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infection and kidney allograft

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https://www.readbyqxmd.com/read/27872837/antineutrophil-cytoplasmic-antibodies-crescentic-allograft-glomerulonephritis-after-sofosbuvir-therapy
#1
Shilpa Gadde, Belinda Lee, Laura Kidd, Rubin Zhang
Antineutrophil cytoplasmic antibodies (ANCA) are well known to be associated with several types of vasculitis, including pauci-immune crescentic glomerulonephritis, a form of rapid progressive glomerular nephritis (RPGN). ANCA vasculitis has also been reported after administration of propylthiouracil, hydralazine, cocaine (adulterated with levimasole), allopurinol, penicillamine and few other drugs. All previously reported cases of drug-associated ANCA glomerulonephritis were in native kidneys. Sofosbuvir is a new and effective drug for hepatitis C virus infection...
November 6, 2016: World Journal of Nephrology
https://www.readbyqxmd.com/read/27871759/rabbit-atg-or-basiliximab-induction-for-rapid-steroid-withdrawal-after-renal-transplantation-harmony-an-open-label-multicentre-randomised-controlled-trial
#2
Oliver Thomusch, Michael Wiesener, Mirian Opgenoorth, Andreas Pascher, Rainer Peter Woitas, Oliver Witzke, Bernd Jaenigen, Markus Rentsch, Heiner Wolters, Thomas Rath, Tülay Cingöz, Urs Benck, Bernhard Banas, Christian Hugo
BACKGROUND: Standard practice for immunosuppressive therapy after renal transplantation is quadruple therapy using antibody induction, low-dose tacrolimus, mycophenolate mofetil, and corticosteroids. Long-term steroid intake significantly increases cardiovascular risk factors with negative effects on the outcome, especially post-transplantation diabetes associated with morbidity and mortality. In this trial, we examined the efficacy and safety parameters of rapid steroid withdrawal after induction therapy with either rabbit antithymocyte globulin (rabbit ATG) or basiliximab in immunologically low-risk patients during the first year after kidney transplantation...
November 18, 2016: Lancet
https://www.readbyqxmd.com/read/27855166/a-comparison-of-two-types-of-rabbit-antithymocyte-globulin-induction-therapy-in-immunological-high-risk-kidney-recipients-a-prospective-randomized-control-study
#3
F Burkhalter, S Schaub, Ch Bucher, L Gürke, A Bachmann, H Hopfer, M Dickenmann, J Steiger, I Binet
BACKGROUND: Induction treatment with rabbit polyclonal antithymocyte globulins (ATGs) is frequent used in kidney transplant recipients with donorspecific HLA antibodies and shows acceptable outcomes. The two commonly used ATGs, Thymoglobulin and ATG-F have slightly different antigen profile and antibody concentrations. The two compounds have never been directly compared in a prospective trial in immunological high-risk recipients. Therefore we performed a prospective randomized controlled study comparing the two compounds in immunological high-risk kidney recipients in terms of safety and efficacy...
2016: PloS One
https://www.readbyqxmd.com/read/27800206/immune-complex-mediated-glomerulonephritis-with-acute-thrombotic-microangiopathy-following-newly-detected-hepatitis-b-virus-infection-in-a-kidney-transplant-recipient
#4
Tracey Salter, Hannah Burton, Sam Douthwaite, William Newsholme, Catherine Horsfield, Rachel Hilton
Hepatitis B virus (HBV) presents a risk to patients and staff in renal units. To minimise viral transmission, there are international and UK guidelines recommending HBV immunisation for patients commencing renal replacement therapy (RRT) and HBV surveillance in kidney transplant recipients. We report the case of a 56-year-old male who was immunised against HBV before starting haemodialysis. He received a deceased donor kidney transplant three years later, at which time there was no evidence of HBV infection...
2016: Case Reports in Transplantation
https://www.readbyqxmd.com/read/27799969/bk-viremia-among-iranian-renal-transplant-candidates
#5
Manizheh Jozpanahi, Amitis Ramezani, Shahrzad Ossareh, Mohammad Banifazl, Anahita Bavand, Setareh Mamishi, Arezoo Aghakhani
BACKGROUND: Primary infection with BK virus (BKV) is occurred during childhood and usually asymptomatic, but after initial infection, BKV may persist lifelong in the kidney and genitourinary tract. Reactivation may occur in individuals with compromised immunity such as renal transplant recipients. Due to the role of BKV in BK virus-associated nephropathy (BKVAN) and potentially renal allograft rejection, the detection of BKV in renal transplant candidates is very important. The aim of this study was to evaluate the frequency of BK viremia in end stage renal disease cases who were candidates for renal transplantation...
