Impact of immunosuppressive therapy on pulmonary perfusion in kidney transplant recipients after COVID-19 illness
IntroductionPatients who have received kidney transplants (KTR) are considered to be more susceptible to the severity of COVID-19-related illness. The transplanted patient’s respiratory outcome worsened because of the ventilation-perfusion mismatch that occurs during the infection, which has been li...
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Frontiers Media S.A.
2025-06-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2025.1562407/full |
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| author | Barbara Infante Dario Troise Dario Troise Matteo Gravina Bruno Minopoli Marcella Gambacorta Carmen Montanile Luca Macarini Silvia Mercuri Annalisa Cappiello Maddalena Panico Elena Ranieri Giuseppe Stefano Netti Francesca Fortunato Carlo Alfieri Giuseppe Castellano Giovanni Stallone |
| author_facet | Barbara Infante Dario Troise Dario Troise Matteo Gravina Bruno Minopoli Marcella Gambacorta Carmen Montanile Luca Macarini Silvia Mercuri Annalisa Cappiello Maddalena Panico Elena Ranieri Giuseppe Stefano Netti Francesca Fortunato Carlo Alfieri Giuseppe Castellano Giovanni Stallone |
| author_sort | Barbara Infante |
| collection | DOAJ |
| description | IntroductionPatients who have received kidney transplants (KTR) are considered to be more susceptible to the severity of COVID-19-related illness. The transplanted patient’s respiratory outcome worsened because of the ventilation-perfusion mismatch that occurs during the infection, which has been linked to endothelial damage. In this context, a reduction in immunosuppressive therapy is advisable to improve patient outcomes. However, the prognosis and suggested treatment for these types of patients are still debated.MethodsWe retrospectively analyzed 48 KTRs with stable graft function on calcineurin inhibitor therapy who underwent transient modification of the maintenance immunosuppressive regimen with withdrawal of mycophenolic acid/mycophenolate mofetil or mTOR inhibitor (mTORi) during COVID-19 infection and their reintroduction after healing. Pulmonary functional tests (EGA and spirometry) and DECT (Dual-energy CT) scans were performed 1 month following the negative nasopharyngeal swab (T0) and then after 6 months (T6).ResultsThe presence an mTOR inhibitor in immunosuppressive therapy was associated with a significant increase in lung perfusion for the entire lung parenchyma of the mTORi-treated group, both in each lung segment considered separately and all of them together.ConclusionOur findings are consistent with the observation that the use of mTORi could play a potentially beneficial role in improving pulmonary perfusion. |
| format | Article |
| id | doaj-art-8b520d7dc1e1431285745f5429f7c381 |
| institution | Kabale University |
| issn | 2296-858X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj-art-8b520d7dc1e1431285745f5429f7c3812025-08-20T03:46:21ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-06-011210.3389/fmed.2025.15624071562407Impact of immunosuppressive therapy on pulmonary perfusion in kidney transplant recipients after COVID-19 illnessBarbara Infante0Dario Troise1Dario Troise2Matteo Gravina3Bruno Minopoli4Marcella Gambacorta5Carmen Montanile6Luca Macarini7Silvia Mercuri8Annalisa Cappiello9Maddalena Panico10Elena Ranieri11Giuseppe Stefano Netti12Francesca Fortunato13Carlo Alfieri14Giuseppe Castellano15Giovanni Stallone16Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, Advanced Research Center on Kidney Aging (A.R.cK.A), University of Foggia, Foggia, ItalyNephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, Advanced Research Center on Kidney Aging (A.R.cK.A), University of Foggia, Foggia, ItalyRenal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, SwedenRadiology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, ItalyRadiology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, ItalyRadiology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, ItalyRadiology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, ItalyRadiology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, ItalyNephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, Advanced Research Center on Kidney Aging (A.R.cK.A), University of