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Infection after renal transplant

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https://www.readbyqxmd.com/read/28804237/aneurysmal-degeneration-of-the-brachial-artery-after-vascular-access-creation-surgical-treatment-results
#1
Sérgio Teixeira, Pedro Sá Pinto, Carlos Veiga, Ivone Silva, Rui Almeida
True peripheral artery aneurysms proximal to a longstanding arteriovenous fistula is a well-recognized complication. Late aneurysmal degeneration is rare. This study analyzed the characteristics, therapeutic options, and outcomes of true donor brachial artery aneurysms (DBAA) after arteriovenous fistula (AVF) for hemodialysis. We retrospectively collected the data of patients with DBAA after AVF creation, surgically repaired between January 2001 and September 2015. We excluded patients with pseudoaneurysms, anastomotic aneurysms, and infected aneurysms...
September 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28803446/urinary-tract-infections-due-to-esbl-producing-enterobacteriaceae-in-renal-transplant-recipients-a-systematic-review-and-meta-analysis
#2
Michail Alevizakos, Dimitrios Nasioudis, Eleftherios Mylonakis
BACKGROUND: Urinary tract infections (UTIs) are the most common infectious complications among renal transplant recipients (RTR). UTIs caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-PE) have been associated with inferior clinical outcomes and increased financial burden. METHODS: We performed a systematic review and meta-analysis by searching through the PubMed and EMBASE databases (to May 20, 2016) and identifying studies that reported data on the number of RTR who developed an ESBL-PE UTI...
August 13, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28802764/factors-influencing-renal-graft-survival-7-year-experience-of-a-single-center
#3
Rūta Auglienė, Eglė Dalinkevičienė, Vytautas Kuzminskis, Mindaugas Jievaltas, Laima Peleckaitė, Agnė Gryguc, Edgaras Stankevičius, Inga Arūnė Bumblytė
BACKGROUND AND OBJECTIVE: The demand for kidney transplants exceeds the existing supply. This leads to a recently growing interest of research in the area of factors that could prolong graft long-term outcomes and survival. In Lithuania, approximately 90% of kidney transplantations are from deceased donors. Donor organs are received and shared only inside the country territory in Lithuania; therefore, donor data is accurate and precise. This study was performed to present particularities of kidney transplantation data in Lithuania and to identify the effect of donor and recipient factors and histologic findings on renal graft outcomes...
July 29, 2017: Medicina
https://www.readbyqxmd.com/read/28801959/outcomes-of-patients-with-atypical-hemolytic-uremic-syndrome-with-native-and-transplanted-kidneys-treated-with-eculizumab-a-pooled-post-hoc-analysis
#4
Christophe M Legendre, Josep M Campistol, Thorsten Feldkamp, Giuseppe Remuzzi, John F Kincaid, Åsa Lommelé, Jimmy Wang, Laurent E Weekers, Neil S Sheerin
Atypical hemolytic uremic syndrome (aHUS) often leads to end-stage renal disease (ESRD) and kidney transplantation; graft loss rates are high due to disease recurrence. A post hoc analysis of four prospective clinical trials in aHUS was performed to evaluate eculizumab, a terminal complement inhibitor, in patients with native or transplanted kidneys. The trials included 26-week treatment and extension periods. Dialysis, transplant, and graft loss were evaluated. Study endpoints included complete thrombotic microangiopathy (TMA) response, TMA event-free status, hematologic and renal parameters, and adverse events...
