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https://www.readbyqxmd.com/read/29775554/outcomes-and-predictors-of-early-infection-after-heart-transplantation
#1
Kendall C Shultes, Jerrica E Shuster, Scott Micek, Justin M Vader, Keki Balsara, Akinobu Itoh, Bethany R Tellor
BACKGROUND: Limited data exist on the incidence and outcome of early infection after orthotopic heart transplantation (OHT). The purpose of this study was to describe characteristics and outcomes of OHT recipients with an early infection and to identify predictors of such infections. METHODS: This retrospective, single-center study included patients greater than 18 years of age who underwent OHT from February 2009 to May 2014 and had an infection within 30 days of transplantation...
May 18, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29771270/effect-of-conversion-from-calcineurin-inhibitors-to-everolimus-on-hepatitis-c-viremia-in-adult-kidney-transplant-recipients
#2
Larissa Sgaria Pacheco, Valter Duro Garcia, Ronivan Luis Dal Prá, Bruna Doleys Cardoso, Mariana Ferras Rodrigues, Helen Kris Zanetti, Gisele Meinerz, Jorge Neumann, Diego Gnatta, Elizete Keitel
INTRODUCTION: Currently, there is no specific immunosuppressive protocol for hepatitis C (HCV)-positive renal transplants recipients. Thus, the aim of this study was to evaluate the conversion effect to everolimus (EVR) on HCV in adult kidney recipients. METHOD: This is an exploratory single-center, prospective, randomized, open label controlled trial with renal allograft recipients with HCV-positive serology. Participants were randomized for conversion to EVR or maintenance of calcineurin inhibitors...
May 14, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29765170/bk-virus-induced-renal-allograft-nephropathy
#3
Karel Krejci, Tomas Tichy, Jana Bednarikova, Kamil Zamboch, Josef Zadrazil
BK virus nephropathy (BKVN) is a serious opportunistic infection threatening renal function especially during the first year after transplantation. Its incidence is now on the rise and is closely related to the level of the recipient's immune system inhibition. This is more intensive with current trends in transplantation medicine, where more potent immunosuppressive protocols are used and more aggressive antirejection therapy is applied. In the absence of BK virus (BKV) specific therapy and limited treatment options for advanced BKVN, active screening of BKV replication and subsequent preemptive adjustment of immunosuppression are essential measures to prevent BKVN...
May 16, 2018: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/29761588/infection-is-the-chief-cause-of-mortality-and-non-death-censored-graft-loss-in-the-first-year-after-renal-transplantation-in-a-resource-limited-population-a-single-center-study
#4
Vikraman G, Sanjay Kumar Agarwal, Sandeep Agarwal, Sandeep Mahajan, Dipankar Bhowmik, Soumita Bagchi
BACKGROUND: Few studies have assessed the impact of infections after renal transplantation (RTX) in low and middle income countries. This single center study aimed to delineate the profile and impact of infections requiring hospitalisation (IRH) occurring in the first year after RTX in India. METHOD: Patients who underwent RTX between July 2012 and June 2015 were followed up for 12 months after transplantation. RESULTS: 60.2% of the 387 patients studied had atleast one IRH and total 492 infections were diagnosed...
May 14, 2018: Nephrology
https://www.readbyqxmd.com/read/29757021/advagraf%C3%A2-with-or-without-an-induction-therapy-for-de-novo-kidney-transplant-recipients
#5
Johan Noble, Thomas Jouve, Lionel Rostaing, Paolo Malvezzi
Cornerstone immunosuppressive therapy currently relies on immediate-release tacrolimus, a calcineurin inhibitor (CNI) that is potentially nephrotoxic and is more diabetogenic than cyclosporine A. Two new formulations of tacrolimus have been launched: an extended-release formulation (Advagraf®/Astagraf XL®, Astellas company) and a long-lasting formulation (Envarsus®, Veloxis company). Area covered: Herein, we assess the efficacy of an extended-release formulation of tacrolimus (Advagraf®/Astagraf XL®) used in conjunction with or without an induction therapy (i...