2016: Iranian Journal of Pathology
https://www.readbyqxmd.com/read/27798510/infections-in-de-novo-kidney-transplant-recipients-treated-with-the-rankl-inhibitor-denosumab
#6
Marco Bonani, Diana Frey, Olivier de Rougemont, Nicolas J Mueller, Thomas F Mueller, Nicole Graf, Rudolf P Wüthrich
BACKGROUND: Infections are a major cause of morbidity and mortality in kidney allograft recipients. In this posthoc analysis of a randomized clinical trial which tested the effect of denosumab on bone mineral density we assessed the impact of this drug on the incidence and severity of infections in the first year after kidney transplantation. METHODS: In this clinical trial we randomized 90 de novo kidney transplant recipients shortly after transplantation to either denosumab on top of standard treatment (calcium and vitamin D) (n=46), or to standard treatment alone (n=44)...
October 28, 2016: Transplantation
https://www.readbyqxmd.com/read/27788803/incidence-and-risk-factors-for-cytomegalovirus-infection-in-patients-with-kidney-transplantation-a-single-center-experience
#7
S Feng, J Yang, W Wang, X Hu, H Liu, X Qian, D Feng, X Zhang
BACKGROUND: Cytomegalovirus (CMV) infection is deemed to be a major cause of morbidity and mortality in patients after kidney transplantation. The purpose of this study was to analyze the incidence of CMV infection and risk factors for CMV infection in our center, to help in determination of its impact on the kidney function in this patient population, and to provide new ideas for the prevention and treatment of CMV infection. METHODS: A total of 319 kidney transplant recipients from our center were studied between January 2000 and December 2015...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27788796/surveillance-registry-of-sirolimus-use-in-recipients-of-kidney-allografts-from-expanded-criteria-donors
#8
G Laham, R Scuteri, P Cornicelli, M Arriola, P M Raffaele, M Davalos Michel, N Imperiali, R M Fortunato, E C Maggiora, M V Sal, G Soler Pujol
BACKGROUND: The use of expanded criteria donor (ECD) kidneys has increased the overall availability of renal transplants. This study assessed the use of sirolimus in patients receiving Argentina-ECD kidneys. METHODS: This observational, open-label, 1-arm, prospective, longitudinal pilot study was conducted at 8 transplant centers in Argentina. Adults receiving kidney transplants (without pancreas) from ECDs were eligible if they were converted to sirolimus 1 to 36 months' posttransplantation, with sirolimus becoming base therapy within 1 month after conversion...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27776929/kidney-transplantation-for-hiv-positive-patients
#9
Deirdre Sawinski
HIV+ patients are at increased risk for end-stage renal disease, but HIV infection was once considered a contraindication to renal transplantation. However, contemporary studies from the United States and Europe have now demonstrated that renal transplantation is a safe and effective treatment for end-stage renal disease in HIV patients, with equivalent patient and allograft survival to those uninfected. Broader experience in transplantation in HIV+ patients has identified unique challenges including high rates of acute rejection, delayed graft function, and significant drug-drug interactions...
October 11, 2016: Transplantation Reviews
https://www.readbyqxmd.com/read/27776444/impact-of-acute-kidney-injury-on-renal-allograft-survival
#10
Mani Nagarajan, Sakthirajan Ramanathan, Jeyachandran Dhanapriya, Thanigachalam Dineshkumar, T Bala Subramaniyan, Natarajan Gopalakrishnan
BACKGROUND: Acute kidney injury (AKI) is one of the major determinants of graft survival in kidney transplantation (KTx). Renal Transplant recipients are more vulnerable to develop AKI than general population. AKI in the transplant recipient differs from community acquired, in terms of risk factors, etiology and outcome. Our aim was to study the incidence, risk factors, etiology, outcome and the impact of AKI on graft survival. METHODS: A retrospective analysis of 219 renal transplant recipients (both live and deceased donor) was done...
