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Infection and renal transplantation

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https://www.readbyqxmd.com/read/28337568/hospital-microbial-surface-colonization-revealed-during-monitoring-of-klebsiella-spp-pseudomonas-aeruginosa-and-non-tuberculous-mycobacteria
#1
Pedro Geadas Farias, Fernando Gama, Diogo Reis, Susana Alarico, Nuno Empadinhas, José Carlos Martins, Ana Figueiredo de Almeida, Paula Vasconcelos Morais
Hospital environmental conditions, human occupancy, and the characteristics of the equipment influence the survival of microbial communities and raise a concern with regard to nosocomial infections. The objective of the present work was to use the monitoring of Pseudomonas aeruginosa, Klebsiella spp. and non-tuberculous mycobacteria as a strategy to improve knowledge on microbial colonization of non-critical equipment and surfaces, in a tertiary hospital from Central Portugal. A 3-month microbiological survey was performed in a district teaching hospital...
March 23, 2017: Antonie Van Leeuwenhoek
https://www.readbyqxmd.com/read/28333601/simultaneous-occurrence-of-varicella-zoster-virus-induced-pancreatitis-and-hepatitis-in-a-renal-transplant-recipient-a-case-report-and-review-of-literature
#2
Puneet Chhabra, Priyadarshi Ranjan, Deepak K Bhasin
INTRODUCTION: Gastrointestinal complications are common after renal transplantation, including oral lesions, esophagitis, gastritis, diarrhea, and colon carcinoma. The differential diagnosis is difficult in this scenario because multiple factors such as drugs, infections, and preexisting gastrointestinal disease come into play. CASE PRESENTATION: We report a case of varicella zoster virus-induced pancreatitis and hepatitis in a renal transplant recipient. The patient underwent renal transplantation 3 years earlier and now presented with severe pain in the epigastrium radiating to his back and had raised serum lipase levels and skin lesions characteristic of varicella...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28323126/elita-consensus-statements-on-use-of-daas-in-liver-transplant-candidates-and-recipients
#3
REVIEW
Luca S Belli, Christophe Duvoux, Thomas Berg, Mario Strazzabosco, Stefano Fagiuoli, Saye Khoo, Georges Philippe Pageaux, Isabelle Colle, Massimo Puoti, Audrey Coilly, Didier Samuel, Marina Berenguer
The advent of safe and highly effective direct acting antivirals (DAA) had huge implications for the HCV transplant field and changed our management of both, patients on the waiting list and those with HCV graft reinfection after Liver Transplantation (LT). When treating HCV infection before LT, HCV reinfection of the graft may be prevented in nearly all patients. In addition some candidates show a remarkable clinical improvement and are possibly delisted. Alternatively, HCV infection can be treated post LT either soon after the transplant, taking advantage of the removal of the infected native liver, or at the time of disease recurrence as done in the past...
March 18, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28321803/prognosis-of-cirrhotic-patients-admitted-to-intensive-care-unit-a-meta-analysis
#4
Delphine Weil, Eric Levesque, Marc McPhail, Rodrigo Cavallazzi, Eleni Theocharidou, Evangelos Cholongitas, Arnaud Galbois, Heng Chih Pan, Constantine J Karvellas, Bertrand Sauneuf, René Robert, Jérome Fichet, Gaël Piton, Thierry Thevenot, Gilles Capellier, Vincent Di Martino
BACKGROUND: The best predictors of short- and medium-term mortality of cirrhotic patients receiving intensive care support are unknown. METHODS: We conducted meta-analyses from 13 studies (2523 cirrhotics) after selection of original articles and response to a standardized questionnaire by the corresponding authors. End-points were in-ICU, in-hospital, and 6-month mortality in ICU survivors. A total of 301 pooled analyses, including 95 analyses restricted to 6-month mortality among ICU survivors, were conducted considering 249 variables (including reason for admission, organ replacement therapy, and composite prognostic scores)...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28321326/first-canadian-case-report-of-kidney-transplantation-from-an-hiv-positive-donor-to-an-hiv-positive-recipient
#5
Georges Ambaraghassi, Héloïse Cardinal, Daniel Corsilli, Claude Fortin, Marie-Chantal Fortin, Valérie Martel-Laferrière, Jacques Malaise, Michel R Pâquet, Danielle Rouleau
RATIONALE: Kidney transplantation has become standard of care for carefully selected patients living with human immunodeficiency virus (HIV) and end-stage renal disease (ESRD) in the highly active antiretroviral therapy (HAART) era. American and European prospective cohort studies have reported similar patient and graft survival compared with HIV-negative kidney transplant recipients. Despite an increased rate of acute rejection, partially due to drug interactions, HIV immunovirologic parameter generally remains under control during immunosuppression...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28318212/multiple-myeloma-diagnosis-and-treatment
#6
COMPARATIVE STUDY
Thomas C Michels, Keith E Petersen
Multiple myeloma accounts for 1.6% of all cancer cases and approximately 10% of hematologic malignancies in the United States. In 2015, an estimated 28,850 new cases of multiple myeloma were diagnosed in the United States, and the disease caused more than 11,000 deaths. Patients older than 65 years account for 85% of those diagnosed with multiple myeloma, and there is a twofold increased incidence in blacks compared with whites. Patients may present with bone pain or with symptoms that are often nonspecific, such as nausea, vomiting, malaise, weakness, recurrent infections, and weight loss...
