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infection renal transplant

Eva Schrezenmeier, Kayin Wu, Fabian Halleck, Lutz Liefeldt, Susanne Brakemeier, Friederike Bachmann, Susanne Kron, Klemens Budde, Michael Duerr
Recurrence of hepatitis C virus (HCV)-associated membranoproliferative glomerulonephritis (MPGN) in the kidney transplant may lead to continuous graft deterioration and the need for further renal replacement therapy. The novel direct acting antiviral agents (DAAs) allow a highly effective and interferon-free treatment option for chronic HCV infected patients. Data on the therapeutic safety and efficacy in HCV infected renal transplant patients are sparse, especially for patients with severe renal impairment...
October 25, 2016: American Journal of Transplantation
Deirdre Sawinski
HIV+ patients are at increased risk for end-stage renal disease, but HIV infection was once considered a contraindication to renal transplantation. However, contemporary studies from the United States and Europe have now demonstrated that renal transplantation is a safe and effective treatment for end-stage renal disease in HIV patients, with equivalent patient and allograft survival to those uninfected. Broader experience in transplantation in HIV+ patients has identified unique challenges including high rates of acute rejection, delayed graft function, and significant drug-drug interactions...
October 11, 2016: Transplantation Reviews
Mani Nagarajan, Sakthirajan Ramanathan, Jeyachandran Dhanapriya, Thanigachalam Dineshkumar, T Bala Subramaniyan, Natarajan Gopalakrishnan
BACKGROUND: Acute kidney injury (AKI) is one of the major determinants of graft survival in kidney transplantation (KTx). Renal Transplant recipients are more vulnerable to develop AKI than general population. AKI in the transplant recipient differs from community acquired, in terms of risk factors, etiology and outcome. Our aim was to study the incidence, risk factors, etiology, outcome and the impact of AKI on graft survival. METHODS: A retrospective analysis of 219 renal transplant recipients (both live and deceased donor) was done...
October 24, 2016: Renal Failure
Sanjay K Agarwal, Dipankar Bhowmik, Sandeep Mahajan, Soumita Bagchi
INTRODUCTION: Tuberculosis (TB) is an important cause of morbidity and mortality in renal transplant recipient (RTR). Immunosuppressive drugs are one of the most important risk factor for post-transplant tuberculosis (PTTB). A paucity of data exists about the impact of the type of calcineurin inhibitor on PTTB. METHODS: In this retrospective study, all adult patients on calcineurin inhibitor-based immunosuppression were included. Patients receiving TB chemoprophylaxis were excluded...
October 24, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Annabelle Pourbaix, Nacera Ouali, Patrick Soussan, Anne Marie Roque Afonso, Marie-Noelle Péraldi, Eric Rondeau, Julie Peltier
Hepatitis E virus (HEV) can cause chronic infection among immunocompromised patients, especially solid organ transplant (SOT) recipients, and can evolve to cirrhosis. Several modes of transmission are known. Here we describe the first 2 cases, to our knowledge, of HEV infection transmitted by a kidney graft from the same infected donor that led to chronic hepatitis. Consequently, systematic screening of donors by HEV serology and HEV RNA detection by polymerase chain reaction, particularly in endemic regions, should be considered...
October 24, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Yuriy Pya, Makhabbat Bekbossynova, Saltanat Jetybayeva, Serik Bekbossynov, Saltanat Andossova, Roman Salov, Assel Medressova, Svetlana Novikova, Muradym Murzagaliyev
AIMS: The need for the left ventricular assist devices (LVAD) in patients with end-stage heart failure is well established, but prior to 2011, this was not available to patients in Kazakhstan. We describe the development of the sole LVAD programme in the context of a nascent heart transplantation programme and clinical outcomes for the first three years. METHODS AND RESULTS: From November 2011 to November 2014, 146 patients underwent implantation of 152 VADs (approximately 50 devices implanted per year)...
March 2016: ESC Heart Failure
Kathleen O Degnan, Emily A Blumberg
Patients infected with human immunodeficiency virus (HIV) are living longer, healthier lives on highly active antiretroviral therapy and, as a result, interest in kidney transplantation for HIV-infected patients with end-stage renal disease has increased. HIV is no longer considered a contraindication to solid-organ transplantation and the number of kidney transplants performed in HIV-infected patients each year is increasing steadily. HIV-infected kidney transplant recipients have had excellent outcomes overall, but there are still significant challenges, including high rates of acute rejection, drug-drug interactions, and poor outcomes in patients co-infected with hepatitis C virus...
