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Severe COVID-19 in a renal transplant recipient: A focus on pharmacokinetics.
- Source :
-
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2020 Jul; Vol. 20 (7), pp. 1896-1901. Date of Electronic Publication: 2020 May 13. - Publication Year :
- 2020
-
Abstract
- The current coronavirus disease 2019 (COVID-19) pandemic requires extra attention for immunocompromised patients, including solid organ transplant recipients. We report on a case of a 35-year-old renal transplant recipient who suffered from a severe COVID-19 pneumonia. The clinical course was complicated by extreme overexposure to the mammalian target of rapamycin inhibitor everolimus, following coadministration of chloroquine and lopinavir/ritonavir therapy. The case is illustrative for dilemmas that transplant professionals may face in the absence of evidence-based COVID-19 therapy and concurrent pressure for exploration of experimental pharmacological treatment options. However, the risk-benefit balance of experimental or off-label therapy may be weighed differently in organ transplant recipients than in otherwise healthy COVID-19 patients, owing to their immunocompromised status and potential drug interactions with immunosuppressive therapy. With this case report, we aimed to achieve increased awareness and improved management of drug-drug interactions associated with the various treatment options for COVID-19 in renal transplant patients.<br /> (© 2020 The Authors. American Journal of Transplantation published by Wiley Periodicals LLC on behalf of The American Society of Transplantation and the American Society of Transplant Surgeons.)
- Subjects :
- Adult
Antiviral Agents administration & dosage
Antiviral Agents pharmacokinetics
Betacoronavirus
COVID-19
Chloroquine administration & dosage
Chloroquine pharmacokinetics
Drug Combinations
Drug Interactions
Everolimus administration & dosage
Humans
Immunocompromised Host
Immunosuppressive Agents administration & dosage
Immunosuppressive Agents pharmacokinetics
Kidney Failure, Chronic surgery
Lopinavir administration & dosage
Lopinavir pharmacokinetics
Male
Netherlands
Pandemics
Radiography, Thoracic
Ritonavir administration & dosage
Ritonavir pharmacokinetics
SARS-CoV-2
Treatment Outcome
Coronavirus Infections complications
Coronavirus Infections therapy
Everolimus pharmacokinetics
Kidney Failure, Chronic complications
Kidney Transplantation
Pneumonia, Viral complications
Pneumonia, Viral therapy
Transplant Recipients
Subjects
Details
- Language :
- English
- ISSN :
- 1600-6143
- Volume :
- 20
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
- Publication Type :
- Report
- Accession number :
- 32337790
- Full Text :
- https://doi.org/10.1111/ajt.15943