October 24, 2016: Renal Failure
https://www.readbyqxmd.com/read/27772620/cytomegalovirus-and-other-%C3%AE-herpesviruses
#11
Carlos A Q Santos
Cytomegalovirus (CMV), human herpes virus (HHV)-6, and HHV-7 are ubiquitous β-herpesviruses that can cause opportunistic infection and disease in kidney transplant recipients. Active CMV infection and disease are associated with acute allograft failure and death, and HHV-6 and HHV-7 replication are associated with CMV disease. CMV prevention strategies are used commonly after kidney transplantation, and include prophylaxis with antiviral medications and preemptive treatment upon the detection of asymptomatic viral replication in blood...
September 2016: Seminars in Nephrology
https://www.readbyqxmd.com/read/27767010/transmission-of-babesia-microti-parasites-by-solid-organ-transplantation
#12
Meghan B Brennan, Barbara L Herwaldt, James J Kazmierczak, John W Weiss, Christina L Klein, Catherine P Leith, Rong He, Matthew J Oberley, Laura Tonnetti, Patricia P Wilkins, Gregory M Gauthier
Babesia microti, an intraerythrocytic parasite, is tickborne in nature. In contrast to transmission by blood transfusion, which has been well documented, transmission associated with solid organ transplantation has not been reported. We describe parasitologically confirmed cases of babesiosis diagnosed ≈8 weeks posttransplantation in 2 recipients of renal allografts from an organ donor who was multiply transfused on the day he died from traumatic injuries. The organ donor and recipients had no identified risk factors for tickborne infection...
November 2016: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/27762478/bk-polyomavirus-infection-in-pediatric-heart-transplant-recipients-a-prospective-study
#13
Allison Ducharme-Smith, Ben Z Katz, Amy E Bobrowski, Carl L Backer, Elfriede Pahl
BKV infection and nephropathy complicate pediatric HTx, but the incidence and time course of the disease are unknown. We assessed the incidence of BKV infection and its association with kidney dysfunction in pediatric HTx recipients. A single center prospective study compared pediatric (<18 years) HTx recipients, with and without BKV infection, who received an allograft between September 2013 and December 2014. Screening of urine for BKV was performed prior to transplant, and at week 1, and at months 3, 6, 9, 12, and 15 months post-transplantation...
October 20, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27755502/primary-human-renal-derived-tubular-epithelial-cells-fail-to-recognize-and-suppress-bk-virus-infection
#14
Hanneke de Kort, Kirstin M Heutinck, Jurjen M Ruben, Alessa E Valverde da Silva, Katja C Wolthers, Jörg Hamann, Ineke J M Ten Berge
BACKGROUND: BK polyomavirus (BKV)-associated nephropathy is a threat to kidney allograft survival affecting up to 15% of renal transplant patients. Previous studies revealed that tubular epithelial cells (TEC) show a limited response towards BKV infection. Here we investigated the interplay between BKV and TEC in more detail. In particular, we questioned whether BKV suppresses and/or evades antiviral responses. METHODS: Human primary tubular epithelial cells (TEC) and peripheral blood mononuclear cells were infected with BKV Dunlop strain or other viruses...
October 17, 2016: Transplantation
https://www.readbyqxmd.com/read/27753183/tolerability-of-up-to-200%C3%A2-days-of-prophylaxis-with-valganciclovir-oral-solution-and-or-film-coated-tablets-in-pediatric-kidney-transplant-recipients-at-risk-of-cytomegalovirus-disease
#15
G Varela-Fascinetto, C Benchimol, R Reyes-Acevedo, M Genevray, D Bradley, J Ives, H T Silva
This multicenter, open-label study evaluated the tolerability of extended prophylaxis with valganciclovir in pediatric kidney transplant recipients at risk of CMV disease. Fifty-six patients aged 4 months to 16 years received once-daily valganciclovir oral solution and/or tablets, dosed by BSA and renal function, for up to 200 days. The most common AEs on treatment were upper respiratory tract infection (33.9%), urinary tract infection (33.9%), diarrhea (32.1%), leukopenia (25.0%), neutropenia (23.2%), and headache (21...
October 17, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27742382/is-kidney-transplantation-a-better-state-of-ckd-impact-on-diagnosis-and-management
#16
Sandesh Parajuli, Dana F Clark, Arjang Djamali
Patients with CKD are at increased risk for cardiovascular events, hospitalizations, and mortality. Kidney transplantation (KTx) is the preferred treatment for end-stage kidney disease. Although comorbidities including anemia and bone and mineral disease improve or are even halted after KTx, kidney transplant recipients carry higher cardiovascular mortality risk than the general population, as well as an increased risk of infections, malignancies, fractures, and obesity. When comparing CKD with CKD after transplantation (CKD-T), the rate of decline of estimated glomerular filtration rate (eGFR) is significantly lower in CKD-T...
