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CMV infection in renal transplantation

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https://www.readbyqxmd.com/read/28544101/belatacept-combined-with-transient-calcineurin-inhibitor-therapy-prevents-rejection-and-promotes-improved-long-term-renal-allograft-function
#1
A B Adams, J Goldstein, C Garrett, R Zhang, R E Patzer, K A Newell, N A Turgeon, A S Chami, A Guasch, A D Kirk, S O Pastan, T C Pearson, C P Larsen
Belatacept, a T cell costimulation-blocker demonstrated superior renal function, lower cardiovascular risk, and improved graft/patient survival in renal transplant recipients. Despite the potential benefits, adoption of belatacept has been limited in part due to concerns regarding higher rates and grades of acute rejection in clinical trials. Since July 2011 we have utilized belatacept-based immunosuppression regimens in clinical practice. In this retrospective analysis of 745 patients undergoing renal transplantation at our center, we compared patients treated with belatacept (n=535) to a historical cohort receiving a tacrolimus-based protocol (n=205)...
May 23, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28503279/incidence-and-risk-factors-for-cytomegalovirus-in-kidney-transplant-patients-in-babol-northern-iran
#2
Arefeh Babazadeh, Mostafa Javanian, Farshid Oliaei, Roghayeh Akbari, Abazar Akbarzadepasha, Ali Bijani, Mahmoud Sadeghi
BACKGROUND: Cytomegalovirus (CMV) disease is an important cause of death and possibly transplant rejection in kidney transplant (KT) patients. This study was conducted to investigate the incidence and risk factors of CMV disease in kidney transplant patients. METHODS: All end-stage renal disease (ESRD) patients who underwent kidney transplantation during 1998-2014 and their donors were assessed. All samples were followed-up for approximately 70 months. CMV was identified by polymerase chain reaction (PCR) and/or PP65 antigen in peripheral blood leukocytes along with clinical manifestations...
2017: Caspian Journal of Internal Medicine
https://www.readbyqxmd.com/read/28457362/pre-emptive-therapy-for-the-treatment-of-cytomegalovirus-after-kidney-transplantation
#3
R Pretagostini, L Poli, Q Lai, G Russo, F Nudo, M Garofalo, F Melandro, A Gaeta, C Nazzari, C Fazio, E Di Simone, V Vullo, P B Berloco
BACKGROUND: Cytomegalovirus (CMV) represents the leading cause of viral infection in kidney transplantation patients. The aim of the present study was to evaluate the efficacy and safety of pre-emptive anti-CMV therapy. MATERIALS AND METHODS: We performed a retrospective analysis based on data from 227 consecutive patients transplanted from 2010 to 2015, of whom 38 (16.6%) were from a living donor, considering: incidence of rejection, CMV organ localization, and graft and patient survival...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28432714/high-human-cytomegalovirus-dnaemia-early-post-transplantation-associates-with-irreversible-and-progressive-loss-of-renal-function
#4
Wouter T Lollinga, Lilli Rurenga-Gard, Willem van Doesum, Rik van Bergen, Arjan Diepstra, Judith M Vonk, Annelies Riezebos-Brilman, Hgm Niesters, Willem J van Son, Jacob van den Born, Jan-Stephan Sanders
BACKGROUND: Transplant recipients are prone to viral infections, which could affect renal transplantation outcome. Our aim was to assess the effects of early human cytomegalovirus (CMV) DNAemia on transplant renal function. METHODS: 264 (age 50.9±13.5; male 55%) Renal transplantation recipients undergoing preemptive anti-CMV therapy were retrospectively categorized based on early (<3 months post-Tx) CMV peak viral load (PVL); PVL≤536, PVL536-6310 or PVL>6310 International Units/ml (IU/ml)...
