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infection and kidney allograft

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https://www.readbyqxmd.com/read/28338458/hepatitis-b-in-solid-organ-transplant-procedures-other-than-liver
#1
Dina Halegoua-De Marzio, Jonathan M Fenkel, Cataldo Doria
Transplant is often the best treatment available for patients with end-stage organ failure. Hepatitis B virus infection in transplant procedures other than liver is a major concern because it can be a significant cause of morbidity and mortality after transplant. Due to the increased risk of hepatic complications, such as fibrosing cholestatic hepatitis or histologic deterioration after transplant, systematic use of nucleoside or nucleotide analogues shortly before or at the time of transplant is recommended (tenofovir or entecavir are preferable to lamivudine) in all patients, whatever the baseline histologic evaluation...
April 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28302440/kidney-allograft-pyelonephritis-caused-by-salmonella-enterica-serovar-schwarzengrund
#2
Kenta Ito, Haruomi Nishio, Yuji Iwatani, Ryo Yamada, Takao Okawa, Takumi Yamamoto, Masaaki Murakami, Yoko Matsuo, Ken Matsuo, Satoshi Tanaka, Kiyoshi Mori, Noriko Mori
Kidney transplant recipients (KTRs) taking immunosuppressive drugs have a 20-fold greater risk of nontyphoidal Salmonella (NTS) infection than the healthy adult population. Among KTRs, the urinary tract is the most common site of infection. However, few cases of urinary tract infection caused by NTS have been documented in KTRs, and only one in Japan. Furthermore, it frequently induces acute allograft rejection with high mortality. Salmonella enterica subsp. enterica serovar Schwarzengrund (S. Schwarzengrund) is now among the more common Salmonella serovars isolated in Japan and is likely to be invasive...
March 13, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28296035/sepsis-after-renal-transplantation-clinical-immunological-and-microbiological-risk-factors
#3
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/28270929/changing-paradigms-in-the-management-of-rejection-in-kidney-transplantation-evolving-from-protocol-based-care-to-the-era-of-p4-medicine
#4
Mirela Maier, Tomoko Takano, Ruth Sapir-Pichhadze
PURPOSE OF REVIEW: P4 medicine denotes an evolving field of medicine encompassing predictive, preventive, personalized, and participatory medicine. Using the example of kidney allograft rejection because of donor-recipient incompatibility in human leukocyte antigens, this review outlines P4 medicine's relevance to the various stages of the kidney transplant cycle. SOURCES OF INFORMATION: A search for English articles was conducted in Medline via OvidSP (up to August 18, 2016) using a combination of subject headings (MeSH) and free text in titles, abstracts, and author keywords for the concepts kidney transplantation and P4 medicine...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28265581/impact-of-desensitization-on-antiviral-immunity-in-hla-sensitized-kidney-transplant-recipients
#5
Mieko Toyoda, Bong-Ha Shin, Shili Ge, James Mirocha, David Thomas, Maggie Chu, Edgar Rodriguez, Christine Chao, Anna Petrosyan, Odette A Galera, Ashley Vo, Jua Choi, Alice Peng, Joseph Kahwaji, Stanley C Jordan
Viral infections represent significant morbidity and mortality factors in kidney transplant recipients, with CMV, EBV, and BKV infections being most common. Desensitization (DES) with IVIg and rituximab with/without plasma exchange followed by kidney transplantation with alemtuzumab induction increased successful transplant rates in HLA-sensitized patients but may represent an increased risk for viral infections due to severe lymphocyte depletion. Here, we report on the posttransplant viral infection status in 372 DES versus 538 non-DES patients...
