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Infection after renal transplant

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https://www.readbyqxmd.com/read/28725563/atypical-hemolytic-uremic-syndrome-triggered-by-varicella-infection
#1
Pauline Condom, Jean-Michel Mansuy, Stéphane Decramer, Jacques Izopet, Catherine Mengelle
Varicella Zoster Virus (VZV) is a well-known virus that belongs to the Herpesviridae family which induces a self-limited disease except in specific cases in particular among stem cell transplant patients. This virus is not known however to trigger atypical Hemolytic Uremic Syndrome (aHUS). Here we report the case of a six-year-old boy who was hospitalized with fever and abdominal pains associated to pruritic and vesicular rash, thrombocytopenia and acute renal failure. He was diagnosed with aHUS precipitated by varicella virus...
2017: IDCases
https://www.readbyqxmd.com/read/28714558/everolimus-and-reduced-calcineurin-inhibitor-therapy-in-pediatric-liver-transplant-recipients-results-from-a-multicenter-prospective-study
#2
Rainer Ganschow, Bo-Goran Ericzon, Anil Dhawan, Khalid Sharif, El-Djouher Martzloff, Barbara Rauer, Jennifer Ng, Patricia Lopez
In a 24-month, multicenter, single-arm, prospective study, 56 pediatric liver transplant patients with or without basiliximab induction were converted at 1-6 months post-transplant from standard calcineurin inhibitor (CN) therapy (± mycophenolic acid), to everolimus with reduced exposure to CNI (tacrolimus n=50, cyclosporine n=6). Steroid therapy was optional. Recruitment was stopped prematurely due to high rates of PTLD, treatment-related serious infections leading to hospitalization and premature study drug discontinuation...
July 17, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28708266/belatacept-conversion-in-an-hiv-positive-kidney-transplant-recipient-following-anti-thymocyte-globulin-induction
#3
Samatha A Kuten, Samir J Patel, Ashvin Baru, A Osama Gaber, Rustin D Crutchley, Venkataraman Ramanathan, Richard J Knight
Herein, we describe a case of early belatacept conversion in a human immunodeficiency virus (HIV)-positive kidney transplant recipient in an effort to improve suboptimal graft function and avoid drug interactions following anti-thymocyte globulin (ATG) administration. We observed improvement in renal function without HIV disease progression or opportunistic infections. Donor-specific antibodies appeared shortly after conversion but cleared without intervention. This case highlights belatacept as a means to improve renal function and avoid significant drug interactions even following ATG induction...
July 14, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28697717/timing-and-predictors-of-early-urologic-and-infectious-complications-after-renal-transplant-an-analysis-of-a-new-york-statewide-database
#4
Wilson Sui, Michael J Lipsky, Justin T Matulay, Dennis J Robins, Ifeanyi C Onyeji, Maxwell B James, Marissa C Theofanides, Sven Wenske
OBJECTIVES: The most common complications after renal transplant are urologic and are a cause of significant morbidity in a vulnerable population. We sought to characterize the timing and predictors of urologic complications after renal transplant using a statewide database. MATERIALS AND METHODS: We queried the New York Statewide Planning and Research Cooperative System database to identify patients who underwent renal transplant from 2005 to 2013. Postoperative complications included hydronephrosis, ureteral stricture, vesicoureteral reflux, nephrolithiasis, and urinary tract infections...
July 11, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28697541/first-experience-of-cadaveric-renal-transplantation-in-sri-lanka
#5
P K Harrischandra, D N Jayatunge, U B Rambukwella, I B Sumithraarachchi, U I Karunadasa, A S Abeyagunawardena
Objectives: To analyse the outcome of 50 consecutive cadaveric renal transplants performed in Sri Lanka. Methods: This was a single-centre longitudinal cohort study conducted in the Nephrology and Kidney Transplant Unit, Teaching Hospital Kandy, Sri Lanka. Records of 50 Sri Lankan cadaveric renal transplant recipients from 7th December 2004 to 1st September 2013 were reviewed and categorized according to early graft function, cold ischaemia time and the duration of dialysis before surgery...
