Necla BENLİER, Medet KORKMAZ, Hatice GÜZEL, Mehmet Fatih YÜZBAŞIOĞLU

Factors Affecting Adverse Effects after Kidney Transplantation

Objective: The incidence of developing adverse effects in recipients after kidney transplantation (Tx) was analyzed.Methods: A total of 206 patients (mean age was 41.40±11.88 years, 92.7% were between 46 and 59 years old, and 66.0% were men) whounderwent Tx between 2011 and 2016 were evaluated retrospectively. Information regarding the sociodemographic characteristics ofthe patients was collected using the “Sociodemographic Characteristics Data Collection Form,” which was created by the researcher.Results: Various adverse effects were detected in 206 patients who participated in our study. The incidence of adverse effects wassignificantly higher in patients who had hypertension and chronic glomerulonephritis who underwent dialysis treatment during0–12 months before Tx and who received a kidney transplant from a living donor (p=0.001). The incidence of adverse effects relatedto the immunosuppressive drugs used after transplantation was significantly higher in patients receiving mycophenolate mofetil(MMF)+steroid+tacrolimus and MMF+steroid+cyclosporine, and weight gain was higher in patients receiving the same group of drugs(p=0.001). There were no significant differences in terms of adverse effects that occurred in other drug combinations.Conclusion: We found that many factors (e.g., immunosuppressive drugs) in Tx patients may be associated with the incidence of adverseeffects.

