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Infection after renal transplant

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https://www.readbyqxmd.com/read/28937070/renal-transplantation-in-hiv-positive-patients-no-more-a-scare
#1
Eswarappa Mahesh, Manns Manohar John, Gurudev Channabasappa Konana, Rakesh Madhyastha Parampalli, Sujeeth Reddy Bande, Sarita Suryadevara
Human immunodeficiency virus (HIV) infection has posed as a major global health epidemic for almost three decades. With the advent of highly active antiretroviral therapy in 1996 and the application of prophylaxis and management of opportunistic infections, acquired immunodeficiency syndrome mortality has decreased markedly. The most aggressive HIV-related renal disease is end-stage renal disease due to HIV-associated nephropathy. Presence of HIV infection used to be viewed as a contraindication to renal transplantation for multiple reasons; concerns for exacerbation of an already immunocompromised state by administration of additional immunosuppressants; the use of a limited supply of donor organs with unknown long-term outcomes...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28933173/-cytomegalovirus-and-polyomavirus-infection-after-renal-transplantation
#2
Jana Machová, Tomáš Reischig
Viral infections are among the most common infectious complications affecting transplant recipients. Due to immunosuppressive therapy predominantly affecting cellular immunity and thus successfully reducing the incidence of acute rejection, there is a higher incidence of viral infections. Herpesviruses and polyomaviruses are ubiquitous pathogens which have the ability to persist in a state of latent infection. In addition to post-transplant reactivation, donor-induced primoinfection can also occur, leading to increased morbidity and contributing to decreased survival of patients...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28926523/familial-mediterranean-fever-is-associated-with-increased-mortality-after-kidney-transplantation-a-19-years-single-center-experience
#3
Hefziba Green, Shelly Lichtenberg, Ruth Rahamimov, Avi Livneh, Avry Chagnac, Eytan Mor, Benaya Rozen-Zvi
BACKGROUND: Current data regarding the outcome of kidney transplantation in patients with familial Mediterranean fever (FMF) who reach end-stage renal disease (ESRD) due to reactive amyloidosis A (AA) are scarce and inconclusive. METHODS: The outcomes of 20 patients with FMF and biopsy-proven AA amyloidosis that were transplanted between 1995 and 2014 were compared with 82 control patients (32 with diabetes mellitus and 50 with nondiabetic kidney disease). Major outcome data included overall patient and graft survivals...
October 2017: Transplantation
https://www.readbyqxmd.com/read/28924461/do-the-benefits-of-transplant-tourism-amongst-nigerian-patients-outweigh-the-risks-a-single-center-experience
#4
C O Amira, B T Bello
BACKGROUND: Transplant tourism (TT) is the term used to describe travel outside one's country of abode for the sole purpose of obtaining organ transplantation services. OBJECTIVE: This study describes the characteristics and outcomes of kidney transplant tourists who were followed up in our institution. METHODS: A retrospective study was conducted on patients who underwent kidney transplantation outside the country and were followed up in our institution from 2007 to 2015...
2017: International Journal of Organ Transplantation Medicine
https://www.readbyqxmd.com/read/28912780/inflammatory-markers-for-arterial-stiffness-in-cardiovascular-diseases
#5
REVIEW
Ioana Mozos, Clemens Malainer, Jarosław Horbańczuk, Cristina Gug, Dana Stoian, Constantin Tudor Luca, Atanas G Atanasov
Arterial stiffness predicts an increased risk of cardiovascular events. Inflammation plays a major role in large arteries stiffening, related to atherosclerosis, arteriosclerosis, endothelial dysfunction, smooth muscle cell migration, vascular calcification, increased activity of metalloproteinases, extracellular matrix degradation, oxidative stress, elastolysis, and degradation of collagen. The present paper reviews main mechanisms explaining the crosstalk between inflammation and arterial stiffness and the most common inflammatory markers associated with increased arterial stiffness, considering the most recent clinical and experimental studies...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28905454/management-considerations-in-the-failing-renal-allograft
#6
REVIEW
Tom Lea-Henry, Bobby Chacko
Patients with a failed or failing renal transplant are increasing in number. Graft failure resulting in dialysis re-initiation is not uncommon, yet there are limited data to guide management of these patients. Physician practices vary regarding timing of dialysis initiation and the timing and extent of immunosuppression withdrawal. The risks of immunosuppression withdrawal need to be carefully balanced against the benefits of continuing low-dose therapy. The latter helps minimise the risk of sensitisation and has been proposed to possibly slow the loss of residual renal function; however, the use of common immunosuppressive agents may contribute to cardiovascular disease, malignancy, and infection, the major causes of death following the loss of a renal transplant...