March 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28317077/de-novo-cancer-in-patients-on-dialysis-and-after-renal-transplantation-north-western-italy-1997-2012
#7
Valentina Mazzucotelli, Pierluca Piselli, Diana Verdirosi, Claudia Cimaglia, Giovanni Cancarini, Diego Serraino, Silvio Sandrini
BACKGROUND: Kidney transplant recipients (KTR) are known to have a higher risk of cancer than the general population, especially of malignancies related to oncogenic viral infections. This study assessed the incidence of de novo malignancies (DNMs) in patients receiving kidney transplantation and in dialysis patients (DP) on the waiting list for transplantation at the same centre. The aim was to quantify the contribution of post-transplant immunosuppression to the underlying risk of developing a DNM in dialysis patients on the waiting list for kidney transplant...
March 19, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28316848/strongyloides-hyperinfection-in-a-renal-transplant-patient-always-be-on-the-lookout
#8
Murtaza Mazhar, Ijlal Akbar Ali, Nelson Iván Agudelo Higuita
We present a case of a 71-year-old Vietnamese man with chronic kidney disease secondary to adult polycystic kidney disease. He had been a prisoner of war before undergoing a successful cadaveric renal transplant in the United States. He presented to clinic one year after the transplant with gross hematuria, productive cough, intermittent chills, and weight loss. Long standing peripheral eosinophilia of 600-1200/μL triggered further evaluation. A wet mount of stool revealed Strongyloides stercoralis larvae...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28316844/aspergillus-pericarditis-with-tamponade-in-a-renal-transplant-patient
#9
Sylvia Biso, Rapeepat Lekkham, Antoinette Climaco
Aspergillus pericarditis is a rare and life-threatening infection in immunosuppressed patients. It has nonspecific clinical manifestations that often mimic other disease entities especially in patients who have extensive comorbidities. Diagnosis is oftentimes delayed and rarely done antemortem. A high degree of suspicion in immunocompromised patients is necessary for evaluation and timely diagnosis. This is a case of Aspergillus pericarditis with cardiac tamponade in a renal transplant patient with liver cirrhosis...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28315744/cardiac-implantable-electronic-device-infections-who-is-at-greatest-risk
#10
Parijat Saurav Joy, Gagan Kumar, Jeanne E Poole, Barry London, Brian Olshansky
BACKGROUND: Cardiac Implantable Electronic Device (CIED) infections are associated with hospitalization, mortality, increased costs and adverse outcomes. OBJECTIVE: Determine the burden of infections for CIEDs based on device type, associated comorbidities and clinical characteristics over a 12-year period. METHODS: Utilizing the National Inpatient Sample database from 2000-2012, procedures for device related infection (DRI) were identified using ICD-9-CM code for CIED removal with diagnosis codes for device-related infection or systemic infection...