2017: Journal of Immunology Research
https://www.readbyqxmd.com/read/28261220/dual-role-of-natural-killer-cells-on-graft-rejection-and-control-of-cytomegalovirus-infection-in-renal-transplantation
#6
REVIEW
Miguel López-Botet, Carlos Vilches, Dolores Redondo-Pachón, Aura Muntasell, Aldi Pupuleku, José Yélamos, Julio Pascual, Marta Crespo
Allograft rejection constitutes a major complication of solid organ transplantation requiring prophylactic/therapeutic immunosuppression, which increases susceptibility of patients to infections and cancer. Beyond the pivotal role of alloantigen-specific T cells and antibodies in the pathogenesis of rejection, natural killer (NK) cells may display alloreactive potential in case of mismatch between recipient inhibitory killer-cell immunoglobulin-like receptors (KIRs) and graft HLA class I molecules. Several studies have addressed the impact of this variable in kidney transplant with conflicting conclusions; yet, increasing evidence supports that alloantibody-mediated NK cell activation via FcγRIIIA (CD16) contributes to rejection...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28260468/tuberculosis-after-renal-transplant
#7
Samia Barbouch, Meriam Hajji, Imed Helal, Mondher Ounissi, Mohammed Mongi Bacha, Fathi Ben Hamida, Ezzedine Abderrahim, Taieb Ben Abdallah
Tuberculosis is one of the leading infections after renal transplant, particularly in developing countries where the incidence and prevalence in the general population are high. Diagnosis requires bacteriologic and histologic confirmation. Interactions among the antitubercular drugs and the immunosuppressive agents have to be considered while prescribing, and surveillance for adverse effects is required. Although rare, case reports are available on extrapulmonary tuberculosis in allograft recipients. Here, we present a 25-year-old kidney transplant recipient who was diagnosed with lymph node tuberculosis under uncommon circumstances but who had a good outcome...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260443/outcome-of-renal-transplant-in-recipients-with-vasculitis
#8
Samia Barbouch, Meriam Hajji, Raja Aoudia, Monther Ounissi, Asma Zammouri, Rym Goucha, Fathi Ben Hamida, Mohammed Mongi Bacha, Ezzedine Abderrahim, Taieb Ben Abdallah
OBJECTIVES: End-stage renal disease develops in a high percentage of patients with vasculitis, in whom kidney transplant has become a therapeutic option. However, limited data are available on the prognosis and outcomes after kidney transplant in these patients. We aimed to compare the long-term graft survival and graft function in 8 renal transplant recipients with vasculitis (granulomatosis with polyangiitis, microscopic polyangiitis, Goodpasture syndrome, and Henoch-Schonlein purpura) with the other kidney recipients at a single center...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260428/renin-angiotensin-system-blockage-and-avoiding-high-doses-of-calcineurin-inhibitors-prevent-interstitial-fibrosis-and-tubular-atrophy-in-kidney-transplant-recipients
#9
Burak Sayin, Burak Canver, Bahar Gurlek Demirci, Turan Colak, Binnaz Handan Ozdemir, Mehmet Haberal
OBJECTIVES: Chronic allograft dysfunction is a complex and multifactorial process characterized by progressive interstitial fibrosis and tubular atrophy. The finding of interstitial fibrosis and tubular atrophy is prevalent among kidney transplant patients receiving a calcineurin inhibitor-based immunosuppressive regimen and may be considered as a surrogate of allograft survival. Both immune (acute rejection episodes, sensitization, and HLA incompatibility) and nonimmune (donor age, delayed graft function, calcineurin inhibitor toxicity, infections, and hypertension) mechanisms play a role in chronic allograft dysfunction, and different causes all lead to similar histologic and clinical final pathways, with the end result of graft loss...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28247735/-the-first-national-experience-of-laparoscopic-removal-of-the-transplanted-kidney
#10
M A Lysenko, V I Vtorenko, R N Trushkin, A E Lubennikov, D A Kuvyrdin, N O Kolesnikov
As a rule, the excision of a non-functioning renal graft in late (over 12 months) post-transplant period is performed using Fedorov subcapsular technique. This is because the kidney is embedded in scar tissue due to immune response to the allograft. This surgical approach is associated with the two major complications: bleeding during surgery or early postoperative hematoma and infection of hematoma confined in the remaining kidney capsule. To reduce blood loss and the risk of inflammatory complications, we, for the first time, carried out laparoscopic transplantectomy in a 42 year old female patient using the extracapsular technique...