August 12, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28795150/the-effects-of-tacrolimus-on-t-cell-proliferation-are-short-lived-a-pilot-analysis-of-immune-function-testing
#5
Benjamin L Laskin, Jing Jiao, H Jorge Baluarte, Sandra Amaral, Susan L Furth, Tatiana Akimova, Wayne W Hancock, Matthew H Levine, Peter P Reese, Ulf H Beier
BACKGROUND: Optimal immunosuppression after organ transplant should balance the risks of rejection, infection, and malignancy while minimizing barriers to adherence including frequent or time-sensitive dosing. There is currently no reliable immune function assay to directly measure the degree of immunosuppression after transplantation. METHODS: We developed an immune function assay to mea//sure T-cell proliferation after exposure to immunosuppression in vivo. We tested the assay in mice, and then piloted the approach using single time point samples, 11 pediatric kidney transplant recipients prescribed tacrolimus, mycophenolate, and prednisone 6 months to 5 years posttransplant, with no history of rejection, opportunistic infection, or cancer...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28792635/favorable-results-in-abo-incompatible-renal-transplantation-without-b-cell-targeted-therapy-advantages-and-disadvantages-of-rituximab-pretreatment
#6
Manabu Okada, Yoshihiko Watarai, Kenta Iwasaki, Kenta Murotani, Kenta Futamura, Takayuki Yamamoto, Takahisa Hiramitsu, Makoto Tsujita, Norihiko Goto, Shunji Narumi, Asami Takeda, Kunio Morozumi, Kazuharu Uchida, Takaaki Kobayashi
The effectiveness of desensitization with rituximab in ABO-incompatible renal transplantation (ABO-I) has been widely reported. However, ABO-I outcomes are still worse than those of ABO-identical or ABO-compatible renal transplantation (ABO-Id/C). We retrospectively examined the outcomes in consecutive living donor ABO-Id/C (n = 412) and ABO-I (n = 205) cases to elucidate the causes of inferiority in ABO-I. ABO-I cases included recipients treated with rituximab (RIT, n = 131), splenectomy (SPX, n = 21), or neither because of low anti-A/B antibody titers (NoR/S, n = 53)...
August 9, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28790832/combination-of-sofosbuvir-and-daclatasvir-in-the-treatment-of-genotype-3-chronic-hepatitis-c-virus-infection-in-patients-on-maintenance-hemodialysis
#7
Jan Sperl, Sona Frankova, Miluse Kreidlova, Dusan Merta, Monika Tothova, Julius Spicak
Chronic hepatitis C virus infection (HCV) has a negative impact on the long-term survival of recipients of kidney transplants. HCV should be treated in hemodialyzed patients before their enlistment for kidney transplantation in order to avoid the reactivation of virus after transplantation. Direct-acting antivirals represent the current standard of care in hemodialyzed patients with HCV genotypes 1 and 4; in patients with genotypes 2 or 3, the optimal regimen is yet to be established. Sofosbuvir (SOF) and daclatasvir (DCV) represent an antiviral pangenotypic regimen with favorable pharmacokinetics in hemodialyzed patients...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28771455/confirmed-transmission-of-bacterial-or-fungal-infection-to-kidney-transplant-recipients-from-donated-after-cardiac-death-dcd-donors-in-china-a-single-center-analysis
#8
Qiquan Wan, Huanmiao Liu, Shaojun Ye, Qifa Ye
BACKGROUND We aimed to investigate blood and urine cultures of donated after cardiac death (DCD) donors and report the cases of confirmed (proven/probable) transmission of bacterial or fungal infection from donors to kidney recipients. MATERIAL AND METHODS Seventy-eight DCD donors between 2010 and 2016 were included. Sixty-one DCD donors underwent blood cultures and 22 episodes of bacteremias developed in 18 donors. Forty-three donors underwent urine cultures and 14 donors experienced 17 episodes of urinary infections...
August 3, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28762681/-novel-antiviral-agents-for-the-treatment-of-hcv-among-renal-transplant-recipients
#9
REVIEW
Fabrizio Fabrizi, Francesca M Donato, Piergiorgio Messa
The frequency of hepatitis C virus infection remains high in renal transplant recipients and plays a detrimental role on survival in this population. According to the latest evidence, the adjusted relative risk of mortality and graft loss for anti-HCV seropositive versus anti-HCV negative renal transplant recipients was 1.85 with a 95% confidence interval (CI) of 1.49 ; 2.31 (P < 0.0001) and 1.76 (95% CI, 1.46 ; 2.11) (P < 0.0001), respectively. Interferon-based regimens have been recommended for the treatment of hepatitis C after renal transplantation only in selected circumstances because of an increased risk of acute rejection due to the immuno-stimulatory properties of interferon...
August 1, 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28760516/-rare-complication-of-renal-transplantation-emphysematous-pyelonephritis
#10
Ahmed Saadi, Haroun Ayed, Omar Karray, Walid Kerkeni, Abderrazak Bouzouita, Mohamed Cherif, Riadh Ben Slama, Amine Derouiche, Mohamed Chebil
Emphysematous pyelonephritis is a necrotizing infection of the renal parenchyma and peri-renal tissues, characterized by the presence of air within the parenchyma of the urinary tract and peri-renal space. This is a severe complication, which involves the functional prognosis of the kidney and the patient's prognosis. The emphysematous pyelonephritis is a rare complication of renal transplantation. Its gravity is linked particularly to the fragility of immunosuppressed patients. The authors report the case of an emphysematous pyelonephritis having occurred 9 months after transplantation in a patient 58 years...