September 14, 2017: Nephrology
https://www.readbyqxmd.com/read/28895794/effect-of-a-short-course-treatment-with-synbiotics-on-plasma-p-cresol-concentration-in-kidney-transplant-recipients
#7
Bruna Guida, Mauro Cataldi, Andrea Memoli, Rossella Trio, Martina di Maro, Lucia Grumetto, Ivana Capuano, Stefano Federico, Antonio Pisani, Massimo Sabbatini
OBJECTIVE: We evaluated whether a short-term course with synbiotics may lower plasma p-Cresol concentrations in kidney transplant patients (KTRs) who accumulate this uremic toxin both because of increased production by their dysbiotic gut microbiome and because of reduced elimination by the transplanted kidneys. METHODS: Thirty-six KTRs (29 males, mean age 49.6 ± 9.1 years) with transplant vintage > 12 months, stable graft function, and no episode of acute rejection or infection in the last 3 months were enrolled in this single-center, parallel-group, double-blinded, randomized (2:1 synbiotic to placebo) study...
September 12, 2017: Journal of the American College of Nutrition
https://www.readbyqxmd.com/read/28877127/renal-transplant-recipients-the-factors-related-to-immunosuppressive-medication-adherence-based-on-the-health-belief-model
#8
Pen-Chen Kung, Mei Chang Yeh, Ming-Kuen Lai, Hsueh-Erh Liu
BACKGROUND: Kidney transplant failures are caused primarily by lack of adherence to immunosuppressive medication regimens by patients after transplantation. A number of studies have indicated that health-related beliefs are an effective predictor of health-related behavior. PURPOSE: The aim of this study is to understand the influence of the personal characteristics and health-related beliefs of patients on adherence to treatment with immunosuppressive medication based on the Health Belief Model...
October 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/28869325/epstein-barr-virus-infection-in-children-with-renal-transplantation-a-single-center-experience
#9
Jihye You, Mijin Kim, Jina Lee, Duck Jong Han, Young Seo Park, Joo Hoon Lee
AIM: This study aimed to investigate the incidence, timing, manifestations, managements, and outcomes of Epstein-Barr virus (EBV) infection in pediatric renal transplant recipients in Korea. METHODS: We retrospectively evaluated 70 patients aged <18 years who had undergone renal transplantation between January 1990 and November 2014 at a single center in Korea. EBV infection was diagnosed via serological test or real-time quantitative polymerase chain reaction (PCR)...
September 4, 2017: Nephrology
https://www.readbyqxmd.com/read/28867309/b-cell-activating-factor-baff-reflects-patients-immunological-risk-profile-after-kidney-transplantation
#10
A Schuster, B Jung, J Hofbauer, L Kühne, D Zecher, B Banas, T Bergler
The B-cell activating factor BAFF plays an important role in the development and maturation of B-lymphocytes, which can contribute to the generation of donor-specific antibodies and thus may influence graft function and graft survival. Inconsistent data on the role of BAFF levels after renal transplantation for the formation of donor-specific antibodies and the contribution for allograft rejection exist. The aim of the current study was to determine to what extent the degree of pre-immunization is reflected by each patient's BAFF levels before transplantation and in the follow-up...
