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Transplant Infectious Disease: An Official Journal of the Transplantation Society

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https://www.readbyqxmd.com/read/29178554/selective-t-cell-depletion-targeting-cd45ra-reduces-viremia-and-enhances-early-t-cell-recovery-compared-to-cd3-targeted-t-cell-depletion
#1
Brandon M Triplett, Brad Muller, Guolian Kang, Li Ying, Shane J Cross, Joseph Moen, Lea Cunningham, William Janssen, Ewelina Mamcarz, David R Shook, Ashok Srinivasan, John Choi, Randall T Hayden, Wing Leung
BACKGROUND: T-cell depletion (TCD) effectively reduces severe graft-versus-host disease in recipients of HLA-mismatched allografts. However, TCD is associated with delayed immune recovery and increased infections. We hypothesized that specific depletion of CD45RA+ naïve T cells, rather than broad depletion of CD3+ T cells, can preserve memory-immunity in the allografts, and confer protection against important viral infections in the early post-transplant period. METHODS: Sixty-seven patients who received TCD haploidentical donor transplantation for hematologic malignancy on three consecutive trials were analyzed...
November 27, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29178465/detection-of-human-immunodeficiency-virus-hepatitis-c-virus-and-hepatitis-b-virus-in-post-mortem-blood-specimens-using-infectious-disease-assays-licensed-for-cadaveric-donor-screening
#2
Melissa A Greenwald, Stephen Kerby, Kori Francis, Anna C Noller, William T Gormley, Robin Biswas, Richard A Forshee
BACKGROUND: Evaluation of assay performance on post-mortem blood specimens (obtained after cessation of the heartbeat) presents unique scientific and regulatory challenges. In the United States, assay performance is evaluated in part by spiking postmortem specimens. METHODS: Fifty-four specimens obtained from decedents known to be infected with human immunodeficiency virus (HIV), hepatitis C virus (HCV), or hepatitis B virus (HBV), including some coinfections, were tested for each virus using Food and Drug Administration (FDA)-licensed donor screening tests for nucleic acid, antibody, and antigen...
November 27, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29178379/successful-treatment-of-thrombotic-microangiopathy-associated-to-dengue-infection-a-case-report-and-literature-review
#3
John Fredy Nieto-Ríos, María Fernanda Álvarez Barreneche, Sara Catalina Penagos, Diana Carolina Bello Márquez, Lina Maria Serna-Higuita, Isabel Cristina Ramírez Sánchez
Dengue infection has been associated with multiple renal complications, including glomerulonephritis, acute tubular necrosis, tubulointerstitial nephritis, and thrombotic microangiopathy (TMA); the last one being a rare complication of dengue, with only a few reported cases. TMA associated with dengue can be explained by an alteration in the activity of the enzyme ADAMTS13, leading to thrombotic thrombocytopenic purpura; or it can be secondary to direct or indirect endothelial injury by the virus, which leads to hemolytic uremic syndrome...
November 27, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29178248/no-indication-of-increased-infection-rates-using-low-dose-alemtuzumab-instead-of-anti-thymocyte-globulin-as-graft-versus-host-disease-prophylaxis-before-allogeneic-stem-cell-transplantation
#4
Thomas Neumann, Laila Schneidewind, Thomas Thiele, Daniel Pink, Meike Schulze, Christian Schmidt, William Krüger
BACKGROUND: Alemtuzumab as part of the conditioning protocol is effective in reducing graft-versus-host disease (GvHD), but may be associated with increased infection rates, especially when using high doses (ie, 100 mg). METHODS: We performed a retrospective, single-centre, case-control study analysing the rates of neutropenic fever, cytomegalovirus (CMV) reactivation, Epstein-Barr virus (EBV) reactivation, clinical manifest toxoplasmosis, and clinical manifest human herpesvirus-6 (HHV6) infection using low-dose alemtuzumab in comparison with anti-thymocyte globulin (ATG) as GvHD prophylaxis before allogeneic stem cell transplantation...