July 28, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28760118/renal-transplant-in-the-abnormal-bladder-long-term-follow-up
#11
Baher Salman, Ahmed Hassan, Sultan Sultan, Paul Tophill, Ahmed Halawa
OBJECTIVES: Normal urinary bladder stores urine at low pressure, does not leak, and completely empties by natural voiding. An abnormal bladder may be due to neurologic or urologic disorders that render the bladder of small capacity, of high storage pressure, or of poor compliance. The aim of this study was to determine the long-term outcomes of renal transplant in patients with abnormal bladders. MATERIALS AND METHODS: We retrospectively compared 30 transplanted kidneys in 25 patients with abnormal bladders with a control group comprising 30 grafts transplanted simultaneously during the same period of time (1990-2014) in 30 patients without bladder abnormality...
July 31, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28757006/-pulmonary-mucormycosis-in-a-patient-with-kidney-transplant-and-uncontrolled-haemoptysis
#12
Dulce Iliana Navarro Vergara, Gloria Barragán Pola, Alexandro Bonifaz, Carlos Núñez Pérez-Redondo, Omar Choreño García, Raúl Cicero Sabido
BACKGROUND: Pulmonary mucormycosis is a rare opportunistic infection with high mortality that is caused by species of Mucorales. The most common species involved are Rhizopus, Mucor, Lichtheimia, and Rhizomucor. CASE REPORT: A 56 year-old woman presented with a clinical history of diabetes mellitus type 2 and chronic renal disease. She underwent a cadaveric kidney transplantation two years before her admission, for which immunomodulating therapy with thymoglobulin, tacrolimus, mofetil-microphenolate and prednisone was established...
July 27, 2017: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/28754533/benefits-and-harms-of-treatment-of-asymptomatic-bacteriuria-a-systematic-review-and-meta-analysis-by-the-european-association-of-urology-urological-infection-guidelines-panel
#13
Bela Köves, Tommaso Cai, Rajan Veeratterapillay, Robert Pickard, Thomas Seisen, Thomas B Lam, Cathy Yuhong Yuan, Franck Bruyere, Florian Wagenlehner, Riccardo Bartoletti, Suzanne E Geerlings, Adrian Pilatz, Benjamin Pradere, Fabian Hofmann, Gernot Bonkat, Björn Wullt
People with asymptomatic bacteriuria (ABU) are often unnecessarily treated with antibiotics risking adverse effects and antimicrobial resistance. We performed a systematic review to determine any benefits and harms of treating ABU in particular patient groups. Relevant databases were searched and eligible trials were assessed for risk-of-bias and Grading of Recommendations, Assessment, Development and Education quality. Where possible, a meta-analysis of extracted data was performed or a narrative synthesis of the evidence was presented...
July 25, 2017: European Urology
https://www.readbyqxmd.com/read/28753218/a-review-of-late-complications-of-allogeneic-hematopoietic-stem-cell-transplantations
#14
REVIEW
Erden Atilla, Pinar Ataca Atilla, Selami Kocak Toprak, Taner Demirer
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an effective and curative treament of different malignant and nonmalignant diseases. Early transplant-related mortality after allo-HSCT has decreased with reduced-intensity conditioning regimens and effective anti-infectious treatments, but late transplant related mortality is still a problem. Physicians are now paying more attention to late complications that may worsen the quality of life of many transplant recipients. Chronic graft versus host disease (cGVHD) is one of the major causes of late transplant-related mortality after allo-HSCT...
July 28, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28753040/evaluation-of-sofosbuvir-velpatasvir-plus-voxilaprevir-as-fixed-dose-co-formulation-for-treating-hepatitis-c
#15
Vicente Soriano, Laura Benítez-Gutiérrez, Ana Arias, Itziar Carrasco, Pablo Barreiro, Jose M Peña, Carmen de Mendoza
The fixed-dose combination of three direct-acting antivirals (DAA), namely sofosbuvir, velpatasvir and voxilaprevir is the first pangenotypic, single tablet regimen developed for the treatment of HCV infection. Areas covered: The pharmacokinetics, pharmacodynamics, efficacy and safety of the co-formulation are reviewed. Information on drug absorption, distribution, metabolism and excretion of each of the three antivirals is evaluated. Finally, antiviral activity, safety and potential for drug interactions in phase II/III clinical trials in distinct patient populations are discussed...