August 2016: Urologii︠a︡
https://www.readbyqxmd.com/read/28247521/combination-of-leflunomide-and-everolimus-for-treatment-of-bk-virus-nephropathy
#11
Juli Jaw, Prue Hill, David Goodman
BK nephropathy (BKN) is a common cause of graft dysfunction following kidney transplantation. Minimization of immunosuppressive therapy remains the first line of therapy, but this may lead to rejection and graft loss. In some cases, despite lowering immunosuppression, BK infection can persist, leading to chronic damage and kidney failure. Currently, there is no specific anti-BK viral therapy. Recent in vitro experiments have demonstrated a reduction in BK viral replication when infected cells are treated with the combination of Leflunomide and Everolimus...
April 2017: Nephrology
https://www.readbyqxmd.com/read/28220747/three-cases-of-neurologic-syndrome-caused-by-donor-derived-microsporidiosis
#12
Rachel M Smith, Atis Muehlenbachs, Joanna Schaenmann, Sanjiv Baxi, Sophia Koo, Dianna Blau, Peter Chin-Hong, Anna R Thorner, Matthew J Kuehnert, Kristina Wheeler, Alexis Liakos, Jonathan W Jackson, Theresa Benedict, Alexandre J da Silva, Jana M Ritter, Dominique Rollin, Maureen Metcalfe, Cynthia S Goldsmith, Govinda S Visvesvara, Sridhar V Basavaraju, Sherif Zaki
In April 2014, a kidney transplant recipient in the United States experienced headache, diplopia, and confusion, followed by neurologic decline and death. An investigation to evaluate the possibility of donor-derived infection determined that 3 patients had received 4 organs (kidney, liver, heart/kidney) from the same donor. The liver recipient experienced tremor and gait instability; the heart/kidney and contralateral kidney recipients were hospitalized with encephalitis. None experienced gastrointestinal symptoms...
March 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28219603/acute-rejection-of-a-kidney-transplant-in-a-patient-with-common-variable-immunodeficiency-a-case-report
#13
O Al Nimri, A Rajput, E Martinez, J M Fahrenholz, P Paueksakon, A Langone, B P Concepcion
Common variable immunodeficiency is a primary immunodeficiency characterized by hypogammaglobulinemia and recurrent bacterial infections. We report a case of a 44-year-old male patient with end-stage renal disease and an established diagnosis of common variable immunodeficiency who underwent a living unrelated kidney transplant. He remained nearly infection free on maintenance immunoglobulin replacement. However, his posttransplant course was complicated by acute rejection that ultimately led to allograft loss...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28207975/stabilization-of-renal-function-after-the-first-year-of-follow-up-in-kidney-transplant-recipients-treated-for-significant-bk-polyomavirus-infection-or-bk-polyomavirus-associated-nephropathy
#14
Marie-Christine Simard-Meilleur, Paule Bodson-Clermont, Gilles St-Louis, Michel R Pâquet, Catherine Girardin, Marie-Chantal Fortin, Héloïse Cardinal, Marie-Josée Hébert, Reneé Lévesque, Edith Renoult
BACKGROUND: BK polyomavirus virus (BKPyV) screening and immunosuppression reduction effectively prevent graft loss due to BKPyV-associated nephropathy (BKPVAN) during the first year after transplantation. The aim of our study was to evaluate the impact of this infection during longer follow-up periods. METHODS: We reviewed the outcome of our screening and immunosuppression reduction protocol in 305 patients who received a kidney transplant between March 2008 and January 2013...
February 16, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28196049/hiv-infection-in-the-native-and-allograft-kidney-implications-for-management-diagnosis-and-transplantation
#15
Véronique Avettand-Fenoël, Christine Rouzioux, Christophe Legendre, Guillaume Canaud
The native kidney is a reservoir for HIV-1 and a site of viral replication, similar to lymphoid tissue, gut-associated lymphoid tissue or semen. The ability of the virus to persist may result from either a true latency or sequestration in an anatomic site that is not effectively exposed to antiretroviral therapy. The presence of HIV in kidney epithelial cells will lead progressively to end-stage renal disease. For decades, HIV-infected patients were excluded from consideration for kidney transplantation. Hemodialysis and peritoneal dialysis were the only forms of treatment available to these patients...
