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Infection after renal transplant

Nancy Kim, Roxanna Juarez, Angela D Levy
In patients with end-stage renal disease, the treatment of choice for most patients is renal transplantation. Complications that occur after kidney transplant can be broadly divided into vascular and non-vascular categories. Non-vascular complications can further be divided into surgical and medical categories. When evaluating renal transplant imaging, it is helpful to consider the occurrence of complications in a timeline from time of surgery. Ultrasound is often the first modality used for evaluation of renal transplants particularly in the early postoperative period...
March 17, 2018: Abdominal Radiology
Domenico Umberto De Rose, Silvia Giliani, Lucia Dora Notarangelo, Vassilios Lougaris, Arnalda Lanfranchi, Daniele Moratto, Baldassarre Martire, Fernando Specchia, Alberto Tommasini, Alessandro Plebani, Raffaele Badolato
Leukocyte Adhesion Deficiency type 1 (LAD-1) is a rare primary immunodeficiency due to mutations in the gene encoding for the common β-chain of the β2 integrin family (CD18). Herein, we describe clinical manifestations and long-term complications of eight LAD-1 patients. Four LAD-1 patients were treated with hematopoietic stem cell transplantation (HSCT), while the remaining four, including two with moderate LAD-1 deficiency, received continuous antibiotic prophylaxis. Untreated patients presented numerous infections and autoimmune manifestations...
March 13, 2018: Clinical Immunology: the Official Journal of the Clinical Immunology Society
David Moreno-Ajona, José Ramón Yuste, Paloma Martín, Jaime Gállego Pérez-Larraya
The human T-lymphotropic virus type 1 (HTLV-1) is a RNA retrovirus that infects a minimum of 5-10 million people worldwide. Transmission by cell-containing blood products and solid organ transplantation has been reported. Clinical disease occurs in about 5-10% of infected individuals and consists mainly in adult T cell leukemia and HTLV-1-associated myelopathy (HAM). We present a 54-year-old woman who underwent kidney transplant from cadaveric donor in March 2015. Donor also underwent cornea extraction for another recipient (corneal transplant protocol includes HTLV-1/2 serology)...
March 12, 2018: Journal of Neurovirology
Sibel Kara, Nazan Sen, Ebru Kursun, Hakan Yabanoğlu, Sedat Yıldırım, Şule Akçay, Mehmet Haberal
OBJECTIVES: Pulmonary infections are a significant cause of morbidity and mortality in solid-organ transplant recipients despite enhanced facilities for perioperative care. The aim of this study was to evaluate the demographic characteristics, clinical course, and outcomes of renal transplant recipients with pneumonia. MATERIALS AND METHODS: The medical records of all renal transplant recipients from January 2010 to December 2014 were retrospectively reviewed, and patients diagnosed with pneumonia according to Centers for Disease Control and Prevention criteria were evaluated...
March 2018: Experimental and Clinical Transplantation
Sehnaz Tezcan, Ebru Ayvazoglu Soy, Nihal Uslu, Mehmet Haberal
Urinary tract infection is the most common complication after kidney transplant and often is associated with graft loss and mortality. Ultrasonography is the most widely applied imaging modality for diagnosis of complications after kidney transplant. Here, we report a case of a 52-year-old male patient who underwent renal transplant 1 month earlier and who presented with fever, leukocytosis, and leukocyturia. Klebsiella pneumoniae was found in the urine and blood cultures. Ultrasonography revealed multiple, ill-defined margined, hypoechoic areas and cysts within the cortex...
March 2018: Experimental and Clinical Transplantation
Deniz Demet, Nilgün Aksoy, Nihal Kiraz
Kidney transplant is the leading treatment method for patients with recent renal failure in terms of quality of life, cost, and survival. After transplant, rejection, infection, cardiovascular diseases, malignancies, immunosuppressive therapy failure, and psychologic problems may occur. Posttransplant nursing care is as important as pretransplant nursing care in terms of enhancing quality of life, preventing complications, and providing necessary changes to treatment. In this report, we presented ways to increase quality of care after transplant and outlined standardized nursing care to reduce work and time loads by ensuring integrative and systematic approaches of nurses...
March 2018: Experimental and Clinical Transplantation
Ali Riza Ucar, Erol Demir, Mehmet Sukru Sever
Progress in patient care and immunosuppressive medications has resulted in improved allograft survival in the early posttransplant period; however, substantial graft loss continues in the long term. Therefore, the number of dialysis patients with failed allografts is increasing progressively. These patients have a worse prognosis than naive dialysis patients. Cardiovascular causes are the leading cause of death, followed by infections and malignancies. Delay in return to dialysis, a chronic inflammatory state, infections, and cancer are contributing factors to mortality, whereas type of dialysis modality does not have a significant effect on outcomes...
