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CMV infection in renal transplantation

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https://www.readbyqxmd.com/read/29782877/analysis-of-spontaneous-resolution-of-cytomegalovirus-replication-after-transplantation-in-cmv-seropositive-patients-with-pretransplant-cd8-ifng-response
#1
Aurora Páez-Vega, Antonio Poyato, Alberto Rodriguez-Benot, Lluis Guirado, Jesús Fortún, Oscar Len, Edson Abdala, María C Fariñas, Elisa Cordero, Carmen de Gracia, Domingo Hernández, Rafael González, Julián Torre-Cisneros, Sara Cantisán
This prospective study evaluates whether CMV-seropositive (R+) transplant patients with pretransplant CD8+IFNG+ T-cell response to cytomegalovirus (CMV) (CD8+IFNG+ response) can spontaneously clear the CMV viral load without requiring treatment. A total of 104 transplant patients (kidney/liver) with pretransplant CD8+IFNG+ response were evaluable. This response was determined using QuantiFERON-CMV assay. The incidence of CMV replication and disease was 45.2% (47/104) and 6.7% (7/104), respectively. Of the total patients, 77...
May 18, 2018: Antiviral Research
https://www.readbyqxmd.com/read/29696373/risk-factors-for-early-viral-infections-after-liver-transplantation
#2
Cornelius Johannes Busch, Benedikt Hermann Siegler, Heike Werle, Christoph Lichtenstern, Thomas Bruckner, Alexandra Heininger, Arianeb Mehrabi, Karl Heinz Weiss, Markus Alexander Weigand, Marcel Hochreiter
PURPOSE: Viral infections represent a serious threat for patients after liver transplantation (LT). The identification of risk factors during the early post-transplant period might help to improve prevention of viral infections after LT. METHODS: Between 2004 and 2010, 530 adult patients underwent LT at a large university hospital serving a metropolitan region in Europe. This retrospective single-centre study analysed putative risk factors for early viral infections with herpes simplex virus-1 (HSV-1), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), hepatitis A/B/C (HAV/HBV/HCV) and cytomegalovirus (CMV) in the first 3 months after LT...
April 25, 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/29679515/the-influence-of-mtor-inhibitors-on-the-incidence-of-cmv-infection-in-high-risk-donor-positive-recipient-negative-d-r-kidney-transplant-recipients
#3
M P Cristelli, R M Esmeraldo, C Motta Pinto, T V Sandes-Freitas, C Felipe, C F Lobo, L Viana, J Mansur, S Stopa, D W C Santos, P C Grenzi, W F Aguiar, H Tedesco-Silva, J O Medina-Pestana
Several studies and meta-analysis suggest the mTOR inhibitors are associated with reduced incidence of CMV infection after kidney transplantation, although their effects on the high-risk population have not been investigated thoroughly. This retrospective cohort study investigates the association between immunosuppression and CMV infection in D+/R- kidney transplant recipients receiving preemptive therapy. All patients received rabbit anti-thymocyte globulin, tacrolimus, prednisone and azathioprine (AZA), mycophenolate (MPA) or everolimus (EVR)...
April 21, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29676018/conversion-from-tacrolimus-mycophenolate-mofetil-to-tacrolimus-mtor-immunosuppression-after-kidney-pancreas-transplantation-reduces-the-incidence-of-both-bk-and-cmv-viremia
#4
Richard J Knight, Edward A Graviss, Duc T Nguyen, Samantha A Kuten, Samir J Patel, Lillian Gaber, A Osama Gaber
BACKGROUND: We sought to determine if conversion from tacrolimus/mycophenolate mofetil (TAC-MMF) to tacrolimus/mTOR inhibitor (TAC-mTOR) immunosuppression would reduce the incidences of BK and CMV viremia after kidney/pancreas (KP) transplantation. METHODS: In this single center review, the TAC-mTOR cohort (n=39) was converted at one month post-transplant to an mTOR inhibitor and reduced dose tacrolimus. Outcomes were compared to a cohort of KP recipients (n=40) maintained on TAC-MMF...
April 19, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29668074/a-20-year-experience-with-nocardiosis-in-solid-organ-transplant-sot-recipients-in-the-southwestern-united-states-a-single-center-study
#5
Aneela Majeed, Norman Beatty, Ahmad Iftikhar, Adeela Mushtaq, Julia Fisher, Pryce Gaynor, Jeeyong C Kim, Jose Luis Marquez, Francisco E Mora, Anca Georgescu, Tirdad Zangeneh
BACKGROUND: Nocardiosis is a life-threatening opportunistic infection. Solid organ transplant (SOT) recipients are at higher risk (incidence 0.04% to 3.5%) of developing nocardiosis. Rate of nocardiosis in the Southwestern US may be high due to environmental factors. METHODS: We performed a retrospective review study on 54 SOT patients diagnosed with Nocardia between 1997 and 2016 at our center. To explore the association of various risk factors with both the development of disseminated disease and mortality, a series of Fisher's exact tests was used...