May 14, 2018: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/29752413/everolimus-with-reduced-calcineurin-inhibitor-exposure-in-renal-transplantation
#6
Julio Pascual, Stefan P Berger, Oliver Witzke, Helio Tedesco, Shamkant Mulgaonkar, Yasir Qazi, Steven Chadban, Federico Oppenheimer, Claudia Sommerer, Rainer Oberbauer, Yoshihiko Watarai, Christophe Legendre, Franco Citterio, Mitchell Henry, Titte R Srinivas, Wen-Lin Luo, AnaMaria Marti, Peter Bernhardt, Flavio Vincenti
Background Everolimus permits reduced calcineurin inhibitor (CNI) exposure, but the efficacy and safety outcomes of this treatment after kidney transplant require confirmation. Methods In a multicenter noninferiority trial, we randomized 2037 de novo kidney transplant recipients to receive, in combination with induction therapy and corticosteroids, everolimus with reduced-exposure CNI (everolimus arm) or mycophenolic acid (MPA) with standard-exposure CNI (MPA arm). The primary end point was treated biopsy-proven acute rejection or eGFR<50 ml/min per 1...
May 11, 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29748841/characteristics-of-pulmonary-mucormycosis-and-predictive-risk-factors-for-the-outcome
#7
Jun Feng, Xuefeng Sun
PURPOSE: Little is known about risk factors for the outcome of pulmonary mucormycosis. We summarized characteristics of this rare disease, and systemically explored risk factors for the outcome. METHODS: Ninety-two patients with pulmonary mucormycosis, including 12 patients at Peking Union Medical College Hospital and 80 patients published in 62 articles between 2006 and 2016, were retrospectively analyzed. RESULTS: The median age was 47.5 years, and the male to female ratio was 2...
May 10, 2018: Infection
https://www.readbyqxmd.com/read/29748530/bk-virus-a-cause-for-concern-in-thoracic-transplantation
#8
Markus J Barten, Andreas Zuckermann
Human BK polyomavirus (BKV) infection is poorly documented in heart and lung transplant patients. BK viruria and viremia have been estimated to affect 19% and 5% of heart transplant recipients, respectively. Data are limited, especially for lung transplantation, but the proportion of patients progressing from BK viruria to viremia or BKV-related nephropathy (BKVN) appears lower than in kidney transplantation. Nevertheless, a number of cases of BKVN have been reported in heart and lung transplant patients, typically with late diagnosis and generally poor outcomes...
May 11, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29746814/a-case-series-on-the-use-of-levonorgestrel-52mg-intrauterine-system-after-organ-transplant
#9
Cassia R T Juliato, Paulo Stahlscmidt, Arlete Fernandes, Ilza Monteiro, Luis Bahamondes
OBJECTIVE: To assess the clinical performance (pregnancy and occurrence of pelvic infection) of the levonorgestrel 52-mg intrauterine system (LNG IUS) in solid organ transplant recipients. STUDY DESIGN: We performed a retrospective chart review of all patients seen in the Family Planning Clinic at the University of Campinas Department of Obstetrics and Gynecology from 2007-2017 to identify women with solid organ transplantation using immunosuppression who received a LNG- IUS...
May 7, 2018: Contraception
https://www.readbyqxmd.com/read/29743501/a-phase-i-clinical-trial-with-ex-vivo-expanded-recipient-regulatory-t-cells-in-living-donor-kidney-transplants
#10
James M Mathew, Jessica H-Voss, Ann LeFever, Iwona Konieczna, Cheryl Stratton, Jie He, Xuemei Huang, Lorenzo Gallon, Anton Skaro, Mohammed Javeed Ansari, Joseph R Leventhal
There is considerable interest in therapeutic transfer of regulatory T cells (Tregs) for controlling aberrant immune responses. Initial clinical trials have shown the safety of Tregs in hematopoietic stem cell transplant recipients and subjects with juvenile diabetes. Our hypothesis is that infusion(s) of Tregs may induce transplant tolerance thus avoiding long-term use of toxic immunosuppressive agents that cause increased morbidity/mortality. Towards testing our hypothesis, we conducted a phase I dose escalation safety trial infusing billions of ex vivo expanded recipient polyclonal Tregs into living donor kidney transplant recipients...
