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cytomegalovirus and kidney

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https://www.readbyqxmd.com/read/29407331/safety-and-efficacy-of-induction-therapy-with-thymoglobulin-in-ab0-incompatible-kidney-transplantation
#1
A L Herzog, C Kalogirou, C Wanner, K Lopau
INTRODUCTION: Data suggest an additional role of T cells in antibody-mediated rejections. In 2001 a protocol for AB0-incompatible kidney transplantation based on B-cell-depleting anti-CD20 antibody rituximab, antigen-specific blood group IgG immunoadsorption, intravenous immunoglobulins, and triple immunosuppression was introduced in Europe, which used induction therapy with the use of interleukin-2 receptor antibody (IL2-RA) basiliximab. We used thymoglobulin in AB0-incompatible patients as induction in the face of high immunologic risk...
January 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29407298/high-dose-valganciclovir-treatment-for-resistant-cytomegalovirus-colitis-due-to-ul97-and-ul54-mutations
#2
K M Baradhi, R L Aure, J-M El-Amm
We report the first case of a ganciclovir-resistant cytomegalovirus (CMV) involving the gastrointestinal tract that was successfully treated with high-dose valganciclovir. A kidney transplant recipient developed drug-resistant CMV colitis which was initially treated with valganciclovir, but his CMV was found to have major resistance to ganciclovir and cidofovir due to UL97 and UL54 mutations. The patient was switched to intravenous foscarnet 40 mg/kg given every twelve hours. However, foscarnet had to be discontinued after 4 days of treatment due to acute kidney injury...
January 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29407295/bk-virus-associated-nephropathy-current-situation-in-a-resource-limited-country
#3
P Yooprasert, P Rotjanapan
BACKGROUND: Data on BK virus-associated nephropathy (BKVAN) and treatment strategy in a resource-limited country are scarce. This study aimed to evaluate epidemiology of BKVAN and its situation in Thailand. METHODS: A retrospective analysis was conducted among adult kidney transplant recipients at Ramathibodi Hospital from October 2011 to September 2016. Patients' demographic data, information on kidney transplantation, immunosuppressive therapy, cytomegalovirus and BK virus infections, and allograft outcomes were retrieved and analyzed...
January 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29407294/prevention-of-late-onset-cytomegalovirus-infection-and-disease-in-donor-positive-recipient-negative-kidney-transplant-recipients-using-low-dose-valganciclovir
#4
K Nanmoku, T Shinzato, T Kubo, T Shimizu, T Kimura, T Yagisawa
BACKGROUND: The main challenge with cytomegalovirus (CMV) prophylaxis in IgG donor-positive/recipient-negative (D+/R-) kidney transplant recipients is late-onset CMV disease. We evaluated a novel protocol for the prevention of late-onset CMV infection and disease in D+/R- organ recipients. METHODS: Our prospective, observational, cohort study included 100 adult kidney transplant recipients. Prophylaxis with low-dose valganciclovir (450 mg/d, 3 times a week for 6 months) was administered to D+/R- recipients...
January 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29407172/nephron-segment-specific-gene-expression-using-aav-vectors
#5
Laureano D Asico, Cuevas Santiago, Xiaobo Ma, Pedro A Jose, Ines Armando, Prasad R Konkalmatt
AAV9 vector provides efficient gene transfer in all segments of the renal nephron, with minimum expression in non-renal cells, when administered retrogradely via the ureter. It is important to restrict the transgene expression to the desired cell type within the kidney, so that the physiological endpoints represent the function of the transgene expressed in that specific cell type within kidney. We hypothesized that segment-specific gene expression within the kidney can be accomplished using the highly efficient AAV9 vectors carrying the promoters of genes that are expressed exclusively in the desired segment of the nephron in combination with administration by retrograde infusion into the kidney via the ureter...
January 30, 2018: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/29377877/incidence-of-cytomegalovirus-dnaemia-in-pediatric-kidney-transplant-recipients-after-cessation-of-antiviral-prophylaxis
#6
Thanaporn Chaiyapak, Karlota Borges, Angela Williams, Tonny Banh, Jovanka Vasilevska-Ristovska, Upton Allen, Rulan S Parekh, Diane Hébert
BACKGROUND: Late cytomegalovirus (CMV) infection can occur after cessation of viral prophylaxis in kidney transplant recipients, yet, timing of infection is unclear and longer duration of prophylaxis may be warranted. METHODS: We conducted a retrospective cohort study of 86 children (35 CMV donor seropositive, recipient seronegative [D+R-] and 51 CMV recipient seropositive [R+]) <18 years who received a kidney transplant between January 2002-June 2014 and were treated with antiviral prophylaxis for 3 months after transplantation...