November 27, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29178242/deceased-organ-donor-screening-for-human-immunodeficiency-virus-hepatitis-b-and-hepatitis-c-viruses-discordant-serology-and-nucleic-acid-testing-results
#5
Nicole Theodoropoulos, Marek J Nowicki, Claudia Chinchilla-Reyes, Sara Dionne, Andrés Jaramillo, Tom Mone, Richard Hasz, Martin D Jendrisak, Daniela P Ladner, Michael G Ison
BACKGROUND: Before the 2014 policy change pertaining to infectious disease screening, many organ procurement organizations (OPOs) were supplementing serologic screening of deceased organ donors with nucleic acid testing (NAT) for human immunodeficiency virus (HIV-1), hepatitis B virus (HBV), and hepatitis C virus (HCV). The number of seronegative, NAT-positive donors has not been directly measured. METHODS: HIV, HBV, and HCV screening results of 11 229 donor referrals evaluated from 2010 to 2013 were obtained from three OPO-affiliated laboratories, capturing 35% of all donors in the United States...
November 27, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29172240/disseminated-mucormycosis-masquerading-as-rejection-early-after-orthotopic-heart-transplantation
#6
Lindsay Margoles, David DeNofrio, Ayan Patel, Yoav Golan, Amanda Vest, Knarik Arkun, Helen Boucher, Michael Kiernan, Jenica Upshaw
Mucorales organisms are an uncommon cause of invasive fungal infections after solid organ transplantation but are associated with great morbidity and mortality. We report a fatal case of disseminated Cunninghamella infection early after heart transplantation. The patient developed graft dysfunction and elevated markers of myocyte injury and autopsy revealed fulminant fungal myocarditis. This case highlights the need for a high index of suspicion in immunocompromised patients who are not improving with standard antimicrobial therapy...
November 24, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29156094/multiple-transmissions-of-chromosomally-integrated-human-herpesvirus-6-in-one-family
#7
Armin Rashidi, Karam Obeid, Joshua Hill, Erica D Warlick, Daniel J Weisdorf
Chromosomally integrated human herpesvirus-6 (ciHHV-6) can be transmitted from parent to child or via allogeneic hematopoietic cell transplantation (HCT). We report a case of ciHHV-6 transmitted via syngeneic HCT, and vertically across three generations. ciHHV-6 was transmitted from a parent to the patient and her identical twin, and from the patient to her son. The patient underwent syngeneic HCT as rescue from chemotherapy-induced aplasia during which ciHHV-6 was re-transmitted to her, this time from her identical twin...
November 20, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29156086/impact-of-low-level-bk-polyomavirus-viremia-on-intermediate-term-renal-allograft-function
#8
Johannes Korth, Marek Widera, Sebastian Dolff, Hana Guberina, Anja Bienholz, Alexandra Brinkhoff, Olympia Evdoxia Anastasiou, Andreas Kribben, Ulf Dittmer, Jens Verheyen, Benjamin Wilde, Oliver Witzke
BACKGROUND: BK polyomavirus (BKPyV)-associated nephropathy (PyVAN) is a significant cause of premature renal transplant failure. High-level BKPyV viremia is predictive for PyVAN, however, low-level BKPyV viremia does not necessarily exclude the presence of PyVAN. As data are limited whether or not low-level BKPyV viremia has an effect on intermediate-term graft outcome, this study analyzes the impact of low-level BKPyV viremia on intermediate-term graft function and outcome compared to high-level viremia and non-viremic patients...
November 20, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29156082/an-unexpected-but-underestimated-case-of-disseminated-toxoplasmosis
#9
Tiffany Chan, Patrick T Shannon, Michael E Detsky
Toxoplasma gondii is a ubiquitous intracellular parasite that can cause disseminated infection following reactivation in immunocompromised hosts. We describe a 58-year-old man who died of refractory shock because of disseminated toxoplasmosis. The diagnosis was only made post-mortem on autopsy. We discuss the importance of considering toxoplasmosis on the differential diagnosis in high-risk patients, and review the role of screening and chemoprophylaxis in preventing infection. This article is protected by copyright...
November 20, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29151282/epidemiology-and-impact-of-bloodstream-infections-among-kidney-transplant-recipients-a-retrospective-single-center-experience
#10
Ali M Shendi, Gabriel Wallis, Helena Painter, Mark Harber, Sophie Collier
BACKGROUND: Bloodstream infections (BSI) represent an important source of morbidity and mortality, as well as an increasing therapeutic challenge, among solid organ transplant recipients. Understanding the epidemiological and microbiological characteristics of BSI following renal transplantation is paramount to the implementation of appropriate preventative and therapeutic measures. METHODS: We conducted a retrospective review of all BSI episodes occurring between July 2009 and April 2016 in adult patients, who received a renal transplant at Royal Free London hospital...
