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Infection after renal transplant

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https://www.readbyqxmd.com/read/29782877/analysis-of-spontaneous-resolution-of-cytomegalovirus-replication-after-transplantation-in-cmv-seropositive-patients-with-pretransplant-cd8-ifng-response
#1
Aurora Páez-Vega, Antonio Poyato, Alberto Rodriguez-Benot, Lluis Guirado, Jesús Fortún, Oscar Len, Edson Abdala, María C Fariñas, Elisa Cordero, Carmen de Gracia, Domingo Hernández, Rafael González, Julián Torre-Cisneros, Sara Cantisán
This prospective study evaluates whether CMV-seropositive (R+) transplant patients with pretransplant CD8+IFNG+ T-cell response to cytomegalovirus (CMV) (CD8+IFNG+ response) can spontaneously clear the CMV viral load without requiring treatment. A total of 104 transplant patients (kidney/liver) with pretransplant CD8+IFNG+ response were evaluable. This response was determined using QuantiFERON-CMV assay. The incidence of CMV replication and disease was 45.2% (47/104) and 6.7% (7/104), respectively. Of the total patients, 77...
May 18, 2018: Antiviral Research
https://www.readbyqxmd.com/read/29775554/outcomes-and-predictors-of-early-infection-after-heart-transplantation
#2
Kendall C Shultes, Jerrica E Shuster, Scott Micek, Justin M Vader, Keki Balsara, Akinobu Itoh, Bethany R Tellor
BACKGROUND: Limited data exist on the incidence and outcome of early infection after orthotopic heart transplantation (OHT). The purpose of this study was to describe characteristics and outcomes of OHT recipients with an early infection and to identify predictors of such infections. METHODS: This retrospective, single-center study included patients greater than 18 years of age who underwent OHT from February 2009 to May 2014 and had an infection within 30 days of transplantation...
May 18, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29771270/effect-of-conversion-from-calcineurin-inhibitors-to-everolimus-on-hepatitis-c-viremia-in-adult-kidney-transplant-recipients
#3
Larissa Sgaria Pacheco, Valter Duro Garcia, Ronivan Luis Dal Prá, Bruna Doleys Cardoso, Mariana Ferras Rodrigues, Helen Kris Zanetti, Gisele Meinerz, Jorge Neumann, Diego Gnatta, Elizete Keitel
INTRODUCTION: Currently, there is no specific immunosuppressive protocol for hepatitis C (HCV)-positive renal transplants recipients. Thus, the aim of this study was to evaluate the conversion effect to everolimus (EVR) on HCV in adult kidney recipients. METHOD: This is an exploratory single-center, prospective, randomized, open label controlled trial with renal allograft recipients with HCV-positive serology. Participants were randomized for conversion to EVR or maintenance of calcineurin inhibitors...
May 14, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29765170/bk-virus-induced-renal-allograft-nephropathy
#4
Karel Krejci, Tomas Tichy, Jana Bednarikova, Kamil Zamboch, Josef Zadrazil
BK virus nephropathy (BKVN) is a serious opportunistic infection threatening renal function especially during the first year after transplantation. Its incidence is now on the rise and is closely related to the level of the recipient's immune system inhibition. This is more intensive with current trends in transplantation medicine, where more potent immunosuppressive protocols are used and more aggressive antirejection therapy is applied. In the absence of BK virus (BKV) specific therapy and limited treatment options for advanced BKVN, active screening of BKV replication and subsequent preemptive adjustment of immunosuppression are essential measures to prevent BKVN...
May 16, 2018: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/29761588/infection-is-the-chief-cause-of-mortality-and-non-death-censored-graft-loss-in-the-first-year-after-renal-transplantation-in-a-resource-limited-population-a-single-center-study
#5
Vikraman G, Sanjay Kumar Agarwal, Sandeep Agarwal, Sandeep Mahajan, Dipankar Bhowmik, Soumita Bagchi
BACKGROUND: Few studies have assessed the impact of infections after renal transplantation (RTX) in low and middle income countries. This single center study aimed to delineate the profile and impact of infections requiring hospitalisation (IRH) occurring in the first year after RTX in India. METHOD: Patients who underwent RTX between July 2012 and June 2015 were followed up for 12 months after transplantation. RESULTS: 60.2% of the 387 patients studied had atleast one IRH and total 492 infections were diagnosed...