May 9, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29738028/quantitative-detection-of-bk-virus-in-kidney-transplant-recipients-a-prospective-validation-study
#11
Gabriel Godinho Pinto, José Antonio Tesser Poloni, Diego D'Avila Paskulin, Fabio Spuldaro, Fernanda de Paris, Afonso Luís Barth, Roberto Ceratti Manfro, Elizete Keitel, Alessandro C Pasqualotto
INTRODUCTION: BK virus (BKV) infection in renal transplant patients may cause kidney allograft dysfunction and graft loss. Accurate determination of BKV viral load is critical to prevent BKV-associated nephropathy (BKVAN) but the cut-off that best predicts BKVAN remains controversial. OBJECTIVE: To evaluate the performance of a commercial and an in-house qPCR test for quantitative detection of BK virus in kidney transplant recipients. METHODS: This was a prospective study with kidney transplant recipients from two large university hospitals in Brazil...
April 19, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29735575/acute-and-persistent-hepatitis-e-virus-genotype-3-and-4-infection-clinical-features-pathogenesis-and-treatment
#12
Nassim Kamar, Sven Pischke
Hepatitis E virus (HEV) genotype (gt)3 and 4 infections are prevalent in industrialized and high-income countries. Although most HEV gt3 and gt4 infections are clinically silent, acute infection may be symptomatic in some patients. In persons with underlying liver disease and in elderly men, HEV infections may present as acute or acute-on-chronic liver failure. Chronic hepatitis may develop in immunosuppressed individuals, including transplant recipients, human immunodeficiency virus (HIV)-infected patients, and persons with hematologic malignancy undergoing chemotherapy, and may progress to life-threatening liver cirrhosis...
May 7, 2018: Cold Spring Harbor Perspectives in Medicine
https://www.readbyqxmd.com/read/29731096/causes-of-ineligibility-for-recipients-in-living-kidney-transplantation
#13
N Masaki, K Iwadoh, A Kondo, I Koyama, I Nakajima, S Fuchinoue
BACKGROUND: Even if a living donor candidate exists, there are some cases that do not result in kidney transplantation (KTx) due to problems on the recipient side. The aim of this study was to clarify causes of ineligibility for KTx in these cases, so as to make RTx more applicable for patients. METHODS: We targeted 470 patients with end-stage renal disease who applied for the primary kidney KTx from 2010 to 2012. Then we selected those who were not applicable for KTx and investigated recipient causes of ineligibility for KTx or not receiving KTx...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29729061/side-effects-and-efficacy-of-renal-sparing-immunosuppression-in-pediatric-liver-transplantation-a-single-center-matched-cohort-study
#14
Christoph Leiskau, Jeremy Rajanayagam, Eva-Doreen Pfister, Imeke Goldschmidt, Norman Junge, André Karch, Christian Lerch, Nicolas Richter, Frank Lehner, Harald Schrem, Ulrich Baumann
Immunosuppressive combination therapy with MMF can reduce CNI associated nephrotoxicity. We investigated effectiveness and safety of de novo MMF-tacrolimus based immunosuppression after pLTx. Patients after pLTx receiving immunosuppression with MMF/tacrolimus (MMF/TAC) were compared to retrospectively selected age- and diagnosis-matched patients with tacrolimus monotherapy (TAC) and cyclosporine/prednisolone therapy (CSA) (19 patients each, n = 57). Effectiveness, renal function and side effects were analyzed for 1 year after pLTx...
May 5, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29720098/tigecycline-induced-acute-pancreatitis-in-a-renal-transplant-patient-a-case-report-and-literature-review
#15
Jinwen Lin, Rending Wang, Jianghua Chen
BACKGROUND: The purpose of this case report is to increase the awareness of tigecycline-induced pancreatitis specifically in renal transplant patients predisposed to the condition. CASE PRESENTATION: A 48-year-old woman developed a donor-derived infection after kidney transplantation, resulting in a ruptured graft renal artery, followed by peritoneal drainage, blood and urine culture infections. Due to multiple drug resistance Acinetobacter baumannii cultured from the preservation fluid and blood, she was treated with tigecycline at the 8th post-transplant day combined with other antibiotics...
