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https://www.readbyqxmd.com/read/29931826/the-two-faced-nature-of-bk-polyomavirus-lytic-infection-or-non-lytic-large-t-positive-carcinoma
#1
Volker Nickeleit, Harsharan K Singh, Daniel J Kenan, Piotr A Mieczkowski
In immunocompromised patients, reactivation of latent BK-polyomavirus (BKPyV) can cause disease with lytic infections of kidneys and the lower urinary tract. Emerging evidence also links BKPyV to oncogenesis and high grade intra-renal and transitional cell carcinomas. These neoplasms strongly express polyomavirus large-T antigen as a defining feature, i.e. they are "large-T positive carcinomas". Such neoplasms arise in immunocompromised patients, typically in renal allograft recipients and preferentially in tissues harboring latent BKPyV...
June 21, 2018: Journal of Pathology
https://www.readbyqxmd.com/read/29925834/urinary-cell-free-dna-is-a-versatile-analyte-for-monitoring-infections-of-the-urinary-tract
#2
Philip Burnham, Darshana Dadhania, Michael Heyang, Fanny Chen, Lars F Westblade, Manikkam Suthanthiran, John Richard Lee, Iwijn De Vlaminck
Urinary tract infections are one of the most common infections in humans. Here we tested the utility of urinary cell-free DNA (cfDNA) to comprehensively monitor host and pathogen dynamics in bacterial and viral urinary tract infections. We isolated cfDNA from 141 urine samples from a cohort of 82 kidney transplant recipients and performed next-generation sequencing. We found that urinary cfDNA is highly informative about bacterial and viral composition of the microbiome, antimicrobial susceptibility, bacterial growth dynamics, kidney allograft injury, and host response to infection...
June 20, 2018: Nature Communications
https://www.readbyqxmd.com/read/29886220/removal-of-non-infected-arteriovenous-fistulae-following-kidney-transplantation-is-a-safe-and-beneficial-management-strategy-for-unused-dialysis-access
#3
Charles D Fraser, Joshua C Grimm, Rui Han Liu, Russell N Wesson, Faris Azar, Robert J Beaulieu, Thomas Reifsnyder
INTRODUCTION: Renal transplant recipients often maintain their hemodialysis access in the event of future allograft failure. Patients may develop complications related to the unused dialysis access and it also limits vein availability for phlebotomy. Accordingly, a change in the current paradigm may be warranted. This study evaluates the indications for, and safety of, arteriovenous fistula (AVF) removal in patients following successful renal transplantation. METHODS: All patients that underwent AVF excision at a single institution from 2006-2016 were retrospectively reviewed...
June 7, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29867932/the-donor-major-histocompatibility-complex-class-i-chain-related-molecule-a-allele-rs2596538-g-predicts-cytomegalovirus-viremia-in-kidney-transplant-recipients
#4
Hana Rohn, Rafael Tomoya Michita, Esther Schwich, Sebastian Dolff, Anja Gäckler, Mirko Trilling, Vu Thuy Khanh Le-Trilling, Benjamin Wilde, Johannes Korth, Falko M Heinemann, Peter A Horn, Andreas Kribben, Oliver Witzke, Vera Rebmann
The interaction of major histocompatibility complex class I chain-related protein A (MICA) and its cognate activating receptor natural killer (NK) group 2 member D (NKG2D) receptor plays a significant role in viral immune control. In the context of kidney transplantation (KTx), cytomegalovirus (CMV) frequently causes severe complications. Hypothesizing that functional polymorphisms of the MICA/NKG2D axis might affect antiviral NK and T cell responses to CMV, we explored the association of the MICA-129 Met/Val single nucleotide polymorphism (SNP) (affecting the binding affinity of MICA with the NKG2D receptor), the MICA rs2596538 G/A SNP (influencing MICA transcription), and the NKG2D rs1049174 G/C SNP (determining the cytotoxic potential of effector cells) with the clinical outcome of CMV during the first year after KTx in a cohort of 181 kidney donor-recipients pairs...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29863293/granulomatous-inflammation-in-bk-polyomavirus-associated-nephropathy
#5
Yang Zhang, Hiba Ahmed, Abdolreza Haririan, Richard Ugarte, John C Papadimitriou, Cinthia B Drachenberg
Evolving BK polyomavirus associated nephropathy (BKPyVAN) is characterized by tubulointerstitial inflammation that closely resembles acute T-cell mediated allograft rejection if tubulitis is significant. The cellular composition of the inflammation varies during the course of BKPyVAN, and clusters of plasma cells may herald resolution of the infection. Less commonly, BKPyVAN can present with a predominance of histiocytes and granuloma formation. Granulomatous interstitial nephritis is uncommon in biopsies of either native or transplant kidneys...
