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cytomegalovirus and kidney

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https://www.readbyqxmd.com/read/28229376/the-pharmacogenetics-of-tacrolimus-in-corticosteroid-sparse-pediatric-and-adult-kidney-transplant-recipients
#1
Mads Juul Madsen, Troels K Bergmann, Kim Brøsen, Helle Charlotte Thiesson
INTRODUCTION: Tacrolimus is a calcineurin inhibitor used as an immunosuppressant drug in solid organ transplantation, and is mainly metabolized by cytochrome P450 (CYP) 3A4 and CYP3A5. Studies have shown an association between the CYP3A5 genotype and tacrolimus dose-adjusted trough concentrations. Variants in the genes PPARA, POR and CYP3A4 have recently been shown to influence tacrolimus metabolism. Furthermore, pharmacokinetic interaction between corticosteroid treatment and tacrolimus has been shown...
February 22, 2017: Drugs in R&D
https://www.readbyqxmd.com/read/28191298/asymptomatic-epstein-barr-virus-shedding-in-the-urine-of-kidney-transplant-recipients-case-reports-and-review-of-the-literature
#2
Maryam Rahbar, Gholamreza Poormand, Masoud Karkhaneh Mahmoodi, Aboozar Jazayeri, Seyed Mohammad Jazayeri
Epstein-Barr virus (EBV) is associated with a wide range of malignancies and complications like post-transplant lymphoproliferative disorder (PTLD). To suppress active EBV infection in transplant recipients, who are at a heightened risk of developing PTLD, EBV DNAemia monitoring has been recommended. Quantitative multiplex real time polymerase chain reaction (QMRTPCR) offered the advantage of detection of more than one target in the same sample. We present four cases of kidney transplant recipient who were admitted for rising serum creatinine between 9 and 20 months post-transplant with a suspicion of BKV-associated nephropathy...
December 31, 2016: Infectious Disease Reports
https://www.readbyqxmd.com/read/28134984/conversion-from-sirolimus-to-everolimus-in-long-term-liver-graft-recipients
#3
Nina Weiler, Nigar Bilge, Sven Troetschler, Johannes Vermehren, Andreas Anton Schnitzbauer, Eva Herrmann, Christoph Sarrazin, Stefan Zeuzem, Martin-Walter Welker
Immunosuppression by inhibition of the mechanistic target of rapamycin (mTOR) is a promising approach after liver transplantation. The mTOR inhibitor sirolimus was used in selected liver graft recipients despite safety concerns and lack of approval. Everolimus is another mTOR inhibitor approved after liver transplantation. It is currently unknown, whether conversion of sirolimus to everolimus is safe in long-term liver graft recipients. Long-term liver graft recipients treated with sirolimus were converted to everolimus...
January 30, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28131494/immunomodulation-by-hyperimmunoglobulins-after-solid-organ-transplantation-beyond-prevention-of-viral-infection
#4
REVIEW
Rogier van Gent, Herold J Metselaar, Jaap Kwekkeboom
Hyperimmunoglobulins are pharmaceutical formulations of human IgG which contain high titers of antibodies against specific viruses. They have been successfully used in solid organ transplantation (SOT) to prevent Cytomegalovirus (CMV) and Hepatitis B Virus (HBV) infection. The introduction of effective and cheaper antiviral drugs has resulted in decreasing usage of hyperimmunoglobulins in SOT. However, it may still be attractive to combine antiviral drug therapy with hyperimmunoglobulins after SOT, as there is some evidence that hyperimmunoglobulins, similar to high doses of intravenous immunoglobulins (IVIgs), might exert anti-inflammatory activity and thereby prevent immunological graft damage and improve graft and patient survival...
January 19, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28129395/primary-cytomegalovirus-infection-in-seronegative-kidney-transplant-patients-is-associated-with-protracted-cold-ischemic-time-of-seropositive-donor-organs
#5
Fabian Schlott, Dominik Steubl, Dieter Hoffmann, Edouard Matevossian, Jens Lutz, Uwe Heemann, Volker Hösel, Dirk H Busch, Lutz Renders, Michael Neuenhahn
Human Cytomegalovirus (CMV) can lead to primary infection or reactivation in CMV-seronegative or -seropositive kidney transplant recipients, respectively. Complications comprise severe end-organ diseases and acute or chronic transplant rejection. Risk for CMV manifestation is stratified according to the CMV-IgG-serostatus, with donor+/recipient- (D+/R-) patients carrying the highest risk for CMV-replication. However, risk factors predisposing for primary infection in CMV-seronegative recipients are still not fully elucidated...