May 2, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29716597/hepatitis-e-virus-infection-in-turkey-a-systematic-review
#16
REVIEW
Hakan Leblebicioglu, Resat Ozaras
Hepatitis E virus (HEV), a non-enveloped single stranded RNA virus causes sporadic cases of hepatitis or outbreaks. The disease is generally self-limited although it may cause fulminant hepatitis in pregnant women, elderly, those with underlying chronic hepatitis, immunosuppressed, and transplant recipients. It is transmitted through fecal-oral route and zoonotic transmission. Hepatitis is a main health care problem in Turkey; HBV and HCV prevalences are 4 and 1% respectively. Hepatitis D represents another considerable hepatitis etiology with a prevalence of 5-27%...
May 2, 2018: Annals of Clinical Microbiology and Antimicrobials
https://www.readbyqxmd.com/read/29709681/class-iii-obesity-is-a-risk-factor-for-the-development-of-acute-on-chronic-liver-failure-in-patients-with-decompensated-cirrhosis
#17
Vinay Sundaram, Rajiv Jalan, Joseph C Ahn, Michael R Charlton, David S Goldberg, Constantine J Karvellas, Mazen Noureddin, Robert Wong
BACKGROUND AND AIMS: Acute on chronic liver failure (ACLF) is a syndrome of systemic inflammation and organ failures. Obesity, also characterized by chronic inflammation, is a risk factor among patients with cirrhosis for decompensation, infection, and mortality. Our aim was to test the hypothesis that obesity predisposes to ACLF development in patients with decompensated cirrhosis. METHODS: We examined the United Network for Organ Sharing (UNOS) database, from 2005-2016, characterizing patients at wait-listing as non-obese (BMI < 30), obese class I-II (BMI 30-39...
April 27, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29709266/saprochaete-capitata-geotrichum-capitatum-an-emerging-fungal-infection-in-kidney-transplant-recipients
#18
N Rizk, Z Hajar, W Medawar
We are reporting the case of an 82-year-old Yemeni patient, renal transplant recipient who was admitted to our institution and who subsequently developed disseminated infection with Saprochaete capitata. This pathogenic fungus is rarely reported in patients with solid organ trans-plants. Saprochaete capitata is an emerging fungal pathogen, ubiquitously spread in the environment. This is the second case to our knowledge of infection with Saprochaete capitata in a renal transplant patient. Our patient was treated for multiple nosocomial infections with prolonged antibiotic courses...
April 27, 2018: Journal de Mycologie Médicale
https://www.readbyqxmd.com/read/29709248/identifying-risk-profiles-in-liver-transplant-candidates-and-implications-for-induction-immunosuppression
#19
REVIEW
Umberto Cillo, Wolf O Bechstein, Gabriela Berlakovich, Philipp Dutkowski, Frank Lehner, Silvio Nadalin, Faouzi Saliba, Hans J Schlitt, Johann Pratschke
Changes in recipient and donor characteristics are redefining the role of induction in liver transplant recipients. Older recipients are more common, with greater concomitant comorbidity. Moderate or severe renal dysfunction is now estimated to affect 40% of liver transplant recipients. Donors are also becoming older, and other factors such as more frequent non-alcoholic fatty liver disease (NAFLD) compromise the quality of some grafts. Rejection rates are now relatively low (~10%) but some patients have a markedly increased risk such as younger recipients and those undergoing re-transplantation...
April 13, 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29706010/long-term-study-showed-that-vaccination-protected-paediatric-renal-transplant-recipients-from-life-threatening-varicella-zoster-virus
#20
Jenny K Lindahl, Vanda Friman, Susanne Westphal Ladfors, Sverker Hansson, Rune Andersson, Marianne Jertborn, Susanne Woxenius
AIM: Renal transplant patients are particularly susceptible to highly contagious diseases due to their reduced immunity. We studied transplant recipients to gauge their varicella zoster virus (VZV) serology status over time and the outcome of any VZV infections. METHOD: This retrospective study comprised 85 children who underwent renal transplants in Gothenburg, Sweden, from1986-2014, at a mean age of eight (1-18) years. The children's medical records were reviewed and 47 had the VZV infection pre-transplant and 38 had been vaccinated pre-transplant...
April 29, 2018: Acta Paediatrica
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