January 26, 2018: Transplantation
https://www.readbyqxmd.com/read/29377506/cmv-infected-kidney-grafts-drive-the-expansion-of-blood-borne-cmv-specific-t-cells-restricted-by-shared-class-i-hla-molecules-via-presentation-on-donor-cells
#7
Philippe Gatault, Sally Al-Hajj, Johan Noble, Eloi Chevallier, Marie Piollet, Catherine Forconi, Catherine Gaudy-Graffin, Gilles Thibault, Elodie Miquelestorena-Standley, Jean Michel Halimi, Matthias Büchler, Roxane Lemoine, Christophe Baron
We aimed to determine the role of cytomegalovirus (CMV)-infected donor cells in the development of a CMV-specific immune response in kidney transplant recipients. We assessed the CMV pp65-specific immune response by using interferon-ɣ ELISPOT and dextramers in peripheral blood mononuclear cells from 115 recipients (D+R- 31, D+R+ 44, D-R+ 40) late after transplantation (mean 59±42 months). Receiving a kidney from a D+ donor resulted in a higher number of IFN-ɣ-producing anti-CMV T-cells (p=0.004). This effect disappeared with the absence of shared HLA class I specificities between donors and recipients (p=0...
January 27, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29363415/no-increased-risk-of-posttransplant-lymphoproliferative-disorder-following-alemtuzumab-induction-in-kidney-transplant
#8
Madeleine Oliver, Graham Mitro, Patrick Tenbrink, Samer Alharthi, Nastassja Bedford, Jinling Wu, Amira Gohara, Matthew Jordan, Cassandra Zaremba, Michael Rees, Jorge Ortiz
OBJECTIVES: Posttransplant lymphoproliferative disorder is a known complication of solid-organ transplant. The use of depleting induction agents has demonstrated varying associations with incidence of posttransplant lymphoproliferative disorder. Alemtuzumab, a depleting induction agent for kidney transplant patients, has shown promising results in reducing the risk of acute rejection and graft loss in the first year. Its unique mechanism of depleting both T-cell and B-cell populations may be beneficial in preventing the occurrence of posttransplant lymphoproliferative disorder...
January 22, 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29360250/impact-of-electronic-health-record-based-pharmacist-driven-valganciclovir-dose-optimization-in-solid-organ-transplant-recipients
#9
David Hensler, Chad L Richardson, Joslyn Brown, Christine Tseng, Phyllis J DeCamp, Amy Yang, Anna Pawlowski, Bing Ho, Michael G Ison
BACKGROUND: Prophylaxis with valganciclovir reduces the incidence of cytomegalovirus (CMV) infection following solid organ transplant (SOT). Under-dosing of valganciclovir is associated with an increased risk of CMV infection and development of ganciclovir-resistant CMV. METHODS: An automated electronic health record (EHR)-based, pharmacist-driven program was developed to optimize dosing of valganciclovir in solid organ transplant recipients at a large transplant center...
January 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29360195/reduction-of-late-onset-cytomegalovirus-primary-disease-after-discontinuation-of-antiviral-prophylaxis-in-kidney-transplant-recipients-treated-with-de-novo-everolimus
#10
Arnaud Devresse, Marianne Leruez-Ville, Anne Scemla, Véronique Avettand-Fenoel, Lise Morin, Xavier Lebreton, Claire Tinel, Lucile Amrouche, Lionel Lamhaut, Marc Olivier Timsit, Julien Zuber, Christophe Legendre, Dany Anglicheau
BACKGROUND: donor (D)+/recipient (R)- serostatus is closely associated with a higher risk of cytomegalovirus (CMV) infection and disease. Antiviral prophylaxis is conventionally used in such patients, but late-onset CMV infection/disease still occurs after the discontinuation of prophylaxis. METHODS: we retrospectively analyzed the data of 215 low immunological risk patients who received kidney transplantation in our center between 2011 and 2016. RESULTS: ninety-seven patients received a combination of everolimus (EVL)/reduced doses of calcineurin inhibitors (CNI) (EVL group) de novo, and 118 received a combination of mycophenolic acid (MPA)/standard doses of CNI (MPA group) de novo...