2017: PloS One
https://www.readbyqxmd.com/read/28121742/association-of-baseline-viral-serology-and-sirolimus-regimens-with-kidney-transplant-outcomes-a-14-year-registry-based-cohort-study-in-the-united-states
#6
Alfonso H Santos, Michael J Casey, Wen Xuerong, Karl L Womer
BACKGROUND: The risks for transplant outcomes associated with baseline viral serostatus in kidney transplant recipients (KTR) on sirolimus have not been widely studied. METHODS: We performed a cohort-study of 61 590 adult KTR in 2000 to 2013. We used Cox regression models to determine the adjusted hazard ratio (aHR) of patient death, death-censored graft loss and posttransplant malignancy associated with the baseline serostatus (+ or -: hepatitis B core [HBc], hepatitis C virus [HCV], Epstein-Barr virus [EBV], or cytomegalovirus [CMV]) in KTR on sirolimus (SRL) + mycophenolate (MPA) or SRL + tacrolimus (Tac), relative to the control-regimen: Tac + MPA...
February 2017: Transplantation
https://www.readbyqxmd.com/read/28104150/comparison-of-mizoribine-and-mycophenolate-mofetil-with-a-tacrolimus-based-immunosuppressive-regimen-in-living-donor-kidney-transplantation-recipients-a-retrospective-study-in-china
#7
Y Shi, H Liu, X-G Chen, Z-Y Shen
BACKGROUND: A retrospective study was conducted to investigate the prevalence of gastrointestinal (GI) symptoms as well as the efficacy and safety of mizoribine (MZR) and mycophenolate mofetil (MMF) in Chinese living-donor kidney transplantation (LDKT). METHODS: Forty-two recipients enrolled between January 2012 and March 2014 were treated with either MZR (n = 22) or MMF (n = 20). All patients were treated in combination with a tacrolimus-based immunosuppressive regimen, besides the study drugs...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28091392/the-impact-of-viral-load-and-time-to-onset-of-cytomegalovirus-replication-on-long-term-graft-survival-after-kidney-transplantation
#8
Tomas Reischig, Martin Kacer, Petra Hruba, Pavel Jindra, Ondrej Hes, Daniel Lysak, Mirko Bouda, Ondrej Viklicky
BACKGROUND: Asymptomatic cytomegalovirus (CMV) infection is associated with graft dysfunction and failure. However, no study assessed CMV viral load in terms of the risk for graft failure. METHODS: In prospective cohort of kidney transplant recipients, we assessed the impact of CMV DNAemia on the overall graft survival and the incidence of moderate-to-severe interstitial fibrosis and tubular atrophy (IF/TA) in protocol biopsy at 36 months. CMV DNAemia was stratified by viral load in whole blood...
January 16, 2017: Antiviral Therapy
https://www.readbyqxmd.com/read/28089555/epstein-barr-virus-and-renal-transplantation
#9
REVIEW
Jade Le, Christine M Durand, Irfan Agha, Daniel C Brennan
Epstein-Barr virus (EBV) is a gamma herpesvirus associated with diseases ranging from asymptomatic viremia to post-transplant malignancies in kidney transplant recipients. EBV specifically is associated with post-transplantation lymphoproliferative disorder (PTLD), in kidney transplant recipients, with increased risk in EBV seronegative patients with EBV seropositive donors on intensified immunosuppression. The diagnosis of PTLD relies on clinical suspicion plus tissue biopsy with polymerase chain reaction (PCR) testing of blood currently used for risk determination in high-risk recipients...
December 29, 2016: Transplantation Reviews
https://www.readbyqxmd.com/read/28088953/-research-of-mhla-g-and-the-receptor-expression-with-kidney-rejection-and-cmv-active-infection-following-kidney-transplantation
#10
L L Bi, Y Gao, Y J Sun, X R Kong, X Y He, X H Ma, W H Zhang, L Xiao, B Y Shi
Objective: To study the expression of membrane HLA-G (mHLA-G) and the receptor immunoglobulin-like transcript 2(ILT2) on lymphocyte and find their association with rejection and cytomegalovirus (CMV) infection after renal transplantation. Methods: A total of 88 cases of renal transplant recipients for the first time from February 2014 to February 2016 were studied in this work. Recipients can be divided into rejection group (n=12) and stable renal function group (n=41) according to whether rejection occurred...