May 14, 2018: Nephrology
https://www.readbyqxmd.com/read/29752413/everolimus-with-reduced-calcineurin-inhibitor-exposure-in-renal-transplantation
#6
Julio Pascual, Stefan P Berger, Oliver Witzke, Helio Tedesco, Shamkant Mulgaonkar, Yasir Qazi, Steven Chadban, Federico Oppenheimer, Claudia Sommerer, Rainer Oberbauer, Yoshihiko Watarai, Christophe Legendre, Franco Citterio, Mitchell Henry, Titte R Srinivas, Wen-Lin Luo, AnaMaria Marti, Peter Bernhardt, Flavio Vincenti
Background Everolimus permits reduced calcineurin inhibitor (CNI) exposure, but the efficacy and safety outcomes of this treatment after kidney transplant require confirmation. Methods In a multicenter noninferiority trial, we randomized 2037 de novo kidney transplant recipients to receive, in combination with induction therapy and corticosteroids, everolimus with reduced-exposure CNI (everolimus arm) or mycophenolic acid (MPA) with standard-exposure CNI (MPA arm). The primary end point was treated biopsy-proven acute rejection or eGFR<50 ml/min per 1...
May 11, 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29748530/bk-virus-a-cause-for-concern-in-thoracic-transplantation
#7
Markus J Barten, Andreas Zuckermann
Human BK polyomavirus (BKV) infection is poorly documented in heart and lung transplant patients. BK viruria and viremia have been estimated to affect 19% and 5% of heart transplant recipients, respectively. Data are limited, especially for lung transplantation, but the proportion of patients progressing from BK viruria to viremia or BKV-related nephropathy (BKVN) appears lower than in kidney transplantation. Nevertheless, a number of cases of BKVN have been reported in heart and lung transplant patients, typically with late diagnosis and generally poor outcomes...
May 11, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29746814/a-case-series-on-the-use-of-levonorgestrel-52mg-intrauterine-system-after-organ-transplant
#8
Cassia R T Juliato, Paulo Stahlscmidt, Arlete Fernandes, Ilza Monteiro, Luis Bahamondes
OBJECTIVE: To assess the clinical performance (pregnancy and occurrence of pelvic infection) of the levonorgestrel 52-mg intrauterine system (LNG IUS) in solid organ transplant recipients. STUDY DESIGN: We performed a retrospective chart review of all patients seen in the Family Planning Clinic at the University of Campinas Department of Obstetrics and Gynecology from 2007-2017 to identify women with solid organ transplantation using immunosuppression who received a LNG- IUS...
May 7, 2018: Contraception
https://www.readbyqxmd.com/read/29729061/side-effects-and-efficacy-of-renal-sparing-immunosuppression-in-pediatric-liver-transplantation-a-single-center-matched-cohort-study
#9
Christoph Leiskau, Jeremy Rajanayagam, Eva-Doreen Pfister, Imeke Goldschmidt, Norman Junge, André Karch, Christian Lerch, Nicolas Richter, Frank Lehner, Harald Schrem, Ulrich Baumann
Immunosuppressive combination therapy with MMF can reduce CNI associated nephrotoxicity. We investigated effectiveness and safety of de novo MMF-tacrolimus based immunosuppression after pLTx. Patients after pLTx receiving immunosuppression with MMF/tacrolimus (MMF/TAC) were compared to retrospectively selected age- and diagnosis-matched patients with tacrolimus monotherapy (TAC) and cyclosporine/prednisolone therapy (CSA) (19 patients each, n = 57). Effectiveness, renal function and side effects were analyzed for 1 year after pLTx...