June 30, 2017: Ceylon Medical Journal
https://www.readbyqxmd.com/read/28691954/maintenance-belatacept-based-immunosuppression-in-lung-transplantation-recipients-who-failed-calcineurin-inhibitors
#6
Carlo J Iasella, Ryan J Winstead, Cody A Moore, Bruce A Johnson, Ayelet T Feinberg, Matthew R Morrell, J W Awori Hayanga, Elizabeth A Lendermon, Adriana Zeevi, John F McDyer, Christopher R Ensor
BACKGROUND: Traditional immunosuppressive regimens (ISR) used in lung transplantation rely on calcineurin inhibitors (CNI) that occasionally cause severe adverse reactions necessitating discontinuation. Belatacept is a novel costimulation antagonist approved for use in renal transplantation which lacks data in lung transplantation. This series aims to describe the response to belatacept ISR in 11 lung transplantation recipients after CNI failure. METHODS: Single center, retrospective medical record review of adult lung transplant recipients (LTR) before and after conversion to belatacept-based ISR...
July 6, 2017: Transplantation
https://www.readbyqxmd.com/read/28688917/real-world-economic-burden-associated-with-transplant-related-complications
#7
M A Perales, M Bonafede, Q Cai, P M Garfin, D McMorrow, N C Josephson, A Richhariya
Approximately 20,000 hematopoietic cell transplantation (HCT) procedures are performed in the US annually. Real-world evidence on the costs associated with post-transplant complications are limited. Patients with hematologic malignancies aged ≥18 years undergoing auto-HCT or allo-HCT between January 1, 2011 and June 30, 2014 were identified in the Truven Health MarketScan(®) Research Databases. Patients were required to have 12 months of continuous medical and pharmacy enrollment pre- and post-HCT with the exception that patients with evidence of inpatient death within 12 months post-HCT were also included...
July 5, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28680827/clinical-analysis-of-single-filtration-plasmapheresis-using-continuous-renal-replacement-therapy-machines-in-kidney-transplantation
#8
Eunsoo Lim, Yujeong Kim, Jong Cheol Jeong, Inwhee Park, Heungsoo Kim, Su Hyung Lee, Chang-Kwon Oh, Gyu-Tae Shin
BACKGROUND: Plasmapheresis has become an essential element of kidney transplantation (KT). In the present study, we report clinical outcomes of filtration plasmapheresis using continuous renal replacement therapy machines with a single filter for the first time in Korea. METHODS: We retrospectively analyzed six patients who underwent filtration plasmapheresis for KT in our center; plasmapheresis was performed using the Plasmaflex (Baxter(®)) with a TPE 2000 filter set (Baxter(®)) in our hemodialysis unit...
June 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28680033/left-renal-vein-compression-syndrome-cracking-the-nut-of-clinical-dilemmas-three-cases-and-review-of-literature
#9
Waqas Javed Siddiqui, Abu Bakar, Muhammad Aslam, Hasan Arif, Brian A Bianco, Alexander E Trebelev, Ellie Kelepouris, Sandeep Aggarwal
BACKGROUND The term nutcracker phenomenon (NCP) elucidates anatomical structure and hemodynamics, whereas nutcracker syndrome (NCS) refers to clinical manifestations. We present three cases of similar clinical features of hematuria and flank pain with different clinical outcomes. CASE REPORT Case 1: A 36-year-old Caucasian female with a past medical history (PMH) of HIV infection presented for evaluation of hematuria. Computed tomography (CT) without contrast showed pelvic venous congestion and narrowing of the extra-renal left renal vein (LRV)...
July 6, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28679466/successful-launch-of-an-abo-incompatible-kidney-transplantation-program-to-overcome-the-shortage-of-compatible-living-donors-experience-at-a-single-center%C3%A2
#10
Seung Hwan Song, Juhan Lee, Beom Seok Kim, Sinyoung Kim, Jae Geun Lee, Hyeon Joo Jeong, Yu Seun Kim, Myoung Soo Kim, Hyun Ok Kim, Soon Il Kim, Kyu Ha Huh
AIMS: ABO-incompatible (ABOi) kidney transplantation (KT) is being increasingly performed to overcome donor shortages. However, debate persists regarding the post-transplant outcomes of ABOi KT vs. that of ABO-compatible (ABOc) KT. METHODS: A total 454 recipients who underwent living-donor KT (LDKT) between June 2010 and July 2014 at Severance Hospital (Seoul) were retrospectively reviewed. 100 ABOi and 354 ABOc KTs were compared. Recipients with a pretransplant positive crossmatch to their donors, pretransplant donor-specific anti-HLA antibody (DSA), or high panel reactive antibody (PRA ≥ 50%) were excluded from both the ABOi and ABOc KT groups...