January 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29347945/microrna-transcriptome-analysis-of-porcine-vital-organ-responses-to-immunosuppressive-porcine-cytomegalovirus-infection
#11
Xiao Liu, Haoche Wei, Shan Liao, Jianheng Ye, Ling Zhu, Zhiwen Xu
BACKGROUND: Porcine cytomegalovirus (PCMV) is an immunosuppressive virus that mainly inhibits T-lymphocyte and macrophage immune functions; it has significantly damaged the farming industry. Although recent studies have shown that miRNAs play important roles in immune responses, the regulatory mechanisms of miRNAs during immunosuppressive virus infection remain unclear. METHODS: In this study, porcine small-RNA transcriptomes of PCMV-infected and uninfected vital organs were first characterised by high-throughput sequencing...
January 18, 2018: Virology Journal
https://www.readbyqxmd.com/read/29340535/prevalence-of-cytomegalovirus-disease-in-kidney-transplant-patients-in-an-intensive-care-unit
#12
Sanmya Danielle Rodrigues Dos Santos, Antonio Tonete Bafi, Flávio Geraldo Rezende de Freitas, Luciano César Pontes de Azevedo, Flávia Ribeiro Machado
OBJECTIVES: To define the frequency of cytomegalovirus disease among kidney transplant patients in an intensive care unit in which this complication was suspected and to identify predisposing factors and their possible impact on clinical outcome. METHODS: Retrospective observational study in which kidney transplant patients over the age of 18 years were hospitalized for any reason in an intensive care unit with at least one collection of samples to test for the presence of antigenemia or cytomegalovirus via polymerase chain reaction during hospitalization...
October 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29319770/factors-associated-with-hospital-mortality-in-renal-transplant-patients-admitted-to-the-intensive-care-unit-with-acute-respiratory-failure
#13
Rafael Mendes da Silva, Flavio Geraldo Rezende de Freitas, Antonio Tonete Bafi, Hélio Tedesco Silva Junior, Bartira de Aguiar Roza
INTRODUCTION: The lungs are often involved in a variety of complications after kidney transplantation. Acute respiratory failure (ARF) is one of the most serious manifestations of pulmonary involvement. OBJECTIVE: To describe the main causes of ARF in kidney transplant patients who require intensive care and identify the factors associated with mortality. METHODS: This retrospective study evaluated adult patients with ARF admitted to the intensive care unit of a center with high volume of transplants from August 2013 to August 2015...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29319768/the-current-burden-of-cytomegalovirus-infection-in-kidney-transplant-recipients-receiving-no-pharmacological-prophylaxis
#14
Claudia Rosso Felipe, Alexandra Nicolau Ferreira, Adrieli Bessa, Tamiris Abait, Priscilla Ruppel, Mayara Ivani de Paula, Liliane Hiramoto, Laila Viana, Suelen Martins, Marina Cristelli, Wilson Aguiar, Juliana Mansur, Geovana Basso, Helio Tedesco Silva Junior, Jose Medina Pestana
Cytomegalovirus (CMV) infection in kidney transplantation has changed its clinical spectrum, mostly due to the current and more effective immunosuppression. In the absence of preventive strategies it is associated with significant morbi-mortality. OBJECTIVE: This study evaluated the incidence of CMV events and its effect on outcomes of kidney transplantation in recipients without pharmacological prophylaxis or targeted preemptive treatment. RESULTS: The study cohort comprised 802 recipients of kidney transplants between 04/30/2014 and 04/30/2015...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29306112/predictive-factors-of-spontaneous-cmv-dnaemia-clearance-in-kidney-transplantation
#15
Johan Noble, Philippe Gatault, Bénédicte Sautenet, Catherine Gaudy-Graffin, Agnes Beby-Defaux, Antoine Thierry, Marie Essig, Jean-Michel Halimi, Eliza Munteanu, Sophie Alain, Matthias Buchler
Cytomegalovirus (CMV) infection occurs frequently after solid organ transplantation. Therapeutic strategies, in particular when to start a curative treatment, has not yet been defined. The purpose of this study was to assess predictive factors associated with spontaneous clearance of CMV DNAemia in kidney transplant recipients. METHODS: All kidney recipients of a single center were recruited. Patients with at least one positive CMV DNAemia during the first year post transplantation were included in our analysis...
