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• W2018486987 abstract "Several studies have demonstrated that the glucocorticoids used in kidney transplantation may influence the clinical outcome. Furthermore, recently, research has focused on pharmacokinetics and pharmacodynamics(1-4) of glucocorticoids in kidney transplant recipients. In a study published in 1994, Hirano et al.(5) reported that patients with chronic renal failure who showed impaired preoperative lymphocyte response to prednisolone measured by a 50% inhibition of blastogenese in vitro (IC50) had a significantly high incidence of acute allograft rejection, and suggested that methylprednisolone could be of benefit to prednisolone-resistant recipients as determined preoperatively in vitro. We agreed that this represents an attractive avenue of investigation, since it could help identify patients at risk of rejection and modify the approach for these high-risk patients. From 1993 to 1996, we evaluated in our center the preoperative lymphocyte response to in vitro methylprednisolone in 110 consecutive potential transplant recipients. Plasma lymphocytes were incubated with phytohemagglutinin and different concentrations of methylprednisolone ranging from 8 ng/ml to 2000 ng/ml at 37 °C for 3 days, and then incubated for 4 hr with tritiated thymidine. We then measured the 50% inhibition of blastogenese (IC50). Forty-two of these patients received a renal allograft during this period (35 first grafts and 7 second grafts). We were not able to draw a correlation between the degree of resistance to methylprednisolone in vitro and the occurrence of cellular rejection during the first month after grafting, even when we studied the incidence of rejection for progressive concentrations of methylprednisolone (75, 225, 667, 2000, or more ng/ml). In our experience, the sensibility and specificity of this test were low, as were the positive and negative predictive values. In our opinion, these data indicate that in vitro preoperative lymphocyte response to methylprednisolone is not, at the present time, a reliable tool to predict the occurrence of cellular rejection in kidney transplant recipients, and that more research is needed on this subject. Catherine Girardin Gilles St-Louis1 Transplantation Unit; Nephrology Service; Department of Medicine; Notre Dame Hospital; Montreal, Quebec H2L 4M1, Canada" @default.
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• W2018486987 date "1996-11-01" @default.
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• W2018486987 title "METHYLPREDNISOLONE PHARMACODYNAMICS ASSESSED BY ANTILYMPHOCYTE ACTION IN KIDNEY TRANSPLANTATION: CLINICAL RELEVANCE AND UTILITY" @default.
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• W2018486987 doi "https://doi.org/10.1097/00007890-199611150-00041" @default.
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