Foggia, Foggia, ItalyNephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, Advanced Research Center on Kidney Aging (A.R.cK.A), University of Foggia, Foggia, ItalyNephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, Advanced Research Center on Kidney Aging (A.R.cK.A), University of Foggia, Foggia, ItalyClinical Pathology Unit and Center for Molecular Medicine, Department of Medical and Surgical Sciences, Advanced Research Center on Kidney Aging, University of Foggia, Foggia, ItalyClinical Pathology Unit and Center for Molecular Medicine, Department of Medical and Surgical Sciences, Advanced Research Center on Kidney Aging, University of Foggia, Foggia, ItalyHygiene Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, ItalyDepartment of Clinical Sciences and Community Health, University of Milan Fondazione IRCCS Cà' Granda Ospedale Maggiore Policlinico, Milan, ItalyDepartment of Clinical Sciences and Community Health, University of Milan Fondazione IRCCS Cà' Granda Ospedale Maggiore Policlinico, Milan, ItalyNephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, Advanced Research Center on Kidney Aging (A.R.cK.A), University of Foggia, Foggia, ItalyIntroductionPatients who have received kidney transplants (KTR) are considered to be more susceptible to the severity of COVID-19-related illness. The transplanted patient’s respiratory outcome worsened because of the ventilation-perfusion mismatch that occurs during the infection, which has been linked to endothelial damage. In this context, a reduction in immunosuppressive therapy is advisable to improve patient outcomes. However, the prognosis and suggested treatment for these types of patients are still debated.MethodsWe retrospectively analyzed 48 KTRs with stable graft function on calcineurin inhibitor therapy who underwent transient modification of the maintenance immunosuppressive regimen with withdrawal of mycophenolic acid/mycophenolate mofetil or mTOR inhibitor (mTORi) during COVID-19 infection and their reintroduction after healing. Pulmonary functional tests (EGA and spirometry) and DECT (Dual-energy CT) scans were performed 1 month following the negative nasopharyngeal swab (T0) and then after 6 months (T6).ResultsThe presence an mTOR inhibitor in immunosuppressive therapy was associated with a significant increase in lung perfusion for the entire lung parenchyma of the mTORi-treated group, both in each lung segment considered separately and all of them together.ConclusionOur findings are consistent with the observation that the use of mTORi could play a potentially beneficial role in improving pulmonary perfusion.https://www.frontiersin.org/articles/10.3389/fmed.2025.1562407/fullimmunosuppressionkidney transplantationCOVID-19pulmonary perfusionmTOR inhibitors |
| spellingShingle | Barbara Infante Dario Troise Dario Troise Matteo Gravina Bruno Minopoli Marcella Gambacorta Carmen Montanile Luca Macarini Silvia Mercuri Annalisa Cappiello Maddalena Panico Elena Ranieri Giuseppe Stefano Netti Francesca Fortunato Carlo Alfieri Giuseppe Castellano Giovanni Stallone Impact of immunosuppressive therapy on pulmonary perfusion in kidney transplant recipients after COVID-19 illness Frontiers in Medicine immunosuppression kidney transplantation COVID-19 pulmonary perfusion mTOR inhibitors |
| title | Impact of immunosuppressive therapy on pulmonary perfusion in kidney transplant recipients after COVID-19 illness |
| title_full | Impact of immunosuppressive therapy on pulmonary perfusion in kidney transplant recipients after COVID-19 illness |
| title_fullStr | Impact of immunosuppressive therapy on pulmonary perfusion in kidney transplant recipients after COVID-19 illness |
| title_full_unstemmed | Impact of immunosuppressive therapy on pulmonary perfusion in kidney transplant recipients after COVID-19 illness |
| title_short | Impact of immunosuppressive therapy on pulmonary perfusion in kidney transplant recipients after COVID-19 illness |
| title_sort | impact of immunosuppressive therapy on pulmonary perfusion in kidney transplant recipients after covid 19 illness |
| topic | immunosuppression kidney transplantation COVID-19 pulmonary perfusion mTOR inhibitors |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2025.1562407/full |
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