January 10, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28073178/polyclonal-and-monoclonal-antibodies-for-induction-therapy-in-kidney-transplant-recipients
#11
REVIEW
Penny Hill, Nicholas B Cross, A Nicholas R Barnett, Suetonia C Palmer, Angela C Webster
BACKGROUND: Prolonging kidney transplant survival is an important clinical priority. Induction immunosuppression with antibody therapy is recommended at transplantation and non-depleting interleukin-2 receptor monoclonal antibodies (IL2Ra) are considered first line. It is suggested that recipients at high risk of rejection should receive lymphocyte-depleting antibodies but the relative benefits and harms of the available agents are uncertain. OBJECTIVES: We aimed to: evaluate the relative and absolute effects of different antibody preparations (except IL2Ra) when used as induction therapy in kidney transplant recipients; determine how the benefits and adverse events vary for each antibody preparation; determine how the benefits and harms vary for different formulations of antibody preparation; and determine whether the benefits and harms vary in specific subgroups of recipients (e...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28039960/preventive-strategies-against-cytomegalovirus-and-incidence-of-%C3%AE-herpesvirus-infections-in-solid-organ-transplant-recipients-a-nationwide-cohort-study
#12
C Martin-Gandul, S Stampf, D Héquet, N J Mueller, A Cusini, C van Delden, N Khanna, K Boggian, C Hirzel, P Soccal, H H Hirsch, M Pascual, P Meylan, O Manuel
We assessed the impact of antiviral preventive strategies on the incidence of herpes simplex virus (HSV) and varicella-zoster virus (VZV) infections in a nationwide cohort of transplant recipients. Risk factors for the development of HSV or VZV infection were assessed by Cox proportional hazards regression. We included 2781 patients (56% kidney, 20% liver, 10% lung, 7.3% heart, 6.7% others). Overall, 1264 (45%) patients received antiviral prophylaxis (ganciclovir or valganciclovir, n = 1145; acyclovir or valacyclovir, n = 138)...
December 31, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/28039534/hypomagnesemia-and-increased-risk-of-new-onset-diabetes-mellitus-after-transplantation-in-pediatric-renal-transplant-recipients
#13
Wesley Hayes, Sheila Boyle, Adrian Carroll, Detlef Bockenhauer, Stephen D Marks
BACKGROUND: New-onset diabetes after transplantation (NODAT) is a significant co-morbidity following kidney transplantation. Lower post-transplant serum magnesium levels have been found to be an independent risk factor for NODAT in adult kidney transplant recipients. METHODS: We undertook a retrospective analysis of risk factors for NODAT in pediatric renal transplant recipients at our institution with the aim of determining if hypomagnesemia confers a significant risk of developing NODAT in this patient population...
December 30, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27938472/post-transplant-immune-activation-innocent-bystander-or-insidious-culprit-of-post-transplant-accelerated-atherosclerosis
#14
Didier Ducloux, Jamal Bamoulid, Thomas Crepin, Jean-Michel Rebibou, Cecile Courivaud, Philippe Saas
Cardiovascular disease is a major cause of morbidity, disability, and mortality in kidney transplant patients. Cumulative reports indicate that the excessive risk of cardiovascular events is not entirely explained by the increased prevalence of traditional cardiovascular risk factors. Atherosclerosis is a chronic inflammatory disease and it has been postulated that post-transplant immune disturbances may explain the gap between the predicted and observed risks of cardiovascular events. However, whereas concordant data suggest that innate immunity contributes to the posttransplant accelerated atherosclerosis, only few arguments plead for a role of adaptive immunity...