September 2016: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/27741127/anti-tnf%C3%AE-therapy-for-chronic-inflammatory-disease-in-kidney-transplant-recipients-clinical-outcomes
#17
Cyril Garrouste, Dany Anglicheau, Nassim Kamar, Claire Bachelier, Joseph Rivalan, Bruno Pereira, Sophie Caillard, Julien Aniort, Philippe Gatault, Martin Soubrier, Johnny Sayegh, Charlotte Colosio, Anthony Buisson, Eric Thervet, Nicolas Bouvier, Anne Elisabeth Heng
Anti-tumor necrosis factor-α (TNFα) therapy has improved the prognosis of many chronic inflammatory diseases. It appears to be well-tolerated by liver-transplant patients. However, their use and their safety in kidney-transplant patients have yet to be determined.In this retrospective study, we identified 16 adult kidney-transplant patients aged 46.5 years (34-51.8) who received anti-TNFα therapy from 7 kidney transplantation centers. The indications for this treatment included: chronic inflammatory bowel disease (n = 8), inflammatory arthritis (n = 5), AA amyloidosis (n = 1), psoriasis (n = 1), and microscopic polyangiitis (n = 1)...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27693310/the-selective-biomarker-il-8-identifies-ifta-after-kidney-transplantation-in-blood-cells
#18
Mareen Matz, Christine Lorkowski, Katharina Fabritius, Kaiyin Wu, Birgit Rudolph, Stefan Frischbutter, Susanne Brakemeier, Jens Gaedeke, Hans-H Neumayer, Mir-Farzin Mashreghi, Klemens Budde
Cellular and antibody-mediated rejection processes and also interstitial fibrosis/tubular atrophy (IFTA) lead to allograft dysfunction and loss. The search for accurate, specific and non-invasive diagnostic tools is still ongoing and essential for successful treatment of renal transplanted patients. Molecular markers in blood cells and serum may serve as diagnostic tools but studies with high patient numbers and differential groups are rare. We validated the potential value of several markers on mRNA level in blood cells and serum protein level in 166 samples from kidney transplanted patients under standard immunosuppressive therapy (steroids±mycophenolic acid±calcineurin inhibitor) with stable graft function, urinary tract infection (UTI), IFTA, antibody-mediated rejection (ABMR), and T-cell-mediated rejection (TCMR) applying RT-PCR and ELISA...
November 2016: Transplant Immunology
https://www.readbyqxmd.com/read/27683628/bk-nephropathy-in-the-native-kidneys-of-patients-with-organ-transplants-clinical-spectrum-of-bk-infection
#19
REVIEW
Darlene Vigil, Nikifor K Konstantinov, Marc Barry, Antonia M Harford, Karen S Servilla, Young Ho Kim, Yijuan Sun, Kavitha Ganta, Antonios H Tzamaloukas
Nephropathy secondary to BK virus, a member of the Papoviridae family of viruses, has been recognized for some time as an important cause of allograft dysfunction in renal transplant recipients. In recent times, BK nephropathy (BKN) of the native kidneys has being increasingly recognized as a cause of chronic kidney disease in patients with solid organ transplants, bone marrow transplants and in patients with other clinical entities associated with immunosuppression. In such patients renal dysfunction is often attributed to other factors including nephrotoxicity of medications used to prevent rejection of the transplanted organs...
September 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/27649571/the-spectrum-of-renal-allograft-failure
#20
Sourabh Chand, David Atkinson, Clare Collins, David Briggs, Simon Ball, Adnan Sharif, Kassiani Skordilis, Bindu Vydianath, Desley Neil, Richard Borrows
BACKGROUND: Causes of "true" late kidney allograft failure remain unclear as study selection bias and limited follow-up risk incomplete representation of the spectrum. METHODS: We evaluated all unselected graft failures from 2008-2014 (n = 171; 0-36 years post-transplantation) by contemporary classification of indication biopsies "proximate" to failure, DSA assessment, clinical and biochemical data. RESULTS: The spectrum of graft failure changed markedly depending on the timing of allograft failure...
2016: PloS One
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