February 11, 2017: Transplantation
https://www.readbyqxmd.com/read/28176620/epidemiology-of-infectious-complications-in-renal-allograft-recipients-in-the-first-year-after-transplant
#16
Afsane Bahrami, Seyyede Fatemeh Shams, Elham Shaarbaf Eidgahi, Zahra Lotfi, Maryam Sheikhi, Sepideh Shakeri
OBJECTIVES: Renal transplant is one of the best ways to extend life of patients in the end stage of renal disease. Infections are significant causes of morbidity and mortality after renal transplant. The aim of this study was to evaluate frequency, risk factors, causative pathogens, and clinical manifestations in renal transplant recipients from Mashhad City during the first year after transplant. MATERIALS AND METHODS: This research was conducted at Montaserie Hospital of Mashhad University of Medical Sciences from March 2013 to July 2015...
February 7, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28176616/different-courses-of-hepatitis-b-reinfection-after-renal-transplant-a-case-report
#17
Ozan Yegit, Erol Demir, Yasar Caliskan, Halil Yazici, Mehmet Sukru Sever
Hepatitis B surface antigen-positive allografts may be a source of transmission in patients who undergo renal transplantation. Treatment of hepatitis B virus infection with nucleoside/nucleotide analogs in kidney recipients who have hepatitis B virus infection or who have received transplants from hepatitis B surface antigen-positive donors improves long-term patient survival. Antiviral agents are administered as a preemptive or prophylactic therapy at the time of kidney transplantation, rather than as salvage treatment...
February 7, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28133935/post-transplant-immune-complex-nephritis-in-a-patient-with-systemic-lupus-erythematosus-associated-with-anca-vasculitis
#18
Carlos Sanchez, Alejandra Rebolledo, Junior Gahona, Mauricio Rojas, Raquel Jiménez, Aurora Bojórquez
Nearly 20% of SLE corresponds to the pediatric population, and 75% of them have kidney involvement representing an important etiology of chronic kidney disease. A correlation between SLE and ANCA-associated vasculitis has been identified as an overlapping syndrome. Kidney allograft recurrence is rare in SLE when disease control is achieved and with nowadays immunosuppression treatment. Histologic transformation is unusual, especially when there are negative serologic markers and no immune complex deposition reported in native kidneys...
January 29, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28104138/a2-to-b-blood-type-incompatible-deceased-donor-kidney-transplantation-in-a-recipient-infected-with-the-human-immunodeficiency-virus-a-case-report
#19
R C Forbes, A DeMers, B P Concepcion, D R Moore, H M Schaefer, D Shaffer
BACKGROUND: With the introduction of the Kidney Allocation System in the United States in December 2014, transplant centers can list eligible B blood type recipients for A2 organ offers. There have been no prior reports of ABO incompatible A2 to B deceased donor kidney transplantation in human immunodeficiency virus-positive (HIV+) recipients to guide clinicians on enrolling or performing A2 to B transplantations in HIV+ candidates. We are the first to report a case of A2 to B deceased donor kidney transplantation in an HIV+ recipient with good intermediate-term results...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104135/renal-allograft-aspergillus-infection-presenting-with-obstructive-uropathy-a-case-report
#20
L Sadagah, M Alharbi, M Alshomrani, A Almalki
BACKGROUND: Isolated renal allograft aspergillosis is rare and usually presents with fever and decreased glomerular filtration rate. Presentation with obstructive uropathy caused by aspergillus fungal balls is much less common. We report a young male patient who presented with obstructive uropathy secondary to isolated renal allograft aspergillus infection 6 weeks after transplant. He was treated with nephrectomy and antifungal medications. CASE PRESENTATION: A 29-year-old Saudi male patient had a recent living non-related kidney transplantation in Pakistan...
January 2017: Transplantation Proceedings
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