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Tx studygroup 2

Tx studygroup 2. Karlien, Ann, Tonny, Jaap & Nikki. Goals. To formulate research questions To discuss the Tx treatment policies. Tx data. 138 Tx in 135 children Outflow: (20 to adult care, 1 died, 1 pre Tx failure) Current therapy HD: 5 PD: 1 Tx: 107. Rejection. Tx failure.

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Tx studygroup 2

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  1. Tx studygroup 2 Karlien, Ann, Tonny, Jaap & Nikki

  2. Goals • To formulate research questions • To discuss the Tx treatment policies

  3. Tx data 138 Tx in 135 children Outflow: (20 to adult care, 1 died, 1 pre Tx failure) Current therapy HD: 5 PD: 1 Tx: 107

  4. Rejection

  5. Tx failure • N=7 • M0: 4 (reasons missing) • M3: 2 (1x vasc rejection, 1xmissing) • M24: 1 (chronic rejection)

  6. Cause of infection

  7. Research Proposals 1. Pharmacokinetics/immigrants – Karlien 2. Infections after tx • prevalence and association tx failure BK viremia • Policies with regard to immunosuppression/therapy • Course • Addition data from German centres (?) • prevalence CMV infection: • Influence aciclovir prophylaxisi on disease activity • Influence donor/recipient +/- 3. MBL- polymorphism

  8. Research Proposals • Tx + MBL deficiency: • Favour (bacterial) infection? (de Rooij ea) • less renal damage in ischemia-reperfusion? • Aim; association between MBL-polymorphism + MBL activity vs. • Time to reach lowest s-creatinine post tx • Number of bacterial infections with fever • Number of rejections • Genotype • MASP + MBL-MASP complex d 1 tx + 1/6m

  9. Farmacokinetiek/-genetica • Immigranten hebben meer acute rejecties, waarom? • (zou onafhankelijk van donorbron zijn) • Zelfde immsupp behandeling? (RichQ) • Zelfde geschatte therapietrouw? (RichQ)

  10. Aanvullende Methoden • Selectie uit onderzoek: alle patienten die TCL gebruiken, trpl > 1,5 jaar geleden • C0 en variabiliteit tussen mnd 6 en mnd 18 • C0/relatieve dosis (mg/kg.dag) • Farmacogenetica CYP3a4, 3a5, ABCB polymorfismes uit spijtbloed

  11. Management policies • In 2007 management policies • Treatment policies dialysis accepted by NDT • NDT: Also transplantation data?

  12. Management policies Tx • More detailed questionnaire of Tx management policies • Compared to literature • Compared to RICH-Q data

  13. Management policies topics • Pre Tx (screening, medication, ….) • Tx (donor, medication, ….) • Post Tx (medication, follow up)

  14. Please…. • Send me the management policies Tx • Send a copy of all your protocols concerning transplantation to n.j.schoenmaker@amc.nl >>Publication

  15. New Tx form Changes? Variables to add? >> Please let us know a.s.a.p.

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