November 19, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29143415/severe-bk-polyomavirus-induced-hemorrhagic-cystitis-in-a-kidney-transplant-recipient-with-absence-of-renal-allograft-involvement
#11
Mahwash Kamal, Amit Govil, Manish Anand, Bassam G Abu Jawdeh, Silvi Shah
BK polyomavirus mostly manifests as polyomavirus-associated nephropathy (PyVAN) in kidney transplant patients and polyoma virus-associated hemorrhagic cystitis (PyVHC) in bone marrow transplant patients. PyVHC in kidney transplant patients is only reported in four cases in the literature. Our patient had severe hemorrhagic cystitis without renal involvement. We postulate that our patient's exposure to ifosfamide and radiation 8 years prior transplantation might pre-dispose him to this disease. This article is protected by copyright...
November 16, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29139181/direct-antiviral-treatment-of-chronic-hepatitis-c-in-heart-transplant-recipients
#12
Martina Vitrone, Roberto Andini, Irene Mattucci, Ciro Maiello, Luigi Atripaldi, Emanuele Durante-Mangoni, Rosa Zampino
Direct-acting antiviral agents (DAAs) are a safe and effective treatment for chronic hepatitis C (CHC). This may be particularly valuable for patients with severe comorbidities or baseline conditions, including non-liver solid organ transplant. We report cases of two heart transplant recipients with CHC treated with DAA (sofosbuvir and daclatasvir) achieving sustained virological response. Treatment was well tolerated and no relevant side effects were observed. The drug-drug interactions and graft function were carefully monitored...
November 15, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29139180/successful-heart-transplantation-in-patients-with-active-staphylococcus-bloodstream-infection-and-suspected-mechanical-circulatory-support-device-infection
#13
Timothy Sullivan, Sarah Taimur, Meenakshi Rana, Gopi Patel, Sean Pinney, Anelechi Anyanwu, Shirish Huprikar
BACKGROUND: An active bloodstream infection (BSI) is typically considered a contraindication to heart transplantation (HT). However, in some patients with Staphylococcus bacteremia and mechanical circulatory support device infection, positive blood cultures may persist until removal of the infected device, and eradicating the infection prior to HT may not be possible. We report the outcomes of six patients with active Staphylococcus BSI at the time of HT. METHODS: All cases of HT performed at The Mount Sinai Hospital from 2009 through 2015 were reviewed...
November 15, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29136326/dna-based-testing-in-lung-transplant-recipients-with-suspected-non-viral-lower-respiratory-tract-infection-a-prospective-observational-study
#14
Nora Drick, Benjamin Seeliger, Mark Greer, Benjamin A Bollmann, Stefan Ziesing, Tobias Welte, Jens Gottlieb
BACKGROUND: Non-viral lower respiratory tract infections (LRTI) are common among lung transplant (LTx) recipients with increased mortality. Early pathogen identification is crucial to guide therapy and avoid adverse events. Results from cultures may require up to 72 hours. Multiplex polymerase chain reaction assay (PCR) may allow faster pathogen identification, but its utility in LTx recipients with suspected non-viral LRTI remains unclear. METHODS: In a prospective open-label observational trial, LTx recipients presenting with suspected LRTI received bronchoscopy with bronchoalveolar lavage (BAL)...
November 14, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29125713/outbreak-of-invasive-aspergillosis-in-heart-transplant-recipients-the-role-of-screening-computed-tomography-scans-in-asymptomatic-patients-and-universal-antifungal-prophylaxis
#15
Dima Kabbani, Livia Goldraich, Heather Ross, Coleman Rotstein, Shahid Husain
BACKGROUND: Delays in diagnosing invasive pulmonary aspergillosis (IA), a significant cause of morbidity and mortality among heart transplant recipients (HTRs), may impact on successful treatment. The appropriate screening strategy for IA in these patients remains undefined, particularly in the setting of nosocomial outbreaks. We describe our experience employing chest computed tomography (CT) scans as a screening method for IA. In addition, we comment on antimicrobial prophylaxis in HTRs in the setting of an outbreak...