May 5, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29720098/tigecycline-induced-acute-pancreatitis-in-a-renal-transplant-patient-a-case-report-and-literature-review
#10
Jinwen Lin, Rending Wang, Jianghua Chen
BACKGROUND: The purpose of this case report is to increase the awareness of tigecycline-induced pancreatitis specifically in renal transplant patients predisposed to the condition. CASE PRESENTATION: A 48-year-old woman developed a donor-derived infection after kidney transplantation, resulting in a ruptured graft renal artery, followed by peritoneal drainage, blood and urine culture infections. Due to multiple drug resistance Acinetobacter baumannii cultured from the preservation fluid and blood, she was treated with tigecycline at the 8th post-transplant day combined with other antibiotics...
May 2, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29709266/saprochaete-capitata-geotrichum-capitatum-an-emerging-fungal-infection-in-kidney-transplant-recipients
#11
N Rizk, Z Hajar, W Medawar
We are reporting the case of an 82-year-old Yemeni patient, renal transplant recipient who was admitted to our institution and who subsequently developed disseminated infection with Saprochaete capitata. This pathogenic fungus is rarely reported in patients with solid organ trans-plants. Saprochaete capitata is an emerging fungal pathogen, ubiquitously spread in the environment. This is the second case to our knowledge of infection with Saprochaete capitata in a renal transplant patient. Our patient was treated for multiple nosocomial infections with prolonged antibiotic courses...
April 27, 2018: Journal de Mycologie Médicale
https://www.readbyqxmd.com/read/29701380/renal-autotransplantation-the-solution-for-different-pathologies
#12
Pedro Pinto Sousa, Rui Machado, Pedro Sá Pinto, Rui Almeida
INTRODUCTION: Renal autotransplantation (RA) is a safe and effective procedure to reconstruct the urinary tract which first successful surgery was performed by Hardy in 1963. The main indications reported for performing RA generally includes renovascular disease, ureteral pathologies and neoplastic disease. RA may be also useful as the last recourse in preventing kidney loss in highly selected patients, especially when conventional methods have failed. METHODS: The authors pretend to describe four total different situations where the RA was the key solution for the pathology initially presented...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701351/heart-transplantation-early-results-of-two-different-regimes-of-immnunosuppression
#13
Carlos Branco, David Prieto, André Antunes, Manuel Batista, Manuel J Antunes
INTRODUCTION: The management of induction and maintenance immunosuppression therapy after heart transplantation (HT) remains a controversial issue. The dosage and the timing has been a changing target. We aimed at evaluate the incidence of acute cellular rejection (ACR) [≥1R grade], major infection and survival in first year after HT in patients receiving two different induction immunosuppression regimes and with a reduction in intensity of triple maintenance immunosuppression dose...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29696373/risk-factors-for-early-viral-infections-after-liver-transplantation
#14
Cornelius Johannes Busch, Benedikt Hermann Siegler, Heike Werle, Christoph Lichtenstern, Thomas Bruckner, Alexandra Heininger, Arianeb Mehrabi, Karl Heinz Weiss, Markus Alexander Weigand, Marcel Hochreiter
PURPOSE: Viral infections represent a serious threat for patients after liver transplantation (LT). The identification of risk factors during the early post-transplant period might help to improve prevention of viral infections after LT. METHODS: Between 2004 and 2010, 530 adult patients underwent LT at a large university hospital serving a metropolitan region in Europe. This retrospective single-centre study analysed putative risk factors for early viral infections with herpes simplex virus-1 (HSV-1), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), hepatitis A/B/C (HAV/HBV/HCV) and cytomegalovirus (CMV) in the first 3 months after LT...
April 25, 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/29694726/treatment-and-management-options-for-the-hepatitis-c-virus-infected-kidney-transplant-candidate
#15
REVIEW
Adriana Dejman, Marco A Ladino, David Roth
A substantial body of literature has unequivocally established that prevalent hepatitis C virus infection in chronic kidney disease (CKD), end stage renal disease (ESRD) and kidney transplant recipients is associated with a negative impact on patient survival. As a consequence of remarkable work that explained the details of the hepatitis C virus (HCV) genome, a class of drugs referred to as the direct-acting antiviral (DAA) agents were developed that targeted specific key sites in viral replication. Large clinical trials in the HCV-infected general population followed soon after that demonstrated cure rates exceeding 95%...