March 2018: Experimental and Clinical Transplantation
Charat Thongprayoon, Wisit Kaewput, Konika Sharma, Karn Wijarnpreecha, Napat Leeaphorn, Patompong Ungprasert, Ankit Sakhuja, Franco H Cabeza Rivera, Wisit Cheungpasitporn
AIM: To assess outcomes of kidney transplantation including patient and allograft outcomes in recipients with hepatitis B virus (HBV) infection, and the trends of patient's outcomes overtime. METHODS: A literature search was conducted using MEDLINE, EMBASE and Cochrane Database from inception through October 2017. Studies that reported odds ratios (OR) of mortality or renal allograft failure after kidney transplantation in patients with HBV [defined as hepatitis B surface antigen (HBsAg) positive] were included...
February 27, 2018: World Journal of Hepatology
Mari Eriksson, Janne J Jokinen, Sanni Söderlund, Pekka Hämmainen, Jyri Lommi, Karl B Lemström
BACKGROUND: Cytomegalovirus (CMV) remains an important pathogen in solid organ transplant patients. OBJECTIVE: We executed a hybrid prophylactic and pre-emptive valganciclovir (VGCV) prophylaxis to prevent CMV infection in heart transplant patients with antithymocyteglobulin (ATG) induction and retrospectively evaluated the efficacy and safety of this regimen. METHODS: 100 adult heart transplant patients between 2004 and 2010 were included...
March 7, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Mehmet Sarıer, İbrahim Duman, Meltem Demir, Yücel Yüksel, Mestan Emek, Erdal Kukul
Objective: In the early period after renal transplantation, urinary retention stemming from bladder outlet obstruction (BOO) may directly affect graft success. The aim of this study was to evaluate the early and long-term outcomes of transurethral resection of the prostate (TURP) and transurethral incision of prostate (TUIP) procedures performed in the first month following RT due to BOO. Material and methods: Between February 2009 and March 2016, 38 male patients underwent TURP/TUIP due to BOO within the first 30 days of renal transplantation...
March 2018: Turkish Journal of Urology
Chih-Ning Cheng, Shu-Wen Lin, Chien-Chih Wu
Linezolid, an oxazolidinone antibiotic, does not required dose adjustment in patients with Child's class A and B liver cirrhosis. The dose adjustment data for Child's class C liver cirrhosis is inadequate. We reported a case of Child's class C liver cirrhosis, in which lactic acidosis, an adverse effect related to prolonged use, occurred only after two weeks of linezolid treatment. A 63-year old male had underlying diseases, such as end-stage renal disease (ESRD) and Child's class C liver cirrhosis, and was admitted for hepatic encephalopathy management and liver transplantation evaluation...
March 1, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Yooni Yi, Angela Wu, Anne P Cameron
INTRODUCTION: Nephrogenic adenoma (NA) was first described by Davis in 1949 as a "hamartoma" of the bladder. There are many proposed predisposing factors for NA including chronic inflammation, renal transplantation, and bladder cancer. We examined our experience with NA to determine predisposing factors and determine if there was any increased risk for development of subsequent malignancy. MATERIALS AND METHODS: All patients with a pathologic diagnosis of bladder NA from 2001-2013 were included...
March 1, 2018: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Ian A Thomas, Jeffrey J Gaynor, Tameka Joseph, Nestor De La Cruz-Munoz, Junichiro Sageshima, Warren Kupin, Linda J Chen, Gaetano Ciancio, George W Burke, Adela D Mattiazzi, David Roth, Giselle Guerra
Body mass index(BMI)>35-40kg/m2 is often a contraindication, while Roux-en-Y gastric bypass(RYGB) is performed to enable kidney transplantation. This single-center retrospective study evaluated pre- and post-transplant outcomes of 31 morbidly obese end-stage-renal-disease patients having RYGB before kidney transplantation between July,2009-June,2014. Fourteen RYGB patients were subsequently transplanted. Nineteen recipients not having GB with a BMI>36kg/m2 at transplantation were used as historical controls...
February 28, 2018: Clinical Transplantation
Prithiv Prasad, Kevin Bryan Lo, Pradhum Ram
The highest risk of opportunistic infections is from 1 to 6 months post-transplant. We report a rare case of Pneumocystis jirovecii pneumonia in a renal transplant recipient only on maintenance immunosuppression eleven years after transplant without concomitant CMV infection or recent episodes of graft rejection.