August 31, 2017: Transplant Immunology
https://www.readbyqxmd.com/read/28865972/high-dose-melphalan-and-stem-cell-transplantation-in-patients-on-dialysis-due-to-al-amyloidosis-and-monoclonal-immunoglobulin-deposition-disease
#11
Felipe Batalini, Laura Econimo, Karen Quillen, J Mark Sloan, Shayna Sarosiek, Dina Brauneis, Andrea Havasi, Lauren Stern, Laura Dember, Vaishali Sanchorawala
The kidney is the most common organ affected by immunoglobulin light-chain (AL) amyloidosis and monoclonal immunoglobulin deposition disease (MIDD), often leading to end stage renal disease (ESRD). High-dose melphalan and stem cell transplantation (HDM/SCT) is effective for selected patients with AL amyloidosis, with high rates of complete hematologic responses and potential for improvement in organ dysfunction. Data on tolerability and response to HDM/SCT in patients with ESRD due to AL amyloidosis and MIDD are limited...
August 30, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28863048/causes-and-management-of-postrenal-transplant-diarrhea-an-underappreciated-cause-of-transplant-associated-morbidity
#12
Ho Sik Shin, Anil Chandraker
PURPOSE OF REVIEW: This review highlights the current literature on both infectious and noninfectious diarrhea in renal transplant recipients and provides a diagnostic algorithm for the evaluation of posttransplant diarrhea. RECENT FINDINGS: Renal transplant recipients share certain predisposing characteristics for the development of posttransplant diarrhea, including a generalized immunosuppressed state and exposure to polypharmacy, most notably broad-spectrum antimicrobial therapy...
August 31, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28860788/impact-of-immunosuppressant-therapy-on-new-onset-diabetes-in-liver-transplant-recipients
#13
Fu-Chao Liu, Huan-Tang Lin, Jr-Rung Lin, Huang-Ping Yu
This nationwide, population-based study aimed to clarify the effects of immunosuppressive regimens on new-onset diabetes after liver transplantation (NODALT). The National Health Insurance database of Taiwan was explored for patients who received liver transplantation without pre-transplant diabetes from 1998 to 2012. Information regarding clinical conditions and immunosuppressant utilization among these patients was analyzed statistically. Of the 2,140 patients included in our study, 189 (8.8%) developed NODALT...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28856290/recommendations-for-the-treatment-of-hepatitis-c-in-2017
#14
REVIEW
Waldemar Halota, Robert Flisiak, Jacek Juszczyk, Piotr Małkowski, Małgorzata Pawłowska, Krzysztof Simon, Krzysztof Tomasiewicz
The goals of treatment is to eliminate HCV infection, stop or reverse histological changes, reduce the risk of hepatocellular carcinoma development and transmission of the infection to other individuals. According to the recommendation of the Polish Group of Experts for HCV in 2017 all patients with chronic HCV infection should receive treatment, but it is not recommended in patients at high risk of short overall survival. If access to therapy is restricted, priority should be given to patients whose HCV infection can lead to an unfavourable outcome of the disease within a short time frame, particular to individuals with liver cirrhosis, rapidly progressing liver fibrosis, extrahepatic manifestations of HCV infection, chronic kidney diseases, patients before and after organ transplantation...
June 2017: Clin Exp Hepatol
https://www.readbyqxmd.com/read/28844154/vancomycin-prophylaxis-for-prevention-of-clostridium-difficile-infection-recurrence-in-renal-transplant-patients
#15
Lindsey E Splinter, Luiza Kerstenetzky, Margaret R Jorgenson, Jillian L Descourouez, Glen E Leverson, Christopher M Saddler, Jeannina A Smith, Nasia Safdar, Robert R Redfield
BACKGROUND: Incidence of primary and recurrent Clostridium difficile infection (CDI) is higher in solid-organ transplant recipients than in the average hospitalized patient. Strategies for preventing recurrent CDI are limited. Prophylaxis with oral vancomycin (VPPx) for preventing recurrent CDI may be beneficial, but there is limited evidence supporting its use. OBJECTIVE: To examine the impact of VPPx (125 mg twice daily) for the prevention of recurrent CDI in renal transplant recipients (RTX) receiving high-risk broad spectrum antibiotics (BSAs)...