September 2016: Seminars in Nephrology
Kiran Gajurel, Jack T Stapleton
Hepatitis viruses are named for their primary clinical illness, inflammation of the liver. Currently, six types of viruses are designated hepatitis viruses (A, B, C, D, E, and G), although only five of these cause hepatitis. Hepatitis viruses are composed of RNA and DNA viruses from different families and with different virologic properties, some of which typically cause acute hepatitis while others cause acute and chronic hepatitis. In addition to their role in liver disease, members of this group of viruses may cause a variety of pathologic changes in the kidney and other organs, and chronic infection may lead to cirrhosis in addition to raising a variety of important issues in the management of kidney transplant recipients...
September 2016: Seminars in Nephrology
Jennifer Trofe-Clark, Deirdre Sawinski
For more than 40 years, polyomaviruses (BK virus and JC virus) have been known to cause disease in human beings. Recently, 11 new polyomaviruses were discovered. However, the majority of these viruses are rare in renal transplant recipients and BK and JC viruses remain the most important polyomaviruses to impact this population. BK virus presents as BK virus nephropathy and has, in rare instances, been associated with hemorrhagic cystitis or ureteral strictures. JC virus can cause progressive multifocal leukoencephalopathy or nephropathy in this population as well, but is uncommon...
September 2016: Seminars in Nephrology
Cybele Lara Abad, Raymund R Razonable
The α herpes viruses HSV-1, HSV-2, and VZV often reactivate in the setting of immune suppression after solid organ transplantation. Oral or genital mucocutaneous disease is the most common clinical manifestation of HSV disease while VZV manifests as varicella (or chickenpox) or reactivation herpes zoster, characterized by a diffuse rash, or a painful unilateral vesicular eruption in a dermatomal distribution, respectively. The diagnosis of HSV and VZV is primarily based on history and clinical presentation, although diagnostic tests may be necessary for atypical presentations of disease...
September 2016: Seminars in Nephrology
Jayme E Locke, Sally Gustafson, Shikha Mehta, Rhiannon D Reed, Brittany Shelton, Paul A MacLennan, Christine Durand, Jon Snyder, Nicholas Salkowski, Allan Massie, Deirdre Sawinski, Dorry L Segev
OBJECTIVE: To determine the survival benefit of kidney transplantation in human immunodeficiency virus (HIV)-infected patients with end-stage renal disease (ESRD). SUMMARY BACKGROUND DATA: Although kidney transplantation (KT) has emerged as a viable option for select HIV-infected patients, concerns have been raised that risks of KT in HIV-infected patients are higher than those in their HIV-negative counterparts. Despite these increased risks, KT may provide survival benefit for the HIV-infected patient with ESRD, yet this important clinical question remains unanswered...
April 26, 2016: Annals of Surgery
Valentina Talarico, Monica Aloe, Alice Monzani, Roberto Miniero, Gianni Bona
Hemolytic uremic syndrome (HUS) is a thrombotic microangiopathy defined by thrombocytopenia, non-immune microangiopathic hemolytic anemia and acute renal failure. HUS is typically classified into two primary types: 1) HUS due to infections, often associated with diarrhea (D+HUS, Shiga toxin-producing Escherichia Coli-HUS), with the rare exception of HUS due to a severe disseminated infection caused by Streptococcus; 2) HUS related to complement, such HUS is also known as "atypical HUS" and is not diarrhea associated (D-HUS, aHUS); but recent studies have shown other forms of HUS, that can occur in the course of systemic diseases or physiopathological conditions such as pregnancy, after transplantation or after drug assumption...
December 2016: Minerva Pediatrica
Meghan B Brennan, Barbara L Herwaldt, James J Kazmierczak, John W Weiss, Christina L Klein, Catherine P Leith, Rong He, Matthew J Oberley, Laura Tonnetti, Patricia P Wilkins, Gregory M Gauthier
Babesia microti, an intraerythrocytic parasite, is tickborne in nature. In contrast to transmission by blood transfusion, which has been well documented, transmission associated with solid organ transplantation has not been reported. We describe parasitologically confirmed cases of babesiosis diagnosed ≈8 weeks posttransplantation in 2 recipients of renal allografts from an organ donor who was multiply transfused on the day he died from traumatic injuries. The organ donor and recipients had no identified risk factors for tickborne infection...
November 2016: Emerging Infectious Diseases
Allison Ducharme-Smith, Ben Z Katz, Amy E Bobrowski, Carl L Backer, Elfriede Pahl
BKV infection and nephropathy complicate pediatric HTx, but the incidence and time course of the disease are unknown. We assessed the incidence of BKV infection and its association with kidney dysfunction in pediatric HTx recipients. A single center prospective study compared pediatric (<18 years) HTx recipients, with and without BKV infection, who received an allograft between September 2013 and December 2014. Screening of urine for BKV was performed prior to transplant, and at week 1, and at months 3, 6, 9, 12, and 15 months post-transplantation...