April 18, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29659179/nk-cell-and-th17-responses-are-differentially-induced-in-murine-cytomegalovirus-infected-renal-allografts-and-vary-according-to-recipient-virus-dose-and-strain
#6
Mao Li, Srinivasa Boddeda, Bo Chen, Qiang Zeng, Trenton R Schoeb, Victoria M Velazquez, Masako Shimamura
Human cytomegalovirus (HCMV) donor positive (D+) serostatus with acute rejection is associated with renal allograft loss, but the impact of recipient positive (R+) serostatus is unclear. In an allogeneic renal transplant model, antiviral natural killer (NK) and CD8+ T cell memory responses in murine CMV (MCMV) D+/R+ transplants were compared to D-/R- and D+/R- transplants, with recipient infection varied by MCMV dose and strain. D+/R- transplants had high primary antiviral cytolytic (interferon-γ+) and cytotoxic (granzyme B+) NK responses, whereas NK memory responses were lower in D+/R+ recipients receiving a high primary MCMV dose...
April 16, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29626241/infectious-disease-risks-in-pediatric-renal-transplantation
#7
REVIEW
Felicia A Scaggs Huang, Lara Danziger-Isakov
Renal transplantation is a vital treatment option in children with ESRD with more than 10,000 pediatric kidney transplants and survival rates of greater than 80% at 10 years post-transplant in the USA alone. Despite these advances, infection remains a significant cause of morbidity in pediatric recipients. Screening potential organ donors and recipients is imperative to identify and mitigate infectious risks in the transplant patient. Despite the unique risks of each patient, the timing of many infections post-transplant is predictable...
April 6, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29605690/lack-of-evidence-of-association-between-ifng-and-il28b-polymorphisms-and-quantiferon-cmv-test-results-in-seropositive-transplant-patients
#8
Rocío Aguado, Aurora Páez-Vega, María L Agüera, Miguel Montejo, Lluis Guirado, Jesús Fortún, Alejandro Suárez-Benjumea, Oscar Len, María C Fariñas, Carmen de Gracia, Domingo Hernández, María J Cobos-Ceballos, Julián Torre-Cisneros, Sara Cantisán
The aim of this study was to analyze the relationship between the IFNG+874 T/A and IL28B (rs12979860) C/T polymorphisms and the secretion of IFNG by CD8+ T cells after stimulation with cytomegalovirus (CMV) peptides, measured using QuantiFERON-CMV (QF-CMV) assay. A total of 184 CMV-seropositive solid organ transplant patients (108 kidney, 68 liver and 8 lung) were recruited. Of them, 151 patients were QF-CMV Reactive (IFNG ≥0.2 UI/mL) and 33 were Non-reactive. Genotype frequencies in the study population were TT (26...
March 29, 2018: Human Immunology
https://www.readbyqxmd.com/read/29605470/outcomes-associated-with-mammalian-target-of-rapamycin-mtor-inhibitors-in-heart-transplant-recipients-a-meta-analysis
#9
Douglas L Jennings, Nicholas Lange, Michael Shullo, Farhana Latif, Susan Restaino, Veli K Topkara, Koji Takeda, Hiroo Takayama, Yoshifumi Naka, Maryjane Farr, Paolo Colombo, William L Baker
BACKGROUND: Data evaluating mTOR inhibitor use heart transplant (HT) patients comes from relatively small studies and controversy exists regarding their specific role. We performed a meta-analysis of randomized trials to evaluate the efficacy and safety of mTOR inhibitors in HT patients. METHODS: We performed a systematic literature search of Medline and Embase through July 2017 identifying studies evaluating mTOR inhibitors in HT patients reporting effects on coronary allograft vasculopathy (CAV), renal function, acute cellular rejection (ACR), cytomegalovirus (CMV) infection, and discontinuation due to adverse drug events (ADE)...
