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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

Tx studygroup 2

Karlien, Ann, Tonny, Jaap & Nikki


Goals
Goals

  • To formulate research questions

  • To discuss the Tx treatment policies


Tx data
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



Tx failure
Tx failure

  • N=7

  • M0: 4 (reasons missing)

  • M3: 2 (1x vasc rejection, 1xmissing)

  • M24: 1 (chronic rejection)



Research proposals
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


Research proposals1
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


Farmacokinetiek genetica
Farmacokinetiek/-genetica

  • Immigranten hebben meer acute rejecties, waarom?

  • (zou onafhankelijk van donorbron zijn)

  • Zelfde immsupp behandeling? (RichQ)

  • Zelfde geschatte therapietrouw? (RichQ)


Aanvullende methoden
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


Management policies
Management policies

  • In 2007 management policies

  • Treatment policies dialysis accepted by NDT

  • NDT: Also transplantation data?


Management policies tx
Management policies Tx

  • More detailed questionnaire of Tx management policies

  • Compared to literature

  • Compared to RICH-Q data


Management policies topics
Management policies topics

  • Pre Tx

    (screening, medication, ….)

  • Tx

    (donor, medication, ….)

  • Post Tx

    (medication, follow up)


Please
Please….

  • Send me the management policies Tx

  • Send a copy of all your protocols concerning transplantation to n.j.schoenmaker@amc.nl

    >>Publication


New tx form
New Tx form

Changes?

Variables to add?

>> Please let us know a.s.a.p.