Aerosol deposition of lipid complex amphotericin-B (Abelcet) in lung transplant recipients.

Abstract

Lung transplant recipients exhibit a high incidence of invasive aspergillosis. The inhalation of lipid complex amphotericin-B (Abelcet; ABLC) offers a possible prophylactic strategy. The goals of this study were to select the optimal nebulizer delivery system for ABLC and to measure deposited aerosol dose in 12 lung transplant recipients. In vitro testing was performed to select a nebulizer delivery system, and an empirical model was used to estimate lung deposition. Estimated pulmonary doses varied by as much as 2-fold between different nebulizers. Aerosol deposition testing was performed in six single and six double lung recipients, each of whom received one 7 mL (35 mg) nebulized dose of Technetium-labeled ABLC using the selected nebulizer. In single lung recipients, the average deposited doses were 3.9 +/- 1.6 mg (mean +/- S.D.) in the allograft versus 2.1 +/- 1.1 mg in the native lung. Double lung recipients deposited on average 2.8 +/- 0.8 mg (left lung) and 4.0 +/- 1.3 mg (right lung). The drug was well distributed throughout the lungs, but delivery to the native lung was in some cases suboptimal. These studies provide an important precursor to studies of the efficacy of inhaled ABLC as a prophylaxis of invasive aspergillosis after lung transplant.

• Authors: T E Corcoran, R Venkataramanan, K M Mihelc, A L Marcinkowski, J Ou, B M McCook, L Weber, M-E Carey, D L Paterson, J M Pilewski, K R McCurry, S Husain
• Journal: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (Am J Transplant) Vol. 6 Issue 11 Pg. 2765-73 (Nov 2006) ISSN: 1600-6135 [Print] United States
• PMID: 17049064 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Aerosols
• Antifungal Agents
• Drug Combinations
• Phosphatidylcholines
• Phosphatidylglycerols
• Radioisotopes
• liposomal amphotericin B
• Technetium
• Amphotericin B

Topics

• Aerosols
• Amphotericin B (administration & dosage, pharmacokinetics)
• Antifungal Agents (administration & dosage, pharmacokinetics)
• Drug Combinations
• Humans
• Lung (diagnostic imaging)
• Lung Transplantation
• Metabolic Clearance Rate
• Nebulizers and Vaporizers
• Phosphatidylcholines (administration & dosage, pharmacokinetics)
• Phosphatidylglycerols (administration & dosage, pharmacokinetics)
• Radiography
• Radioisotopes
• Technetium