March 24, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29579857/cytomegalovirus-infection-monitoring-based-on-interferon-gamma-release-assay-in-kidney-transplantation
#10
M D C De Gracia-Guindo, M D C Ruiz-Fuentes, P Galindo-Sacristán, J M Osorio-Moratalla, N Ruiz-Fuentes, J Rodriguez Granger, A Osuna-Ortega
BACKGROUND: Cytomegalovirus (CMV) is the most common viral infection after kidney transplantation and is associated with significant morbidity and mortality. Recent studies showed that CMV-specific CD8+ T cells play the crucial role in protection against CMV. The Quantiferon-CMV (QF-CMV) is an interferon gamma (IFN-γ) release assay (IGRA test) that measures the IFN-γ response to a range of T-cell epitopes of CMV. In the present study, we analyzed the clinical utility of QF-CMV assay to predict CMV infection in kidney transplant recipients and evaluated if reactive result in QF-CMV test could be predictor of the duration of treatment...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29579856/resistant-cytomegalovirus-infection-after-renal-transplantation-literature-review
#11
M Cintra-Cabrera, A Suárez-Benjumea, G Bernal-Blanco, F M González-Roncero, N G Toapanta-Gaibor, M Súñer-Poblet, M Á Pérez-Valdivia, F Fernández-Cuenca, M Á Gentil-Govantes, J L Rocha-Castilla
BACKGROUND: Resistant cytomegalovirus (R-CMV) is an emerging problem in the renal transplantation population. The most frequent CMVs are high-resistance mutations (UL97 gene). METHODS: We describe our experience in management of R-CMV after renal transplant at our center (2012-2016). RESULTS: We encountered 3 cases of R-CMV infection after renal transplant (all primary infections). All 3 patients received induction therapy with corticosteroids, tacrolimus, and mycophenolate mofetil...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29558479/assessment-of-the-t-spot-cmv-interferon-%C3%AE-release-assay-in-renal-transplant-recipients-a-single-center-cohort-study
#12
Dimitrios Chanouzas, Alexander Small, Richard Borrows, Simon Ball
BACKGROUND: The measurement of CMV specific cellular immunity in organ transplant recipients could contribute additional acuity to serology based, CMV infection risk stratification, facilitating optimisation of immunosuppression and anti-viral prophylaxis. METHODS: A pilot study of renal transplant recipient (RTR's) responses in the T-SPOT.CMV ELISPOT based assay. 108 RTR's were recruited 3 months post-transplantation, immediately prior to the cessation of stratified anti-viral prophylaxis, used in recipients from seropositive donors...
2018: PloS One
https://www.readbyqxmd.com/read/29546589/valganciclovir-pharmacokinetics-in-patients-receiving-oral-prophylaxis-following-kidney-transplantation-and-model-based-predictions-of-optimal-dosing-regimens
#13
Thomas Tängdén, Pier Giorgio Cojutti, Jason A Roberts, Federico Pea
BACKGROUND AND OBJECTIVES: Valganciclovir is used as oral prophylaxis for cytomegalovirus (CMV) infection in kidney transplant recipients. However, limited pharmacokinetic data exist to guide dosing in this patient group. This study aimed to describe the population pharmacokinetics of valganciclovir in a large sample of kidney transplant recipients and predict optimal dosing based on Monte Carlo simulations. METHODS: Therapeutic drug monitoring (TDM) data from adult kidney transplant recipients who received valganciclovir prophylaxis during a 10-year study period were collected retrospectively...
March 15, 2018: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/29512249/low-dose-valganciclovir-prohylaxis-is-efficacious-and-safe-in-cytomegalovirus-seropositive-heart-transplant-recipients-with-anti-thymocyte-globulin
#14
Mari Eriksson, Janne J Jokinen, Sanni Söderlund, Pekka Hämmäinen, Jyri Lommi, Karl Lemström
BACKGROUND: Cytomegalovirus (CMV) remains an important pathogen in solid organ transplant patients. OBJECTIVE: We executed a hybrid prophylactic and pre-emptive valganciclovir (VGCV) prophylaxis to prevent CMV infection in heart transplant patients with anti-thymocyte globulin (ATG) induction and retrospectively evaluated the efficacy and safety of this regimen. METHODS: Hundred adult heart transplant patients between 2004 and 2010 were included...
March 7, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29487779/late-presentation-of-pneumocystis-jirovecii-pneumonia-after-renal-transplant-a-case-report
#15
Prithiv Prasad, Kevin Bryan Lo, Pradhum Ram
The highest risk of opportunistic infections is from 1 to 6 months post-transplant. We report a rare case of Pneumocystis jirovecii pneumonia in a renal transplant recipient only on maintenance immunosuppression eleven years after transplant without concomitant CMV infection or recent episodes of graft rejection.
June 2018: Medical Mycology Case Reports
https://www.readbyqxmd.com/read/29456214/outcome-of-renal-transplant-recipients-with-cytomegalovirus-and-bk-polyomavirus-co-infection-nephropathy
#16
Anupma Kaul, Shashi Kumar, Dharmendra Bhaduaria, Vinita Agrawal, R K Sharma, Narayan Prasad, Amit Gupta, Rishi Kumar
Reactivation of cytomegalovirus (CMV) and BK polyomavirus (BKV) can result in virus-associated tubulointerstitial nephritis in renal allografts. All those renal biopsies reported as viral cytopathic were isolated and examined by two independent renal histopathologists from our institute and classified as CMV, BKV, and CMV-BKV coinfection-associated viral cytopathic changes with confirmation through polymerase chain reaction technology in either serum or urine or both. All twenty patients were categorized as 10 in CMV, four in BKV, and six were in CMV-BKV coinfection...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
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
#17
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/29319768/the-current-burden-of-cytomegalovirus-infection-in-kidney-transplant-recipients-receiving-no-pharmacological-prophylaxis
#18
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/29302827/colonic-perforation-due-to-severe-cytomegalovirus-disease-in-granulomatosis-with-polyangiitis-after-immunosuppression
#19
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
#20
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
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