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infection and kidney allograft

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https://www.readbyqxmd.com/read/28423464/high-clinical-suspicion-of-donor-derived-disease-leads-to-timely-recognition-and-early-intervention-to-treat-solid-organ-transplant-transmitted-lymphocytic-choriomeningitis-virus
#1
Gagan Mathur, Kunal Yadav, Bradley Ford, Ilana J Schafer, Shridhar V Basavaraju, Barbara Knust, Wun-Ju Shieh, Sam Hill, Garret D Locke, Patricia Quinlisk, Shelley Brown, Ardith Gibbons, Deborah Cannon, Matthew Kuehnert, Stuart T Nichol, Pierre E Rollin, Ute Ströher, Rachel Miller
Despite careful donor screening, unexpected donor-derived infections continue to occur in organ transplant recipients (OTRs). Lymphocytic choriomeningitis virus (LCMV) is one such transplant-transmitted infection that in previous reports has resulted in a high mortality among the affected OTRs. We report a LCMV case cluster that occurred 3 weeks post-transplant in three OTRs who received allografts from a common organ donor in March 2013. Following confirmation of LCMV infection at Centers for Disease Control and Prevention, immunosuppression was promptly reduced and ribavirin and/or intravenous immunoglobulin therapy were initiated in OTRs...
April 19, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28423197/diabetic-kidney-transplant-recipients-impaired-infection-control-and-increased-alloreactivity
#2
Thomas Schachtner, Maik Stein, Petra Reinke
BACKGROUND: Posttransplantation diabetes mellitus (PTDM) has been associated with inferior patient and allograft outcomes. However, previous studies didn't identify differences in infection control and alloreactivity. METHODS: We studied 449 kidney transplant recipients (KTRs) between 2005 and 2013. 50 (11.1%) KTRs were diagnosed with PTDM and 60 (13.4%) KTRs with pre-existing diabetes. Samples were collected pretransplantation, at +1, +2, +3 months posttransplantation...
April 19, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28396741/renal-allograft-granulomatous-interstitial-nephritis-observations-of-an-uncommon-injury-pattern-in-22-transplant-recipients
#3
Alton B Farris, Carla L Ellis, Thomas E Rogers, W James Chon, Anthony Chang, Shane M Meehan
Background: Granulomatous interstitial nephritis (GIN) is uncommon in native kidneys, and descriptions in allografts are few. We report clinical and pathologic findings in 22 allograft recipients with GIN identified in renal allograft biopsies and nephrectomies. Methods: Renal allografts with GIN were retrieved from the pathology files of two academic medical centers. Available clinical and pathologic data were compiled retrospectively for a 23-year period. Results: GIN was present in 23 specimens from 22 patients (15 males and 7 females) with allograft dysfunction [serum creatinine averaged 3...
April 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28392824/posttransplantation-lymphoproliferative-disorder-after-pediatric-solid-organ-transplantation-experiences-of-20-years-in-a-single-center
#4
Hyung Joo Jeong, Yo Han Ahn, Eujin Park, Youngrok Choi, Nam-Joon Yi, Jae Sung Ko, Sang Il Min, Jong Won Ha, Il-Soo Ha, Hae Il Cheong, Hee Gyung Kang
PURPOSE: To evaluate the clinical spectrum of posttransplantation lymphoproliferative disorder (PTLD) after solid organ transplantation (SOT) in children. METHODS: We retrospectively reviewed the medical records of 18 patients with PTLD who underwent liver (LT) or kidney transplantation (KT) between January 1995 and December 2014 in Seoul National University Children's Hospital. RESULTS: Eighteen patients (3.9% of pediatric SOTs; LT:KT, 11:7; male to female, 9:9) were diagnosed as having PTLD over the last 2 decades (4...
March 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28382751/treatment-of-hcv-infection-in-liver-transplant-recipients-with-ledipasvir-and-sofosbuvir-without-ribavirin
#5
A A Pillai, R Maheshwari, R Vora, J P Norvell, R Ford, S Parekh, N Cheng, A Patel, N Young, J R Spivey, O Mgbemena, J P Wedd
BACKGROUND: Ledipasvir and Sofosbuvir is a well-tolerated regimen with high sustained virological response (SVR) rates in pre-liver transplant patients infected with chronic hepatitis C virus (HCV), but data in liver transplant recipients outside of clinical trials is limited. AIMS: To address this knowledge gap and assess SVR rates without the use of ribavirin in liver transplant recipients METHODS: This is a retrospective study examining the treatment of 75 post-liver transplant recipients with ledipasvir and sofosbuvir without ribavirin...
April 6, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28371308/bk-virus-nephropathy-histological-evolution-by-sequential-pathology
#6
Brian J Nankivell, Jasveen Renthawa, Raghwa N Sharma, Kathy Kable, Philip J O'Connell, Jeremy R Chapman
Reactivation of BK virus in renal allografts causes a destructive chronic infection. This single-centre, retrospective, cohort study describes the evolution of BK virus allograft nephropathy (BKVAN) from 63 kidneys (n=61 patients) using sequential histopathology (n=454 biopsies, averaging 7.8±2.6/kidney) followed for 60.1 months. Uninfected protocol biopsies formulated time-matched control Banff scores (n=975). This article is protected by copyright. All rights reserved.
March 30, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28363168/gut-microbiota-and-renal-transplant-outcome
#7
REVIEW
Mohammadreza Ardalan, Sepideh Zununi Vahed
Gaining long-term graft function and patient survival remain a critical challenge following kidney transplantation. Genetic and environmental factors do not completely account for the individual's graft outcome. Recently, it is reported that gut microbial community (microbiota) is associated with complications in kidney allograft recipients, as well. Commensal microbiota plays a significant role in the immunomodulation of transplant recipient responses. Different factors can disrupt the reciprocal interaction between microbiota and the host immune responses and lead to infection and rejection complications in the organ recipient...
March 28, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28355579/stability-of-bk-polyomavirus-igg-seroreactivity-and-its-correlation-with-preceding-viremia
#8
Herman F Wunderink, Els van der Meijden, Caroline S van der Blij-de Brouwer, Hans L Zaaijer, Aloys C M Kroes, Erik W van Zwet, Joris I Rotmans, Mariet C W Feltkamp
BACKGROUND: Recently we showed that the level of BK polyomavirus (BKPyV) IgG seroreactivity in kidney donors predicted viremia and BKPyV-associated nephropathy in kidney transplant recipients (KTRs). This observation could be explained by assuming a direct association between BKPyV seroreactivity and the amount of persistent infectious virus in the renal allograft. OBJECTIVES: Since the renal BKPyV reservoir is probably sowed by viremia during primary BKPyV infection, we systematically analysed the dynamics of BKPyV IgG seroreactivity in relation to preceding BKPyV viremia in KTRs and healthy individuals...
March 19, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28338458/hepatitis-b-in-solid-organ-transplant-procedures-other-than-liver
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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