April 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29694723/timing-of-hepatitis-c-virus-infection-treatment-in-kidney-transplant-candidates
#16
REVIEW
Abraham Cohen-Bucay, Jean M Francis, Craig E Gordon
Hepatitis C virus (HCV) infection is prevalent in patients with kidney disease including transplant candidates and recipients. It is associated with increased morbidity and mortality in end-stage renal disease patients and also increases the risk of allograft rejection and decreases allograft and patient survival post-transplant. Newly developed direct acting antivirals have revolutionized the way HCV is treated. Whether patients are treated before or after kidney transplantation, the cure rates with direct acting antivirals are >90%...
April 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29694720/pharmacokinetics-and-drug-interactions-of-medications-used-to-treat-hepatitis-c-virus-infection-in-the-setting-of-chronic-kidney-disease-and-kidney-transplantation
#17
REVIEW
Guillermo A Ortiz, Hirsh D Trivedi, Claudia Nader
Hepatitis C infection in patients with chronic kidney disease or kidney transplant carries higher morbidity and mortality compared to noninfected patients. Historically, patients with advanced kidney disease and kidney transplant recipients were undertreated given the multiple adverse effects and limited efficacy of interferon-based therapies for chronic hepatitis C. The development of direct-acting antivirals in the past few years has opened an unprecedented opportunity for treating these populations. However, the impaired renal clearance of some of these medications in patients with kidney disease, and the potential interactions of antiviral therapies with immunosuppressants after kidney transplantation, present some challenges in choosing the proper regimen...
April 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29688849/cryptococcoma-of-a-transplanted-kidney-in-a-patient-presenting-with-recurrent-urinary-tract-infection-a-case-report
#18
Albert Z Muranda, Ludolf Greeff, Mike M Sathekge, Thabo Lengano, Victor O L Karusseit
BACKGROUND: Cryptococcosis is an important opportunistic infection of organ transplant recipients. It is the third most common fungal infection of transplant patients and occurs especially in kidney recipients. Cryptococcus neoformans is a ubiquitous fungus which infects humans by inhalation of spores. C. gattii has more recently been recognised as a pathogen. Infection commonly is disseminated affecting mainly the central nervous system and the lungs. Cryptococcoma, a localised form of the disease, has been described in various organs...
April 23, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29682370/fatal-pneumococcus-sepsis-after-treatment-of-late-antibody-mediated-kidney-graft-rejection
#19
Gunilla Einecke, Jan Hinrich Bräsen, Nils Hanke, Hermann Haller, Anke Schwarz
Antibody-mediated rejection (ABMR) is a major cause of late renal allograft dysfunction and graft loss. Risks and benefits of treatment of late ABMR have not been evaluated in randomized clinical trials. We report on a 35-year-old patient with deterioration in renal function and progressive proteinuria 15 years after transplantation. Recurrent infections after a splenectomy following traumatic splenic rupture 3 years earlier had led to reduction of immunosuppression. Renal transplant biopsy showed glomerular double contours, 40% fibrosis/tubular atrophy, peritubular capillaritis, and positive C4d staining indicating chronic-active ABMR...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29679515/the-influence-of-mtor-inhibitors-on-the-incidence-of-cmv-infection-in-high-risk-donor-positive-recipient-negative-d-r-kidney-transplant-recipients
#20
M P Cristelli, R M Esmeraldo, C Motta Pinto, T V Sandes-Freitas, C Felipe, C F Lobo, L Viana, J Mansur, S Stopa, D W C Santos, P C Grenzi, W F Aguiar, H Tedesco-Silva, J O Medina-Pestana
Several studies and meta-analysis suggest the mTOR inhibitors are associated with reduced incidence of CMV infection after kidney transplantation, although their effects on the high-risk population have not been investigated thoroughly. This retrospective cohort study investigates the association between immunosuppression and CMV infection in D+/R- kidney transplant recipients receiving preemptive therapy. All patients received rabbit anti-thymocyte globulin, tacrolimus, prednisone and azathioprine (AZA), mycophenolate (MPA) or everolimus (EVR)...
April 21, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
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