PMID- 21911134
OWN - NLM
STAT- MEDLINE
DCOM- 20120110
LR  - 20161125
IS  - 1873-2623 (Electronic)
IS  - 0041-1345 (Linking)
VI  - 43
IP  - 7
DP  - 2011 Sep
TI  - Subclinical interstitial lung abnormalities in stable renal allograft recipients 
      in the era of modern immunosuppression.
PG  - 2617-23
LID - 10.1016/j.transproceed.2011.06.033 [doi]
AB  - BACKGROUND: Interstitial lung abnormalities have been detected in up to 24% of 
      kidney transplant patients receiving traditional immunosuppressive therapies (eg, 
      cyclosporine, azathioprine); they usually occur early after transplantation and 
      tend to resolve over time. Newer immunosuppressants such as mycophenolic acid 
      and, particularly, mammalian target of rapamycin (mTOR) inhibitors (eg, 
      sirolimus) may cause significant lung toxicity. However, the prevalence and 
      severity of interstitial lung lesions in long-term, stable kidney transplant 
      patients receiving either traditional or newer immunosuppressants is not known. 
      METHODS: We conducted a prospective, cross-sectional study examining 
      high-resolution lung computed tomography (CT) scans in 63 stable kidney 
      transplant recipients whose immunosuppressive therapy had remained unchanged for 
      over 24 months. We compared CT findings of patients taking newer (mycophenolic 
      acid and mTOR inhibitors) and traditional (calcineurin inhibitors and 
      azathioprine) immunosuppressive drugs. RESULTS: Interstitial lung alterations 
      were observed in only 3/63 patients (4.8%); the prevalence was 11.5% (3/26) 
      versus 0% (0/37) among the newer versus traditional immunosuppressive therapy 
      groups, respectively (P = .065). The CT patterns were usual interstitial 
      pneumonia and nonspecific interstitial pneumonia-like. The median time between 
      transplant and CT was 49 months in the three patients with CT alterations and 95 
      months in the remaining 23 patients on newer immunosuppressants. It was 75 months 
      for all patients on newer immunosuppressive drugs and 133 months for those on 
      traditional therapies (P = .0015). A follow-up CT, performed in 2/3 patients with 
      interstitial abnormalities, showed that the lesions were stable in one, while 
      they had disappeared in the other. CONCLUSIONS: Interstitial lung abnormalities 
      are infrequent and mild in stable kidney transplant patients treated with newer 
      as well as traditional immunosuppressive drugs. As such abnormalities were 
      detected in patients screened earlier after transplantation, the time since 
      transplantation rather than the drug type is probably the major determinant.
CI  - Copyright (c) 2011 Elsevier Inc. All rights reserved.
FAU - Bertolini, L
AU  - Bertolini L
AD  - Department of Radiology, Nephrology and Health Science, University Hospital of 
      Parma, Parma, Italy. bertolini.laur@libero.it
FAU - Vaglio, A
AU  - Vaglio A
FAU - Bignardi, L
AU  - Bignardi L
FAU - Buzio, C
AU  - Buzio C
FAU - De Filippo, M
AU  - De Filippo M
FAU - Palmisano, A
AU  - Palmisano A
FAU - Mercati, K
AU  - Mercati K
FAU - Zompatori, M
AU  - Zompatori M
FAU - Maggiore, U
AU  - Maggiore U
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplant Proc
JT  - Transplantation proceedings
JID - 0243532
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cross-Sectional Studies
MH  - Female
MH  - Humans
MH  - Immunosuppressive Agents/administration & dosage/*adverse effects
MH  - *Kidney Transplantation
MH  - Lung Diseases, Interstitial/*chemically induced/diagnostic imaging
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Tomography, X-Ray Computed
MH  - Transplantation, Homologous
EDAT- 2011/09/14 06:00
MHDA- 2012/01/11 06:00
CRDT- 2011/09/14 06:00
PHST- 2010/08/06 00:00 [received]
PHST- 2011/05/13 00:00 [revised]
PHST- 2011/06/03 00:00 [accepted]
PHST- 2011/09/14 06:00 [entrez]
PHST- 2011/09/14 06:00 [pubmed]
PHST- 2012/01/11 06:00 [medline]
AID - S0041-1345(11)00863-3 [pii]
AID - 10.1016/j.transproceed.2011.06.033 [doi]
PST - ppublish
SO  - Transplant Proc. 2011 Sep;43(7):2617-23. doi: 10.1016/j.transproceed.2011.06.033.