アクション |
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TraPro45_356.pdf (160.3 kB)
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Item type | 学術雑誌論文 / Journal Article(1) | |||||
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公開日 | 2013-04-24 | |||||
タイトル | ||||||
タイトル | Two Case Reports of Successful Withdrawal of Mycofenolate Mofetil After Living Donor Lobar Lung Transplantation | |||||
言語 | ||||||
言語 | eng | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | amphotericin B | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | cotrimoxazole | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | itraconazole | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | micafungin | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | mycophenolic acid 2 morpholinoethyl ester | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | prednisolone | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | tacrolimus | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | voriconazole | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | adult | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | antimicrobial therapy | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | article | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | case report | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | drug withdrawal | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | female | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | human | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | immune function test | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | immunoassay | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | immunosuppressive treatment | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | living donor lobar lung transplantation | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | lung aspergillosis | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | lung transplantation | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | male | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | medical history | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | patient monitoring | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | postoperative infection | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | priority journal | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | T lymphocyte | |||||
資源タイプ | ||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
資源タイプ | journal article | |||||
著者 |
Miyazaki, Takuro
× Miyazaki, Takuro× Tagawa, Tsutomu× Yamasaki, Naoya× Tsuchiya, Tomoshi× Matsumoto, Keitaro× Nagayasu, Takeshi |
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抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | Background: Lung transplantation cases have immunosuppression maintained using a calcineurin inhibitor, anti-metabolites, and steroid. Case Report: We report 2 clinical cases in which anti-metabolites (mycophenolate mofetil) were successfully withdrawn after living donor lobar lung transplantation by monitoring immune function using the ImmuKnow® assay. In the first case, a 43-year-old woman underwent living donor lobar lung transplantation for pulmonary alveolar proteinosis. Two healthy relatives donated a lower lobe each. Immunosuppression was maintained using tacrolimus, mycophenolate mofetil, and steroid. Six months posttransplantation, she developed invasive pulmonary aspergillosis. During anti-fungal treatment, we withdrew mycophenolate mofetil and tacrolimus trough levels were kept around 8 ng/mL. Despite the resulting low-level immunosuppression, the ImmuKnow assay showed immune function to be in the moderate range with tacrolimus and steroid alone, encouraging us to maintain this strategy to avoid recurrence of invasive pulmonary aspergillosis. In the second case, a 24-year-old man underwent living donor lobar lung transplantation for cystic fibrosis. Two healthy relatives donated a lower lobe each. Immunosuppression was maintained using tacrolimus, mycophenolate mofetil, and steroid. Five months posttransplantation, he developed persistent Pseudomonas aeruginosa pneumonia derived from the paranasal sinuses. Under ImmuKnow assay monitoring, mycophenolate mofetil was withdrawn, but immune function was maintained within the moderate range using tacrolimus and steroid alone. Discussion: Respiratory function in both cases was maintained; no findings of bronchiolitis obliterans syndrome were noted during this period. To the best of our knowledge, no reports have described successful anti-metabolite withdrawal in lung transplantation with ImmuKnow monitoring. Immune evaluation by ImmuKnow could offer a useful method to monitor and control immune status, particularly among recipients susceptible to infection, revealing that moderate immune function could be maintained using tacrolimus and steroid in living donor lobar lung transplantation. | |||||
書誌情報 |
Transplantation Proceedings 巻 45, 号 1, p. 356-359, 発行日 2013-01 |
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出版者 | ||||||
出版者 | Elsevier | |||||
ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 00411345 | |||||
DOI | ||||||
関連タイプ | isVersionOf | |||||
識別子タイプ | DOI | |||||
関連識別子 | 10.1016/j.transproceed.2012.09.112 | |||||
権利 | ||||||
権利情報 | © 2013 Elsevier Inc. | |||||
権利 | ||||||
権利情報 | NOTICE: this is the author’s version of a work that was accepted for publication in Transplantation Proceedings. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Transplantation Proceedings, 45, 1(2013) | |||||
著者版フラグ | ||||||
出版タイプ | AM | |||||
出版タイプResource | http://purl.org/coar/version/c_ab4af688f83e57aa | |||||
引用 | ||||||
内容記述タイプ | Other | |||||
内容記述 | Transplantation Proceedings, 45(1), pp.356-359; 2013 |