November 10, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29125670/use-of-a-hepatitis-c-virus-hcv-rna-positive-donor-in-a-treated-hcv-rna-negative-liver-transplant-recipient
#16
Isabel Campos-Varela, Eliana Z Agudelo, Monika Sarkar, John P Roberts, Norah A Terrault
The shortage of livers has led most transplant centers to use extended criteria donors. Hepatitis C virus (HCV) RNA-positive donors are typically not given to patients who have cleared HCV. A 64-year-old male with chronic hepatitis C, genotype 1b was listed for LT with hepatocellular carcinoma. While on the waiting list, the patient was treated with sofosbuvir, ledipasvir, and ribavirin and achieved an HCV RNA <15 IU/mL by week 10. At week 18 of a planned 24-week treatment course, the patient underwent deceased-donor LT and received an organ from an anti-HCV-positive donor...
November 10, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29125666/tenosynovitis-caused-by-mycobacterium-malmoense-in-two-kidney-transplant-recipients-and-review-of-the-literature
#17
Rebecca van Grootveld, Hans U Scherer, Elke E M Peters, André Gaasbeek, Sandra M Arend, Herman F Wunderink
We report two unrelated cases of tenosynovitis caused by Mycobacterium malmoense in kidney transplant recipients. Both patients received immunosuppression and were referred to our tertiary hospital because of persisting complaints lasting >6 months not responding to corticosteroids or surgery. The mycobacterial cultures were positive for the slow-growing M. malmoense after several weeks of incubation. The patient in Case 1 was treated with a combination of surgical debridement and antibiotics, whereas the patient in Case 2 was only treated surgically...
November 10, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29120522/association-between-baseline-serum-hepcidin-levels-and-infection-in-kidney-transplant-recipients-potential-role-for-iron-overload
#18
Mario Fernández-Ruiz, Patricia Parra, Tamara Ruiz-Merlo, Francisco López-Medrano, Rafael San Juan, Natalia Polanco, Esther González, Amado Andrés, José María Aguado
BACKGROUND: The liver-synthesized peptide hepcidin is a key regulator of iron metabolism and correlates with total iron stores. We analyzed the association between pre-transplant hepcidin-25 levels and infection after kidney transplantation (KT). METHODS: Serum hepcidin-25 levels were measured at baseline by high-sensitivity ELISA in 91 patients undergoing KT at our institution between December 2011 and March 2013. The impact of this biomarker on the incidence of post-transplant infection (excluding lower urinary tract infection) during the first year was assessed by Cox regression...
November 9, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29120502/necrotizing-microascus-tracheo-bronchitis-in-a-bilateral-lung-transplant-recipient
#19
Olivier Taton, Benjamin Bernier, Isabelle Etienne, Benjamin Bondue, Sophie Lecomte, Christiane Knoop, Frederique Jacob, Isabel Montesinos
Invasive fungal infections are a major cause of mortality among solid organ transplant recipients. Scopulariopsis species and their teleomorph Microascus are molds found in soil and decaying organic matter. We report here the case of a woman who underwent bilateral lung transplantation for severe emphysema. On day 25 after transplantation, endobronchial green-black lesions were detected during routine endoscopy. Endobronchial swabs, biopsies, and broncho-alveolar lavage samples were positive for Microascus cirrosus...
November 9, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29119669/sinusitis-caused-by-exserohilum-rostratum-after-cord-blood-transplantation-for-myelodysplastic-syndrome-a-case-report-and-literature-review
#20
Sumiko Kohashi, Takaaki Toyama, Norisato Hashimoto, Masatoshi Sakurai, Jun Kato, Taku Kikuchi, Yuya Koda, Kayoko Sugita, Naoki Hasegawa, Kyoko Yarita, Katsuhiko Kamei, Shinichiro Okamoto, Takehiko Mori
Invasive fungal disease is a serious infectious complication of allogeneic hematopoietic stem cell transplantation (HSCT). Exserohilum rostratum is a species causing phaeohyphomycosis, which rarely causes invasive disease in humans. We treated a case of sinusitis caused by E. rostratum after cord blood transplantation (CBT). A 60-year-old man with myelodysplastic syndrome, who had a medical history of an operation to correct deviation of the nasal septum, developed sinusitis caused by E. rostratum under prolonged profound neutropenia after a second CBT because of the graft rejection of the first transplantation...
November 8, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
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