July 6, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28676037/challenges-and-outcomes-of-haemodialysis-among-patients-presenting-with-kidney-diseases-in-dodoma-tanzania
#11
Alfred J Meremo, David P Ngilangwa, Masumbuko Y Mwashambwa, Matobogolo B Masalu, Janet Kapinga, Rehema Tagalile, Issa Sabi
BACKGROUND: Kidney Diseases contribute a significant proportion to the global burden of non-communicable diseases. Haemodialysis services as the main modality of renal replacement therapy in most resource limited countries is only available in few cities and at higher costs. The aim of this study was to determine the challenges and outcomes of patients who were on haemodialysis at the University of Dodoma (UDOM) haemodialysis unit in Tanzania. METHODS: In this retrospective study; we reviewed haemodialysis registers and charts of 116 patients dialyzed from January 2013 to June 2015 at The UDOM haemodialysis unit...
July 4, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28669106/oral-shedding-of-human-herpesviruses-in-renal-transplant-recipients
#12
Dmitry José de Santana Sarmento, Tânia Regina Tozetto-Mendoza, Laura Masami Sumita, Ligia Camara Pierroti, Débora Pallos, Rubens Caliento, Michelle Palmieri, Victor Adriano de Oliveira Martins, Marina Gallottini, Claudio Sergio Pannuti, Paulo Henrique Braz-Silva
OBJECTIVE: To describe the shedding profile of human herpesviruses in the saliva of renal transplant recipients. METHODS: This is a prospective case-control study of 50 renal transplant recipients and control group of 50 individuals (non-transplanted and immunocompetent). Mouthwash samples were collected via oral rinse and then submitted to screening for the presence of eight types of herpesviruses by using multiplex PCR. Fisher's exact, chi-square, and Student t tests were used for statistical analysis, and the significance level was set at 5%...
July 1, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/28666792/post-kidney-transplant-robot-assisted-laparoscopic-ureteral-donor-receiver-anastomosis-for-kidney-graft-reflux-or-stricture-disease
#13
Daniel A Benamran, Jacques Klein, Karine Hadaya, Gregory Wirth, Pierre-Yves Martin, Christophe E Iselin
OBJECTIVES: To report our experience with robot-assisted ureteral anastomosis for kidney graft. Kidney graft complex ureteral strictures and/or symptomatic vesico-ureteral reflux may require complex reconstruction. This is classically done through an open surgical access, which adds to the morbidity of kidney transplantation. The da Vinci robot enables to perform complex laparoscopic procedures, and may hence be used for such reconstructions. METHODS: we retrospectively reviewed all patients undergoing robotic surgical revision for stricture or reflux disease over a three years period...
June 27, 2017: Urology
https://www.readbyqxmd.com/read/28666406/posttransplant-lymphoproliferative-disease-and-inhibitors-of-mammalian-target-of-rapamycin-when-a-quick-look-back-can-change-the-perspective
#14
Lorena Castillo-Eraso, Edoardo Melilli, Carmen Cabre, Anna Manonelles, Julieta Landeyro, Oriol Bestard, Josep M Cruzado, Alberto Martinez-Vea
Posttransplant lymphoproliferative disease represents a heterogeneous group of diseases characterized by uncontrolled proliferation of lymphocytes, favored by immunosuppression. Several risk factors for its development have been described, with Epstein-Barr virus infection being a main cause of early-onset forms and chronic antigen stimulation of donors and/or accumulated immunosuppression as key factors of later forms of lymphocyte transformation. The present clinical case presents a patient diagnosed with posttransplant lymphoproliferative disease 3 years after renal transplant who had a potentially lethal complication related to conversion to inhibitors of mammalian target of rapamycin...
June 28, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28662883/paritaprevir-ritonavir-ombitasvir-plus-dasabuvir-with-ribavirin-for-treatment-of-recurrent-chronic-hepatitis-c-genotype-1-infection-after-liver-transplantation-real-world-experience
#15
Ming-Lung Yu, Yao-Li Chen, Chung-Feng Huang, Kuo-Hua Lin, Ming-Lun Yeh, Ching-I Huang, Meng-Hsuan Hsieh, Zu-Yau Lin, Shinn-Cherng Chen, Jee-Fu Huang, Chia-Yen Dai, Wan-Long Chuang
BACKGROUND/AIMS: The registered trial has demonstrated that paritaprevir/ritonavir/ombitasvir plus dasabuvir (PrOD) with ribavirin was effective for recurrent hepatitis C virus genotype 1 (HCV-1) infection after liver transplantation in patients with mild fibrosis; however, the real-world efficacy and safety of this regimen have not been determined. METHODS: The efficacy (sustained virological response, SVR12, undetectable HCV RNA 12 weeks post-treatment) and safety were evaluated in 12 patients with recurrent HCV-1 infection after liver transplantation...