27, 2016: Cell Transplantation
https://www.readbyqxmd.com/read/27932184/intrapancreatic-splenule-in-a-pancreas-allograft-case-report
#15
K Yadav, O K Serrano, R Kandaswamy
A 16-year-old white man was involved in a motor vehicle collision and suffered head, chest, and abdominal trauma. Despite initial resuscitative efforts, he progressed to brain death and was designated to be an organ donor by his family. He had no earlier medical or surgical history and no high-risk behaviors. Blood work revealed normal creatinine, liver function tests, lipase, and amylase. Viral serologies were negative except for cytomegalovirus IgG and Epstein-Barr virus nucleic acid. Imaging revealed a right kidney contusion, a manubrial fracture, and fractures of right first rib and bilateral scapulae...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932162/rapidly-fatal-hemophagocytic-lymphohistiocytosis-developing-within-six-days-following-deceased-donor-renal-transplantation-case-report
#16
E J Filippone, P Singh, A M Frank, A Gupta, J L Farber
Hemophagocytic lymphohistiocytosis (HLH) is an often fatal hyperinflammatory syndrome that may complicate malignancy, infection, rheumatic disease, or immunosuppression. HLH after kidney transplantation is most often triggered by infection, usually Herpes viruses such as cytomegalovirus and Epstein-Barr virus (EBV). It usually occurs early after transplantation. We present a case of HLH triggered by reactivation of EBV that pursued a rapidly fatal course within 6 days of receiving a deceased-donor kidney transplant...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932110/effect-of-cytomegalovirus-infection-on-survival-of-older-kidney-transplant-patients-d-r-impact-of-valganciclovir-prophylaxis-versus-preemptive-therapy
#17
E Luna, F Caravaca, F Ferreira, N Fernandez, P Martín, M L Vargas, J Saenz de Santamaría, G Garcia Pino, L Azevedo, A Muñoz Sanz
BACKGROUND: Kidney transplant patients with D+/R+ serology can be treated with either prophylaxis or preemptive valganciclovir. The older transplant population suffers severe immunosenescence, especially patients with latent cytomegalovirus (CMV) infection (R+). They are more likely to develop indirect CMV effects. Likewise, many patients have significant cardiovascular comorbidity, which makes them more sensitive to these indirect effects. The aim of this study was to evaluate the incidence of CMV viremia and indirect effects on survival, comparing prophylaxis (V) against preemptive (P) valganciclovir in an older kidney transplant population...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27920290/teaching-neuroimages-cytomegalovirus-infection-mimicking-a-brain-tumor-in-a-kidney-transplant-recipient
#18
Victor Hugo Rocha Marussi, José Luiz Pedroso, Leonardo Furtado Freitas, Alex Baeta, Carmen Lucia Lancellotti, Orlando G Barsottini, Acary S Bulle Oliveira, Lázaro Luís Faria do Amaral
No abstract text is available yet for this article.
December 6, 2016: Neurology
https://www.readbyqxmd.com/read/27913630/adaptive-nkg2c-nk-cell-response-and-the-risk-of-cytomegalovirus-infection-in-kidney-transplant-recipients
#19
Dolores Redondo-Pachón, Marta Crespo, Jose Yélamos, Aura Muntasell, María José Pérez-Sáez, Silvia Pérez-Fernández, Joan Vila, Carlos Vilches, Julio Pascual, Miguel López-Botet
CMV infection in kidney transplant recipients (KTRs) has been associated with an increased risk for graft loss and reduced host survival. CMV promotes persistent expansions of NK cells expressing the CD94/NKG2C receptor. The NKG2C (KLRC2) gene is frequently deleted, and copy number influences the adaptive response of NKG2C(+) NK cells. The distribution of NKG2C(+) NK cells and NKG2C genotypes (NKG2C(+/+), NKG2C(+/del), NKG2C(del/del)) were studied in cross-sectional (n = 253) and prospective (n = 122) KTR cohorts...
January 1, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/27888673/clinical-correlates-of-pp65-antigenemia-monitoring-in-the-first-months-of-post-kidney-transplant-in-patients-undergoing-universal-prophylaxis-or-preemptive-therapy
#20
Fabiana Rabe Carvalho, Rachel Ingrid Juliboni Cosendey, Cintia Fernandes Souza, Thalia Medeiros, Paulo Alexandre Menezes, Andrea Alice Silva, Jorge Reis Almeida, Jocemir Ronaldo Lugon
INTRODUCTION: Human cytomegalovirus is a major cause of morbidity in kidney transplant patients. OBJECTIVES: We aimed to study viral replication and serological response in the first months post kidney transplant in patients undergoing universal prophylaxis or preemptive therapy and correlate the findings with the clinical course of Human cytomegalovirus infection. PATIENTS AND METHODS: Independent from the clinical strategy adopted for managing Human cytomegalovirus infection, prophylaxis versus preemptive therapy, the pp65 antigenemia assay and serological response were assessed on the day of transplantation, and then weekly during the first three months of post-transplant...
January 2017: Brazilian Journal of Infectious Diseases
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