October 20, 2016: Pediatric Transplantation
Saurabh Chaudhri, Alice A Thomas, Nasreen Samad, Stanley L Fan
AIM: To determine if patients with failing kidney transplants who opt to have peritoneal dialysis (PD) have poor short-term PD technique survival and increased rates of peritonitis. METHODS: We performed a retrospective analysis comparing 50 consecutive patients starting PD after a failed kidney transplant to 93 incident patients starting PD (matching for age, gender, diabetes causing renal failure, ethnicity and year of starting PD). RESULTS: The mean follow-up period was 26 months...
October 20, 2016: Nephrology
Masayoshi Okumi, Yasuyuki Sato, Kohei Unagami, Toshihito Hirai, Hideki Ishida, Kazunari Tanabe
BACKGROUND: The reasons for improved outcomes associated with preemptive kidney transplantation (PKT) are incompletely understood, and post-transplant complications have been scarcely investigated. METHODS: We evaluated the outcomes of PKT in both unmatched (n = 1060) and propensity score matched cohorts (n = 186) of adults who underwent living kidney transplant between 2000 and 2014. Outcomes were estimated glomerular filtration rate (eGFR), biopsy-proven rejection, cytomegalovirus (CMV) infection, post-transplant diabetes mellitus (PTDM), cardiovascular disease (CVD), graft failure (non-censored for death), and malignancy...
October 19, 2016: Clinical and Experimental Nephrology
Kohei Naoki, Hideaki Takada, Kosuke Hishiki, Yoshiharu Nakashima, Koji Yoshimura, Yasunori Nishio, Kenta Ito, Ken Matsuo, Noriko Mori
A 24-year-old woman with a high fever presented at our hospital. She had been diagnosed with Kabuki syndrome at the age of 4 years because she had the typical facial features of the condition ; she had undergone living donor renal transplantation 12 years prior. She was prescribed a course of antibiotics to treat pyelonephritis of the transplanted kidney and the high fever disappeared, but the fever developed again 3 days after the discharge. Abdominal computed tomography revealed a tubular structure of recent onset running from the left dorsal side to the lower part of the bladder...
September 2016: Hinyokika Kiyo. Acta Urologica Japonica
Arvind U Gowda, Colton H L McNichols, Ishan Asokan, Jamil A Matthews, E Bryan Buckingham, Jennifer Sabino, John S Maddox, Sheri Slezak, Yvonne Rasko, Devinder P Singh
PURPOSE: The purpose of this study was to compare clinical outcomes of incisional hernia repair in solid organ transplant patients using non-cross-linked porcine acellular dermal matrix (PADM), human derived acellular dermal matrix (HADM) and synthetic mesh. METHODS: A retrospective review of patients who underwent hernia repair with PADM after pancreas and/or renal transplant at the University of Maryland Medical Center from 2008 to 2012 was conducted. Repair type, postoperative infection, hernia recurrence, mesh removal, and length of follow-up were recorded...
October 17, 2016: Annals of Plastic Surgery
Hanneke de Kort, Kirstin M Heutinck, Jurjen M Ruben, Alessa E Valverde da Silva, Katja C Wolthers, Jörg Hamann, Ineke J M Ten Berge
BACKGROUND: BK polyomavirus (BKV)-associated nephropathy is a threat to kidney allograft survival affecting up to 15% of renal transplant patients. Previous studies revealed that tubular epithelial cells (TEC) show a limited response towards BKV infection. Here we investigated the interplay between BKV and TEC in more detail. In particular, we questioned whether BKV suppresses and/or evades antiviral responses. METHODS: Human primary tubular epithelial cells (TEC) and peripheral blood mononuclear cells were infected with BKV Dunlop strain or other viruses...
October 17, 2016: Transplantation
G Varela-Fascinetto, C Benchimol, R Reyes-Acevedo, M Genevray, D Bradley, J Ives, H T Silva
This multicenter, open-label study evaluated the tolerability of extended prophylaxis with valganciclovir in pediatric kidney transplant recipients at risk of CMV disease. Fifty-six patients aged 4 months to 16 years received once-daily valganciclovir oral solution and/or tablets, dosed by BSA and renal function, for up to 200 days. The most common AEs on treatment were upper respiratory tract infection (33.9%), urinary tract infection (33.9%), diarrhea (32.1%), leukopenia (25.0%), neutropenia (23.2%), and headache (21...
October 17, 2016: Pediatric Transplantation
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