July 28, 2017: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/28746204/direct-acting-antiviral-agent-efficacy-and-safety-in-renal-transplant-recipients-with-chronic-hepatitis-c-virus-infection-a-prisma-compliant-study
#16
REVIEW
Keliang Chen, Pei Lu, Rijin Song, Jiexiu Zhang, Rongzhen Tao, Zijie Wang, Wei Zhang, Min Gu
BACKGROUND: The efficacy and safety of direct-acting antivirals (DAAs) for treating hepatitis C virus (HCV)-infected renal transplant recipients (RTRs) has not been determined. METHODS: We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials and assessed the quality of eligible studies using the Joanna Briggs Institute scale. DAA efficacy and safety were assessed using standard mean difference (SMD) with 95% confidence intervals (95%CIs)...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28744628/infection-related-hospitalizations-after-kidney-transplantation-in-children-incidence-risk-factors-and-cost
#17
Julien Hogan, Christine Pietrement, Anne-Laure Sellier-Leclerc, Ferielle Louillet, Rémi Salomon, Marie-Alice Macher, Etienne Berard, Cécile Couchoud
BACKGROUND: Infection is the leading cause of death and hospitalization in renal transplant recipients. We describe posttransplant infections requiring hospitalization, their risk factors and cost in a national pediatric kidney transplantation cohort. METHODS: Data on renal transplant recipients <20 years were extracted from the French National Medicoadministrative Hospital Discharge database between 2008 and 2013 and matched with the Renal Transplant Database...
July 25, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28735999/results-of-real-time-multiplex-polymerase-chain-reaction-assay-in-renal-transplant-recipients-with-sterile-pyuria
#18
M Sarier, M Demir, S Goktas, I Duman, M Buyukkinaci, Y Yuksel, S Tekin, A H Yavuz, A Sengul
Urinary tract infections are a major cause of morbidity and hospitalization after renal transplantation. Patients treated with immunosuppressive drugs suffer not only from common uropathogens but also from opportunistic infections caused by unusual uropathogens. Sterile pyuria is associated with numerous infectious agents including viruses, fungi, and atypical or fastidious organisms. The objective of this study was to investigate the pathogens using real-time multiplex polymerase chain reaction (rtMPCR) assay in sterile pyuria of renal transplant recipients...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28731904/monoclonal-gammopathy-of-undetermined-significance-after-kidney-transplantation-single-center-experience
#19
Gaetano Alfano, Francesco Fontana, Elisabetta Colaci, Andrea Messerotti, Francesca Bettelli, Leonardo Potenza, Mario Luppi, Gianni Cappelli
BACKGROUND: Monoclonal gammopathy of undetermined significance (MGUS) is an asymptomatic premalignant plasma cell disorder. Prevalence and clinical outcomes of MGUS in kidney transplant (KT) recipients have been previously reported in few studies with conflicting results. METHODS: We conducted a retrospective study in a population of 548 KT recipients transplanted between 1998 and 2015. RESULTS: Thirty-nine subjects (8.1%) developed MGUS after KT...
July 21, 2017: Transplantation
https://www.readbyqxmd.com/read/28728576/beneficial-effect-of-kidney-transplantation-from-a-deceased-donor-on-severe-chronic-refractory-intradialytic-hypotension-a-case-report
#20
Ewa Ignacak, Dominik Cieniawski, Alina Bętkowska-Prokop, Czesław Osuch, Marek Kuźniewski, Władysław Sułowicz
BACKGROUND: Chronic refractory hypotension (IDH, intradialytic hypotension) is a rare but serious problem encountered in patients on hemodialysis. Patients with chronic hypotension are often disqualified by transplant teams from renal transplantation. This is due to the possibility of an enormous risk of ischemic complications. CASE PRESENTATION: We describe a 44-year old female patient with severe refractory hypotension (mean BP 60/30 mmHg, the lowest 48/28 mmHg), which appeared after bilateral laparoscopic nephrectomy of the infected kidneys...
July 20, 2017: BMC Nephrology
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