June 2018: Medical Mycology Case Reports
Mehmet Sarier, Ibrahim Duman, Yucel Yuksel, Sabri Tekin, Meltem Demir, Fatih Arslan, Osman Ergun, Alim Kosar, Asuman Havva Yavuz
Allograft lithiasis is a rare urologic complication of renal transplantation (RT). Our aim is to present our experience with minimally invasive surgical treatment of allograft lithiasis in our series of live-donor renal transplant recipients. In a retrospective analysis of 3758 consecutive live-donor RTs performed in our center between November 2009 and January 2017, the results of minimally invasive surgery for the treatment of renal graft lithiasis diagnosed at follow-up were evaluated. Twenty-two (0.58%) patients underwent minimally invasive surgery for renal graft lithiasis...
February 26, 2018: Urolithiasis
Yihang Jiang, Sujuan Feng, Jiawei Ji, Zhemin Lin, Xiaodong Zhang
INTRODUCTION: Post-infectious immunosuppression is disadvantageous to patients' long-term outcomes, especially in transplant recipients receiving large doses of immunosuppressants. A growing body of evidence indicates the immunoregulatory ability of myeloid-derived suppressor cells (MDSCs). We herein investigate the characteristics of monocytic-MDSCs (M-MDSCs) in a cohort of renal transplant recipients with/without infection to clarify the potential involvement in post-infectious immunosuppression...
February 22, 2018: Transplant Immunology
Sandra Bérody, Laurence Heidet, Olivier Gribouval, Jérome Harambat, Patrick Niaudet, Veronique Baudouin, Justine Bacchetta, Bernard Boudaillez, Maud Dehennault, Loïc de Parscau, Olivier Dunand, Hugues Flodrops, Marc Fila, Arnaud Garnier, Ferielle Louillet, Marie-Alice Macher, Adrien May, Elodie Merieau, Françoise Monceaux, Christine Pietrement, Caroline Rousset-Rouvière, Gwenaëlle Roussey, Sophie Taque, Julie Tenenbaum, Tim Ulinski, Rachel Vieux, Ariane Zaloszyc, Vincent Morinière, Rémi Salomon, Olivia Boyer
Background: Recommendations for management of Finnish-type congenital nephrotic syndrome (CNS) followed by many teams include daily albumin infusions, early bilateral nephrectomy, dialysis and transplantation. We aimed to assess the treatment and outcome of patients with CNS in France. Methods: We conducted a nationwide retrospective study on 55 consecutive children born between 2000 and 2014 treated for non-infectious CNS. Results: The estimated cumulative incidence of CNS was 0...
February 20, 2018: Nephrology, Dialysis, Transplantation
Steven Krueger, Jillian Rork, Jennifer Lee, Kristine Cornejo, Laura Gibson, Jennifer S Daly, Nikki A Levin
A 61-year-old immunosuppressed renal transplant patient with inflammatory bowel disease presented with tender pink nodules on the trunk and extremities. An initial biopsy was suggestive of metastatic Crohn disease, but after disease persistence, a second biopsy revealed disseminated Mycobacterium haemophilum. Atypical mycobacterial infections should be considered in immunosuppressed patients. This case highlights the complexities of diagnosing such infections in patients with an underlying granulomatous condition and the particular growth requirements of M...
September 15, 2017: Dermatology Online Journal
Ella J Ariza-Heredia, Roy F Chemaly, Lokesh R Shahani, Ying Jang, Richard Champlin, Victor E Mulanovich
Acyclovir is commonly used to prevent and treat herpes simplex virus (HSV) reactivation after hematopoietic cell transplant (HCT), and only few reports have been published on acyclovir-resistant HSV in HCT recipients. We reviewed the medical records of patients with a microbiologic diagnosis of acyclovir-resistant HSV by plaque reduction test who received an HCT from 2002 through 2014. A total of 4028 HCTs were performed during the study period, and 18 of the recipients met the diagnostic criteria for acyclovir-resistant HSV...
February 21, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
Mehmet Sarier, Ibrahim Duman, Suleyman Kilic, Yucel Yuksel, Meltem Demir, Mesut Aslan, Levent Yucetin, Sabri Tekin, Asuman Havva Yavuz, Mestan Emek
PURPOSE: The aim of this study is to compare the results of transurethral incision of the prostate (TUIP) and transurethral resection of the prostate (TURP) for the surgical treatment of benign prostate hyperplasia (BPH) in patients with renal transplantation. MATERIALS AND METHODS: Between April 2009 and May 2016, BPH patients with renal transplants whose prostate volumes were less than 30 cm3 were treated surgically. Forty-seven patients received TURP and 32 received TUIP...
February 18, 2018: Urology Journal
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