March 15, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28298471/bk-polyomavirus-clinical-aspects-immune-regulation-and-emerging-therapies
#11
REVIEW
George R Ambalathingal, Ross S Francis, Mark J Smyth, Corey Smith, Rajiv Khanna
BK polyomavirus (BKV) causes frequent infections during childhood and establishes persistent infections within renal tubular cells and the uroepithelium, with minimal clinical implications. However, reactivation of BKV in immunocompromised individuals following renal or hematopoietic stem cell transplantation may cause serious complications, including BKV-associated nephropathy (BKVAN), ureteric stenosis, or hemorrhagic cystitis. Implementation of more potent immunosuppression and increased posttransplant surveillance has resulted in a higher incidence of BKVAN...
April 2017: Clinical Microbiology Reviews
https://www.readbyqxmd.com/read/28296195/evaluation-of-the-infection-risk-in-dialysis-and-chronic-kidney-disease-patients-using-an-atp-monitoring-assay
#12
Junichi Kusano, Rei Kato, Hiroto Matsuda, Yoshikazu Hara, Yoshiaki Fujii, Shinya Suzuki, Masao Sekiyama, Eiki Ando, Kentaro Sugiyama, Toshihiko Hirano
The ATP monitoring assay is a useful biomarker for risk monitoring to detect infection and rejection episodes in transplant recipients. Hemodialysis patients have a higher rate of infectious mortality. Infections in hemodialysis patients are mainly caused by venous catheters, uremia, malnutrition and inflammation. However, the risk of infection episodes has not been evaluated using a lymphocyte ATP monitoring assay in hemodialysis and chronic kidney disease (CKD) patients. We measured the ATP amounts in the peripheral CD4+ cells of CKD (N = 85) and dialysis patients (N = 17) using an "Immuknow" assay kit...
March 13, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28296035/sepsis-after-renal-transplantation-clinical-immunological-and-microbiological-risk-factors
#13
Thomas Schachtner, Maik Stein, Petra Reinke
BACKGROUND: As immunosuppressive therapy and allograft survival have improved, the increased incidence of sepsis has become a major hurdle of disease-free survival after renal transplantation. METHODS: We identified 112 of 957 kidney transplant recipients (KTRs) with sepsis. 31 KTRs developed severe sepsis or septic shock, and 30 KTRs died from sepsis. KTRs without sepsis were used for comparison. CMV-specific and alloreactive T-cells were measured using an interferon-γ Elispot-assay...
March 11, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28295968/nosocomial-bk-polyomavirus-infection-causing-hemorrhagic-cystitis-among-patients-with-hematological-malignancies-after-hematopoietic-stem-cell-transplantation
#14
Jun Kato, Takehiko Mori, Tetsuro Suzuki, Masahiko Ito, Tian-Cheng Li, Masatoshi Sakurai, Yusuke Yamane, Rie Yamazaki, Yuya Koda, Takaaki Toyama, Naoki Hasegwa, Shinichiro Okamoto
BK polyomavirus (BKPyV) is recognized as a pathogen that causes diseases such as hemorrhagic cystitis and nephritis after allogeneic hematopoietic stem cell transplantation (HSCT) or renal transplantation. BKPYV-associated disease is thought to occur through reactivation under immunosuppression. However, the possibility of its nosocomial transmission and the clinical significance of such transmission have not been elucidated. During a 6-month period, 9 adult patients (median age: 47 years) with hematological disorders who were treated with HSCT (N=7) or chemotherapy (N=2) in a single hematology department developed hemorrhagic cystitis due to BKPYV infection...
March 14, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28295622/low-vitamin-d-exposure-is-associated-with-higher-risk-of-infection-in-renal-transplant-recipients
#15
Hari V Kalluri, Lauren M Sacha, Amanda I Ingemi, Michael A Shullo, Heather J Johnson, Puneet Sood, Amit D Tevar, Abhinav Humar, Raman Venkataramanan
BACKGROUND: Vitamin-D is a steroid hormone with multiple vital roles within the immune system. Various studies evaluated the influence of vitamin-D on infections post-renal transplantation and found contrasting results. This study aims to assess the relationship between vitamin-D status and the incidence of infection in renal transplant recipients. METHODS: This is a retrospective cohort study of adult renal transplant recipients at the University of Pittsburgh Medical Center between 2005 and 2012...