June 26, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28650734/clostridium-difficile-associated-colitis-post-transplant-is-not-associated-with-elevation-of-tacrolimus-concentrations
#16
Hugo J R Bonatti, Karim W Sadik, Elizabeth Krebs, Costi D Sifri, Timothy L Pruett, Robert G Sawyer
BACKGROUND: Diarrhea is a common condition after solid organ transplant (SOT); Clostridium difficile-associated colitis (CDAC) is one of the most common infections after SOT. We documented previously that some types of enteritis are associated with an elevation of tacrolimus (TAC) trough concentrations by interfering with the drug's complex metabolism. PATIENTS AND METHODS: Tacrolimus concentrations of 25 SOT recipients including 12 renal and 13 liver recipients before, during, and after CDAC were analyzed retrospectively...
June 26, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28622834/morbid-obesity-and-functional-status-as-predictors-of-surgical-complication-after-renal-transplantation
#17
Tara M Veasey, James N Fleming, Sara E Strout, Ryan Miller, Nicole A Pilch, Holly B Meadows, Caitlin R Mardis, Benjamin A Mardis, Sunil Shenvi, John McGillicuddy, Kenneth D Chavin, Prabhakar Baliga, David J Taber
BACKGROUND: This study evaluated the impact of body mass index (BMI) and patient functional status on the risk for surgical complications after kidney transplant. METHODS: This retrospective cohort study of adult kidney transplant recipients grouped patients by baseline Karnofsky status (low function ≤ 70%) and further stratified by morbid obesity (BMI ≥ 35 kg/m(2)) to assess surgical complication risk. RESULTS: 736 patients were included with surgical complications occurring in 25%...
June 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28621639/outcome-of-the-double-j-stent-placement-in-pediatric-kidney-transplant-a-single-center-experience
#18
Hakan Sözen, Onur Özen, Kibriya Fidan, Oğuz Söylemezoğlu, Aydın Dalgıç
OBJECTIVES: Double J stent placement at kidney transplant may reduce stenosis or leakage complication rates. However, placement may also increase risk for early urinary tract infection (ie, < 3 mo after transplant). In children, the usefulness of double J stent placement is not well defined. MATERIALS AND METHODS: We analyzed retrospective data from children who received transplants at the Gazi University Transplantation Center and Pediatric Nephrology (Ankara, Turkey) for outcomes related to double J stents...
June 16, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28620307/peri-and-postoperative-treatment-with-the-interleukin-1-receptor-antagonist-anakinra-is-safe-in-patients-undergoing-renal-transplantation-case-series-and-review-of-the-literature
#19
Catharina M Mulders-Manders, Marije C Baas, Femke M Molenaar, Anna Simon
In patients undergoing solid organ transplantation, the presence of an interleukin-1 (IL-1) driven disease may require the addition of IL-1 inhibiting drugs to the standard immunosuppressive regimen to protect against inflammation and negative graft outcome. Three patients undergoing renal transplantation were treated perioperatively with the interleukin-1 receptor antagonist anakinra. Kidney function increased rapidly in all three and the only complications seen were minor infections. In vitro studies report associations between serum and urinary levels of IL-1β and IL-1 receptor antagonist and negative graft outcome, and studies in animals and two small human trials illustrate a possible protective effect of anti-IL-1 therapy after solid organ transplantation...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28617157/vesicoureteral-reflux-in-kidney-transplantation
#20
Nina M Molenaar, Robert C Minnee, Frederike J Bemelman, Mirza M Idu
BACKGROUND: Vesicoureteral reflux (VUR) is frequently found after transplantation, but its impact on graft function, urine tract infection, and graft loss remains uncertain. Therefore our objective was to evaluate the effects of VUR on the outcome of renal transplantation. MATERIAL AND METHODS: We included 1008 adult renal transplant recipients of whom a 1-week posttransplant voiding cystourethrogram was available. Study end points included occurrence of bacteriuria, renal function, and graft survival...
June 2017: Progress in Transplantation
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