Browsing by Author "Lorca, Eduardo"
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Publication Covid-19 en trasplantados renales hospitalizados: análisis del registro multicéntrico durante la primera ola de la pandemia en chile(2024) Pefaur, Jacqueline; Toro, Luis; Badilla, Ximena; Ardiles, Leopoldo; Boltansky, Andrés; Rosatti, Pía; Tapia, Beatriz; Rocca, Ximena; Mur, Paola; Fernández, Alicia; Castillo, Alvaro; Díaz, Carolina; Elgueta, Leticia; García, Francisco; Müller, Hans; Mansilla, Rodrigo; Muñoz, Carolina; Salvatici, Marcelo; Selame, María Esperanza; Valenzuela, Marcela; Zamora, Daniela; Enciso, Giovanni; Panace, Rita; Cabrera, Sebastián; Ortíz, Ana Mireya; Mardones, Sandra; Oshiro, Carolina; Sánchez, Juan Eduardo; Lorca, Eduardo; Torres, RubénIntroduction: The severity of COVID-19 infection in kidney transplant patients has been well-documented. Objectives: This study aims to determine the epidemiological and clinical data and identify predictors of poor prognosis during the epidemic’s early stages. Material and methods: This is a national semi-prospective, multicenter study of subjects with functioning grafts who were infected during the first wave of the pandemic in Chile between March 1 and September 31, 2020. Results: during this period, we recorded the hospitalization of 97 adult patients throughout the entire national territory. The average age was 52.5 years, 62% men, 45% hypertensive, 11% coronary, 10% diabetic, and 5% with chronic obstructive pulmonary disease, with an average post-transplant follow-up of 7.2 years and an average previous renal function of 47.7ml/min/1.7m2 (CKD-EPI formula). Between the onset of symptoms and diagnosis, there was an average period of 4.8 days, with a predominance of cough (44%), dyspnea (42%), and fever (42%). 34% developed acute kidney injury, and 36% of them required dialysis support. The lethality was 30%, prevailing in those with multiple organ failure (80%) and those who required invasive mechanical ventilation (52%). In the multivariate analysis, the best predictors of mortality were older age (OR: 2.92) and living in a low-income commune (OR: 2.35). Conclusions: This national project of the Chilean Society of Nephrology provided valuable information for monitoring the epidemiological evolution of the pandemic. It also helped to propose priority vaccination strategies, adjust immunosuppressive therapy, and design logistical aspects to reduce the risks for transplant patients.Item Switching stable kidney transplant recipients to a generic tacrolimus Is feasible and safe, but it must be monitored(Hindawi Publishing Corp., 2017) González, Fernando; López, René; Arriagada, Elizabeth; Carrasco, René; Gallardo, Natalia; Lorca, EduardoBackground. Tacrolimus is the primary immunosuppressive drug used in kidney transplant patients. Replacing brand name products with generics is a controversial issue that we studied after a Chilean Ministry of Health mandate to implement such a switch. Methods. Forty-one stable Prograf (Astellas) receiving kidney transplant patients were switched to a generic tacrolimus (Sandoz) in a 1 : 1 dose ratio and were followed up for up to 8 months. All other drugs were maintained as per normal practice. Results. Neither tacrolimus doses nor their trough blood levels changed significantly after the switch, but serum creatinine did: 1.62 ± 0.90 versus 1.75 ± 0.92 mg/dL (p < 0.001). At the same time, five graft biopsies were performed, and two of them showed cellular acute rejection. There were nine infectious episodes treated satisfactorily with proper therapies. No patient or graft was lost during the follow-up time period. Conclusion. Switching from brand name tacrolimus to a generic tacrolimus (Sandoz) is feasible and appears to be safe, but it must be monitored carefully by treating physicians.