March 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28295601/idiopathic-hyperammonemia-after-solid-organ-transplantation-primarily-a-lung-problem-a-single-center-experience-and-systematic-review
#16
Dustin Krutsinger, Alejandro Pezzulo, Amy E Blevins, Robert M Reed, Michael Voigt, Michael Eberlein
BACKGROUND: Idiopathic hyperammonemia syndrome (IHS) is an uncommon, often deadly complication of solid organ transplantation. IHS cases in solid organ transplantation seem to occur predominantly in lung transplant (LTx) recipients. However to the best of our knowledge the occurrence of IHS has not been systematically evaluated. We set out to identify all reported cases of IHS following non-liver solid organ transplantations. METHODS: Retrospective review of our institutional experience and systematic review of the literature...
March 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28288014/the-times-they-are-a-changing-hope-for-hiv-to-hiv-organ-transplantation
#17
Ghady Haidar, Nina Singh
HIV-infected persons who achieve undetectable viral loads on antiretroviral therapy currently have near-normal lifespans. Liver disease is a major cause of non-AIDS-related deaths, and as a result of longer survival, the prevalence of end-stage renal disease in HIV is increasing. HIV-infected persons undergoing organ transplantation generally achieve comparable patient and graft survival rates compared to their HIV-uninfected counterparts, despite a nearly threefold increased risk of acute rejection. However, the ongoing shortage of suitable organs can limit transplantation as an option, and patients with HIV have higher waitlist mortality than others...
March 1, 2017: Transplantation
https://www.readbyqxmd.com/read/28285802/long-term-prognosis-and-cost-effectiveness-of-left-ventricular-assist-device-as-bridge-to-transplantation-a-systematic-review
#18
Michael Seco, Dong Fang Zhao, Michael J Byrom, Michael K Wilson, Michael P Vallely, John F Fraser, Paul G Bannon
BACKGROUND: This systematic review aimed to evaluate the clinical outcomes and cost-effectiveness of left ventricular assist devices (LVADs) used as bridge to transplantation (BTT), compared to orthotopic heart transplantation (OHT) without a bridge. METHOD: Systematic searches were performed in electronic databases with available data extracted from text and digitized figures. Meta-analysis of short and long-term term post-transplantation outcomes was performed with summation of cost-effectiveness analyses...
May 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28281085/efficacy-and-safety-of-sofosbuvir-based-regimens-in-chronic-hepatitis-c-patients-on-dialysis
#19
Narendra S Choudhary, Amit Kumar, Vijay Bodh, Shyam Bihari Bansal, Reetesh Sharma, Manish Jain, Sanjiv Saigal, Neeraj Saraf
INTRODUCTION: Patients with end-stage renal disease (ESRD) have poor treatment tolerance and outcome to interferon-based regimens. Sofosbuvir-based regimens have improved treatment success in chronic hepatitis C. There is limited data in ESRD patients as sofosbuvir is excreted by the kidney. Several small studies have shown good results. METHODS: Sixteen consecutive patients of ESRD (on dialysis) and chronic hepatitis C were treated with sofosbuvir-based regimens as they were prospective kidney transplantation recipients, at a tertiary care center in north India...
March 9, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28280938/viral-load-of-ebv-dnaemia-is-a-predictor-of-ebv-related-post-transplant-lymphoproliferative-disorders-in-pediatric-renal-transplant-recipients
#20
Elisa Colombini, Isabella Guzzo, Federica Morolli, Germana Longo, Cristina Russo, Alessandra Lombardi, Pietro Merli, Luisa Barzon, Luisa Murer, Simone Piga, Marta Luisa Ciofi Degli Atti, Franco Locatelli, Luca Dello Strologo
BACKGROUND: Post-transplant lymphoproliferative disorder (PTLD) is a severe complication of solid organ transplantation that can be classified into two major subtypes, namely, early lesions and non-early lesions, based on histopathological findings. In the vast majority of cases, proliferating cells are B lymphocytes and, most frequently, proliferation is induced by Epstein-Barr virus (EBV) infection. METHODS: The aim of our study was to evaluate the natural history of EBV infection and its possible evolution toward PTLD in a pediatric cohort of patients who received a renal transplant between January 2000 and December 2013...
March 9, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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