June 4, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29809299/disseminated-mycobacterium-bovis-infection-post-kidney-transplant-following-remote-intravesical-bcg-therapy-for-bladder-cancer
#6
Jennifer Ziegler, Julie Ho, Ian W Gibson, Jasmir G Nayak, Markus Stein, Andrew Walkty, Pamela Orr
Intravesical Bacillus Camlette-Guérin (BCG) is the treatment of choice for non-muscle invasive bladder cancer, and has been used successfully for over 40 years. A rare and potentially fatal complication of intravesical BCG therapy is BCG-induced sepsis. We report a rare case in which a patient with end-stage renal disease secondary to chronic granulomatous interstitial nephritis underwent remote, pre-transplant intravesical BCG treatment for high-grade non-invasive papillary bladder carcinoma. The patient subsequently received a deceased donor kidney transplant 5 years after BCG therapy, with thymoglobulin induction therapy and standard triple maintenance immunosuppression...
May 29, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29797632/risk-factors-associated-with-clostridium-difficile-infection-in-kidney-transplant-recipients
#7
M L Spinner, B R Stephany, P M Cerrato, S W Lam, E A Neuner, K S Patel
BACKGROUND: Solid organ transplant recipients are especially vulnerable to Clostridium difficile infection (CDI) due to cumulative risk factors including increased exposure to healthcare settings, persistent immunosuppression, and higher rates of antimicrobial exposure. We aimed to identify risk factors associated with CDI development in kidney transplant recipients including implications of immunosuppressive therapies and acid-suppressing agents. METHODS: This was a single-center, non-interventional, retrospective case-control study of adult subjects between June 1, 2009 and June 30, 2013...
May 24, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29796578/quantitative-detection-of-bk-virus-in-kidney-transplant-recipients-a-prospective-validation-study
#8
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...
January 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29791046/impact-of-intensive-dosing-of-mycophenolate-on-pancreas-allograft-survival
#9
Jillian L Descourouez, Margaret Jorgenson, Nathan Menninga, Glen Leverson, Jon Odorico, Robert Redfield
PURPOSE: Evaluate the effect of mycophenolate (mycophenolic acid, MPA) dose on pancreas allograft survival following simultaneous pancreas kidney (SPK) transplant. METHODS: This was an observational study of adult SPK recipients transplanted between 1/1/2002-6/30/2015. Recipients were divided into cohorts based on MPA dose at discharge; high dose (HD) 1000mg three times daily mycophenolate mofetil (MMF) and standard dose (SD) 1000mg twice daily MMF. Primary outcome was pancreas allograft survival...
May 23, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29771270/effect-of-conversion-from-calcineurin-inhibitors-to-everolimus-on-hepatitis-c-viremia-in-adult-kidney-transplant-recipients
#10
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
#11
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/29757021/advagraf%C3%A2-with-or-without-an-induction-therapy-for-de-novo-kidney-transplant-recipients
#12
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/29738028/quantitative-detection-of-bk-virus-in-kidney-transplant-recipients-a-prospective-validation-study
#13
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/29731069/bk-virus-infection-in-thai-kidney-transplant-recipients-a-single-center-experience
#14
P Skulratanasak, J Mahamongkhonsawata, M Chayakulkeereeb, N Larpparisutha, N Premasathiana, A Vongwiwatana
INTRODUCTION: BK virus-associated nephropathy (BKVAN) is a significant cause of allograft dysfunction and failure in kidney transplant recipients. Early detection and proper adjustment of immunosuppression is the best method for treatment of this condition and to improve long-term allograft outcome. Here, we reported the prevalence and risk factors of BK virus (BKV) infection in our population. METHODS: We retrospectively reviewed kidney transplant recipients at Siriraj Hospital between January 2012 and December 2015 who had been investigated using real-time polymerase chain reaction BK viral load...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29731058/characteristics-of-recipients-with-10-or-more-years-of-allograft-survival-in-deceased-donor-kidney-transplantation
#15
S S Kang, W Y Park, K Jin, S B Park, S Han