PDF

___

Levey AS, Atkins R, Coresh J, Cohen EP, Collins AJ, Eckardt KU, et al. Chronic kidney disease as a global public health problem: approaches and initiatives - a position statement from Kidney Disease Improving Global Outcomes. Kidney Int 2007; 72: 247-59. [CrossRef]
Rostand SG, Kirk KA, Rutsky EA, Pate BA. Racial Differences in the Incidence of Treatment for End-Stage Renal Disease. N Engl J Med 1982; 306: 1276-79. [CrossRef]
Hoste EA, Dhondt A. Clinical review: use of renal replacement therapies inspecial groups of ICU patients. Crit Care 2012; 16: 201. [CrossRef]
Schieppati A, Remuzzi G. Chronic renal diseases as a public health problem:epidemiology, social, and economic implications. Kidney Int Suppl 2005; 98: S7-S10. [CrossRef]
Abecassis M, Bartlett ST, Collins AJ, Davis CL, Delmonico FL, Friedewald JJ, et al. Kidney transplantation as primary therapy for end stage renal disease: a National Kidney Foundation/ Kidney Disease Outcomes Quality Initiative (NKF/KDOQITM) conference. Clin J Am Soc Nephrol 2008; 3: 471-80. [CrossRef]
Dandel M, Lehmkuhl HB, Knosalla C, Hetzer R.. Impact of different long-term maintenance immunosuppressive therapy strategies on patients’ outcome after heart transplantation. Transpl Immunol 2010; 23: 93-103. [CrossRef]
Pham PT, Everly M, Faravardeh A, Pham PC. Management of patients with a failed kidney transplant: Dialysis reinitiation, immunosuppression weaning, and transplantectomy. World J Nephrol 2015; 4: 148-59. [CrossRef]
Van Gelder FEL, Ohler L. Transplant Immunology. Ohler L, Cupples S, editors. Core Curriculum for Transplant Nurses. Philedelphia: Mosby; 2008.p.27-47.
Costello A, Pearson GJ. Transplant Pharmacology. Ohler L, Cupples S, editors. Core Curriculum for Transplant Nurses. Philadelphia: Mosby; 2008.
Arellano EM1, Campistol JM, Oppenheimer F, Rovira J, Diekmann F. Sirolimus Monotherapy as Maintenace İmmunosuppression: Single-Center Experience in 50 Kidney Transplant Patients. Transplant Proc 2007; 39: 2131-4. [CrossRef]
Akbaba D. İmmunsupresif Kan İlaç Düzeyi İzleminin Ve Elde Edilen Test Sonuçlarıyla Biyokimyasal Parametreler Arasındaki İlişkinin Değerlendirilmesi. Haydarpaşa Numune Eğitim Ve Araştırma Hastanesi Tıbbi Biyokimya Bölümü. Uzmanlık Tezi. 2009. Available from: URL: http://www.istanbulsaglik.gov.tr/w/tez/pdf/biyokimya/dr_derya_ akbaba.pdf
Rogers CC, Alloway RR, Alexander JW, Cardi M, Trofe J, Vinks AA. Pharmacokinetics of mycophenolic acid, tacrolimus and sirolimus after gastric bypass surgery in end-stage renal disease and transplant patients: a pilot study. Clin Transplant 2008; 22: 281-91. [CrossRef]
Zand MS. Immunosuppression and immune monitoring after renal transplantation. Semin Dial 2005; 18: 511-9. [CrossRef]
Rostaing L, Massari P, Garcia VD, Mancilla-Urrea E, Nainan G, del Carmen Rial M, et al. Switching from calcineurin inhibitor-based regimens to a belatacept-based regimen in renal transplant recipients: a randomized phase II study. Clin J Am Soc Nephrol 2011; 6: 430-9. [CrossRef]
Klawitter J, Nashan B, Christians U. Everolimus and sirolimus in transplantation- related but different. Expert Opin Drug Saf 2015; 14: 1055-70. [CrossRef]
Stallone G, Infante B, Grandaliano G, Gesualdo L. Management of advers effects of sirolimus therapy. Transplantation 2009; 87: 23-6. [CrossRef]
Gallon LG, Winoto J, Leventhal JR, Parker MA, Kaufman DB. Effect of prednisone versus no prednisone as part of maintenance immunosuppression on long- term renal transplant function. Clin J Am Soc Nephrol 2006; 1: 1029-38. [CrossRef]
Atalay S. Level monitoring of immunosuppressive drugs in the blood and biochemical parameters evaluation of the relationship between the test results obtained with. Master’s Thesis, 2009.
Talas S, Bayraktar M. Kidney transplantation: determination of the problems encountered by Turkish patients and their knowledge and practices on healthy living. J Clin Nurs 2004; 13: 580-8. [CrossRef]
Ahmed A, Keeffe EB. Current indications and contra indications for liver transplantation. Clin Liver Dis 2007;11: 227-47. [CrossRef]
Herrero MJ, Sánchez-Plumed J, Galiana M, Bea S, Marqués MR, Aliño SF. Influence of pharmacogenetic polymorphisms in routine immunosuppression therapy after renal transplantation. Transplant Proc 2010; 42: 3134-6. [CrossRef]
Pazik J, Ołdak M, Dąbrowski M, Lewandowski Z, Sitarek E, Podgórska M, et al. Association of UDP glucuronosyl transferase 1A9 (UGT1A9) gene polymorphism with kidney allograft function. Ann Transplant 2011; 16: 69-73. [CrossRef]
Mascarell L, Truffa-Bachi P. New aspects of cyclosporin a mode of action: from gene silencing to gene up-regulation. Mini Rev Med Chem 2003; 3: 205-14. [CrossRef]
Dummer JS, Hardy A, Poorsattar A, Ho M. Early infections in kidney, heart, and liver transplant recipients on cyclosporine. Transplantation 1983; 36: 259-67. [CrossRef]
Ho M, Dummer JS. Risk factors and approaches to infection in transplant recipients. Mandell GL, Douglas RG Jr, Bennett JE editors. Principles and Practice of Infectious Diseases. New York, Churchill Livingstone; 1990.p.2294.
Molassiotis A, Morris PJ. Quality of life in patients with chronic myeloid leukemia after unrelated donor bone marrow transplantation. Cancer Nurs 1999; 22: 340-9. [CrossRef]
Halloran PF. Immunosuppressive drugs for kidney transplantation. N Engl J Med 2004; 351: 2715-29. [CrossRef]
Wawrzynowicz-Syczewska M, Karpińska E, Jurczyk K, Laurans L, Boroń-Kaczmarska A. Risk factors and dynamics ofweight gain in patients after liver transplantation. Ann Transplant 2009; 14: 45-50.
Everhart JE, Lombardero M, Lake JR, Wiesner RH, Zetterman RK, Hoofnagle JH. Weightchange and obesity after liver transplantation: incidence and risk factors. Liver Transpl Surg 1998; 4: 285-96. [CrossRef]
Kitazawa T, Matsumoto K, Fujita S, Seto K, Hasegawa T. Cost Analysis of Transplantation in Japan, Performed With the Use of the National Database. Transplant Proc 2017; 49: 4-9. [CrossRef]