August 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28838454/acute-graft-rejection-and-formation-of-de-novo-donor-specific-antibodies-triggered-by-low-cyclosporine-levels-and-interferon-therapy-for-recurrent-hepatitis-c-infection-after-liver-transplantation-a-case-report
#16
R Nakano, M Ohira, K Ishiyama, K Ide, T Kobayashi, H Tahara, S Shimizu, K Arihiro, M Imamura, K Chayama, Y Tanaka, H Ohdan
BACKGROUND: We report a case of acute rejection of a liver graft, together with the occurrence of de novo donor-specific antibodies (DSAs), in a 53-year-old Japanese man who had undergone deceased-donor liver transplantation. METHODS: The graft rejection was triggered by low cyclosporine levels and pegylated interferon treatment for the recurrence of hepatitis C virus (HCV) infection 18 months after transplantation. Although the graft was ABO-compatible, pre-formed DSA B51 was detected; therefore, total plasma exchange was performed and intravenous rituximab (500 mg/body) was administered before transplantation...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28838442/late-onset-allograft-aspergillosis-in-an-hiv-positive-renal-transplant-recipient-a-case-report
#17
M Kamal, S Apewokin, M Anand, B G Abu Jawdeh, A Govil, M M Sheikh, S Shah
Aspergillus infection of the allograft in renal transplant patients is rare and associated with a high mortality. We report a case of a 21-year-old, human immunodeficiency virus-positive, deceased-donor kidney recipient who presented 1 year after transplant with oliguric kidney injury. A nuclear medicine renal scan revealed absence of flow to the transplanted kidney, and a urine fungal culture was positive for Aspergillus flavus. The diagnosis was confirmed with the presence of fungal hyphae along with thrombosis in the vascular structures in renal allograft pathology...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28838433/ophthalmic-findings-in-patients-after-renal-transplantation
#18
K Berindán, B Nemes, R P Szabó, L Módis
The aim of the study was to perform complete ophthalmic examinations in patients after renal transplantation to determine ocular alterations and condition of the eyes. Moreover, ophthalmic findings were correlated with certain clinical characteristics related to transplantation such as post-operative renal functions and immunosuppressive regimen. The study was performed on 84 eyes of 42 patients who had received a renal transplant at least 6 months earlier. All patients underwent a complete ophthalmologic examination...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28838432/autosomal-dominant-polycystic-kidney-disease-transplant-recipients-after-kidney-transplantation-a-single-center-experience
#19
L Illesy, D Á Kovács, R P Szabó, A B L Asztalos, B Nemes
Kidney transplantation is indicated for end-stage renal disease. Autosomal dominant polycystic kidney disease (ADPKD) causes structural degeneration of the kidney and eventually becomes end-stage renal disease. ADPKD patients usually have several renal and nonrenal complications. We analyzed our kidney transplantation activities between 1991 and 2010 regarding ADPKD. We followed up with patients to December 31, 2016. Data were collected as patient and graft survival rates, the prevalence of polycystic manifestation of the gastrointestinal tract and other organs, and the attendance of urinary tract infection...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28834032/bk-polyomavirus-infection-after-renal-transplantation-surveillance-in-a-resource-challenged-setting
#20
Soumita Bagchi, G Vikraman, Sandeep Kumar Srivastava, Ashish Upadhayay, Geetika Singh, Dipankar Bhowmik, Sandeep Mahajan, Amit Dinda, Sanjay Kumar Agarwal
BACKGROUND: A paucity of data is available about BK polyomavirus (BKPyV) infection after renal transplantation (RTX) in resource-limited countries with a predominantly living-donor, ABO-compatible RTX program. We aimed to assess BKPyV infection in such patients in a public hospital in India. METHODS: We prospectively evaluated plasma BKPyV replication in 62 patients at 1, 3, 6, 9, 12 months after RTX. Sustained significant BK viremia (SSBKV) was defined as significant viremia (≥10 000 copies/mL) detected ≥2 times and BKPyV-associated nephropathy (BKVAN) as histologic changes of BKVAN with BK viremia with/without graft dysfunction...
August 21, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
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