BACKGROUND: The development of immunosuppressants improved the short-term outcomes of deceased donor kidney transplantation (DDKT), but the long-term survival rate was not improved. METHODS: The study included 127 patients who received first-time kidneys from deceased donors at Keimyung University Dongsan hospital between October 1994 and June 2007. We analyzed the clinical features of recipients with long-term allograft survival. RESULTS: The mean follow-up period was 163 months...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29696741/outcomes-of-single-kidney-transplantation-from-pediatric-donors-a-single-center-experience
#16
Yamei Jiang, Turun Song, Yang Qiu, Jinpeng Liu, Zhiling Wang, Xianding Wang, Zhongli Huang, Yu Fan, Li Wang, Tao Lin
Kidneys from pDDs are increasingly used to narrow the huge gap between incremental demand and static supply. However, there is still controversy on the clinical outcome of SKT from pDDs. We conducted a retrospective cohort study of 452 adult recipients in our center between March 2012 and February 2017. Outcomes of 3 groups, transplants with organs from pDDs (n=50), aDDs (n=207), and LDs (n=195), were compared. The mean age and weight of pDDs were 8.98 years (range 8 months-17 years) and 30.05 kg (range 8...
April 25, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29694723/timing-of-hepatitis-c-virus-infection-treatment-in-kidney-transplant-candidates
#17
REVIEW
Abraham Cohen-Bucay, Jean M Francis, Craig E Gordon
Hepatitis C virus (HCV) infection is prevalent in patients with kidney disease including transplant candidates and recipients. It is associated with increased morbidity and mortality in end-stage renal disease patients and also increases the risk of allograft rejection and decreases allograft and patient survival post-transplant. Newly developed direct acting antivirals have revolutionized the way HCV is treated. Whether patients are treated before or after kidney transplantation, the cure rates with direct acting antivirals are >90%...
April 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29694721/hepatitis-c-virus-infection-in-kidney-transplantation-changing-paradigms-with-novel-agents
#18
REVIEW
Yuvaram N V Reddy, David Nunes, Vipul Chitalia, Craig E Gordon, Jean M Francis
Hepatitis C virus (HCV) is a common cause of increased morbidity and mortality in kidney transplant patients. It is associated with posttransplant glomerulonephritis, chronic allograft nephropathy, and New Onset Diabetes after Transplant (NODAT). In the past, HCV was difficult to treat due to the presence of interferon alpha-based therapies that were difficult to tolerate and were associated with adverse side-effects, such as the risk of rejection. With the advent of oral directly acting antiviral therapies, the landscape for HCV and transplantation has changed...
April 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29688849/cryptococcoma-of-a-transplanted-kidney-in-a-patient-presenting-with-recurrent-urinary-tract-infection-a-case-report
#19
Albert Z Muranda, Ludolf Greeff, Mike M Sathekge, Thabo Lengano, Victor O L Karusseit
BACKGROUND: Cryptococcosis is an important opportunistic infection of organ transplant recipients. It is the third most common fungal infection of transplant patients and occurs especially in kidney recipients. Cryptococcus neoformans is a ubiquitous fungus which infects humans by inhalation of spores. C. gattii has more recently been recognised as a pathogen. Infection commonly is disseminated affecting mainly the central nervous system and the lungs. Cryptococcoma, a localised form of the disease, has been described in various organs...
April 23, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29682370/fatal-pneumococcus-sepsis-after-treatment-of-late-antibody-mediated-kidney-graft-rejection
#20
Gunilla Einecke, Jan Hinrich Bräsen, Nils Hanke, Hermann Haller, Anke Schwarz
Antibody-mediated rejection (ABMR) is a major cause of late renal allograft dysfunction and graft loss. Risks and benefits of treatment of late ABMR have not been evaluated in randomized clinical trials. We report on a 35-year-old patient with deterioration in renal function and progressive proteinuria 15 years after transplantation. Recurrent infections after a splenectomy following traumatic splenic rupture 3 years earlier had led to reduction of immunosuppression. Renal transplant biopsy showed glomerular double contours, 40% fibrosis/tubular atrophy, peritubular capillaritis, and positive C4d staining indicating chronic-active ABMR...
2018: Case Reports in Nephrology
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