December 29, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/29303612/the-effect-of-induction-therapy-on-established-cmv-specific-t-cell-immunity-in-living-donor-kidney-transplantation
#16
L Stranavova, P Hruba, E Girmanova, I Tycova, A Slavcev, J Fronek, J Slatinska, P Reinke, H-D Volk, O Viklicky
Cytomegalovirus (CMV) infection influences both short and long term outcomes in immunosuppressed organ transplant recipients. The aim of this study was to evaluate the effect of different induction immunosuppression regimens on CMV specific T cell response in patients with already established CMV immunity. In 24 seropositive living donor kidney recipients, the frequency of CMV specific T cells was determined by ELISPOT (Enzyme-Linked ImmunoSpot) assay prior and 6 months after transplantation. Recipients' peripheral blood mononuclear cells were stimulated with immediate-early (IE1) and phosphoprotein 65 (pp65) CMV-derived peptide pools and the number of cells producing interferon gamma (IFN-gamma) was assessed...
January 5, 2018: Physiological Research
https://www.readbyqxmd.com/read/29302827/colonic-perforation-due-to-severe-cytomegalovirus-disease-in-granulomatosis-with-polyangiitis-after-immunosuppression
#17
REVIEW
Alessandra Soriano, Nazareno Smerieri, Stefano Bonilauri, Loredana De Marco, Alberto Cavazza, Carlo Salvarani
Granulomatosis with polyangiitis (GPA) is a small-vessel necrotizing granulomatous vasculitis typically involving upper airways, lungs, and kidneys, which may lead to end-organ damage and life-threatening complications. Major infections during GPA course represent a considerable concern in the management of the disease. Cytomegalovirus (CMV) infection and disease are rare but significant complications in the course of GPA being associated with high morbidity and mortality rates. Colonic perforation due to CMV colitis is exceedingly rare and has so far almost exclusively been documented in HIV, renal transplant, and systemic lupus erythematosus patients...
January 4, 2018: Clinical Rheumatology
https://www.readbyqxmd.com/read/29299892/cytomegalovirus-infection-after-renal-transplantation-occurrence-clinical-features-and-the-cutoff-for-antigenemia-in-a-university-hospital-in-brazil
#18
Sócrates Bezerra de Matos, Roberto Meyer, Fernanda Washington de Mendonça Lima
BACKGROUND: Cytomegalovirus (CMV) is the main infectious agent causative of morbidity and mortality in transplant recipients. This study aimed to describe the occurrence and clinical features of CMV infection, and the optimum antigenemia assay cutoff associated with symptomatic infection. MATERIALS AND METHODS: This was a cohort study that investigated 87 patients undergoing renal transplantation. The patients were monitored with the CMV antigenemia assay performed weekly for the first 3 months post-transplantation and subsequently, when CMV infection was suspected clinically...
December 2017: Infection & Chemotherapy
https://www.readbyqxmd.com/read/29284181/clinical-validation-of-a-novel-elispot-based-in-vitro-diagnostic-assay-to-monitor-cmv-specific-cell-mediated-immunity-in-kidney-transplant-recipients-a-multicenter-longitudinal-prospective-observational-study
#19
Bernhard Banas, Dominik Steubl, Lutz Renders, Dominik Chittka, Miriam C Banas, Thomas Wekerle, Martina Koch, Oliver Witzke, Anja Mühlfeld, Claudia Sommerer, Antje Habicht, Christian Hugo, Thomas Hünig, Monika Lindemann, Traudel Schmidt, Anne Rascle, Sascha Barabas, Ludwig Deml, Ralf Wagner, Bernhard K Krämer, Bernd Krüger
Impaired cytomegalovirus (CMV)-specific cell-mediated immunity (CMV-CMI) is a major cause of CMV reactivation and associated complications in solid-organ transplantation. Reliably assessing CMV-CMI is desirable to individually adjust antiviral and immunosuppressive therapy. This study aimed to evaluate the suitability of T-Track® CMV, a novel IFN-γ ELISpot assay based on the stimulation of peripheral blood mononuclear cells with pp65 and IE-I CMV proteins, to monitor CMV-CMI following kidney transplantation...
December 28, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29277957/early-post-transplant-diagnosis-of-cytomegalovirus-esophagitis-in-an-abo-incompatible-kidney-transplant-recipients-a-case-report
#20
M Yazawa, H Sasaki, Y Sakurai, H Kudo, R Nakazawa, T Chikaraishi, Y Shibagaki
Cytomegalovirus (CMV) is a common infectious pathogen in kidney transplant patients. Here we present a case of CMV esophagitis with antigenemia, that developed within three days of kidney transplantation, a timeline generally considered to be too early for development of a CMV infection. Intense immunosuppressive therapy for desensitization in ABO-incompatibility or in the presence of donor-specific antibody can increase the risk for significant opportunistic infection immediately after or even before transplantation...
December 26, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
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