April 22, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28370833/infectious-complications-in-indigenous-renal-transplant-recipients-in-western-australia
#5
Peter Boan, Ramyasuda Swaminathan, Ashley Irish
BACKGROUND: Infectious complications remain a significant risk following renal transplantation. AIMS: To examine the burden and pattern of infection following renal transplantation in Aboriginal and Torres Strait Islanders (ATSI) compared to non-ATSI. METHODS: Retrospective cohort study of 141 consecutive adult renal transplant recipients in Western Australia between 2005 and 2011. We determined baseline serological status for relevant organisms, the number of patients with specific infections and infectious admission in the first year post transplantation and the rate of infectious death during follow up...
April 3, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28369203/risk-factors-and-outcomes-of-ganciclovir-resistant-cytomegalovirus-infection-in-solid-organ-transplant-recipients
#6
C E Fisher, J L Knudsen, E D Lease, K R Jerome, R M Rakita, M Boeckh, A P Limaye
Background: Ganciclovir-resistant (ganR)-CMV is an emerging and important problem in solid-organ transplant (SOT) recipients. Only through direct comparison of ganR- and ganciclovir-sensitive (ganS)-CMV infection can risk factors and outcomes attributable specifically to ganciclovir resistance be appropriately determined. Methods: We performed a retrospective, case-control (1:3) study of SOT recipients with genotypically-confirmed ganR-CMV (n=37) and ganS-CMV infection (n=109), matched by donor/recipient CMV serostatus, year and organ transplanted, and clinical manifestation...
March 29, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28355408/evaluation-of-diagnostic-tests-for-cytomegalovirus-active-infection-in-renal-transplant-recipients
#7
Rodrigo Fontanive Franco, Rosangela Munhoz Montenegro, Alice Beatriz Mombach Pinheiro Machado, Fernanda de Paris, Denise Silva Menezes, Roberto Ceratti Manfro
INTRODUCTION: Cytomegalovirus (CMV) infection is a main viral infection after kidney transplantation. The diagnostic methods currently employed are pp65 antigenemia and nucleic acid amplification by polymerase chain reaction (PCR) and aim at detecting viral replication. OBJECTIVE: The goal of this study was to evaluate and compare by both methods the incidence of CMV active infection in kidney transplant patients and to establishthe best clinical-laboratory correlation...
March 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/28296035/sepsis-after-renal-transplantation-clinical-immunological-and-microbiological-risk-factors
#8
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. In all, 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/28199780/cytomegalovirus-responsive-cd8-t-cells-expand-after-solid-organ-transplantation-in-the-absence-of-cmv-disease
#9
L E Higdon, J Trofe-Clark, S Liu, K B Margulies, M K Sahoo, E Blumberg, B A Pinsky, J S Maltzman
Cytomegalovirus (CMV) is a major cause of morbidity and mortality in solid organ transplant recipients. Approximately 60% of adults are CMV seropositive, indicating previous exposure. Following resolution of the primary infection, CMV remains in a latent state. Reactivation is controlled by memory T cells in healthy individuals; transplant recipients have reduced memory T cell function due to chronic immunosuppressive therapies. In this study, CD8(+) T cell responses to CMV polypeptides immediate-early-1 and pp65 were analyzed in 16 CMV-seropositive kidney and heart transplant recipients longitudinally pretransplantation and posttransplantation...
February 15, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28198539/cytomegalovirus-infection-alters-phenotypes-of-different-%C3%AE-%C3%AE-t-cell-subsets-in-renal-transplant-recipients-with-long-term-stable-graft-function
#10
Silvia Lee, Jacquita S Affandi, Ashley B Irish, Patricia Price
Cytomegalovirus (CMV) infection alters the phenotypic profiles of T-cells and NK cells in healthy and immunocompromised individuals. Here, we examined the effects of CMV infection on the phenotype and functions of γδ T-cell subsets in renal transplant recipients (RTR) stable several years after transplantation (n = 80) and healthy controls (n = 72). Differentiation status, function, and expression of HLA-DR, CD57, and LIR-1 on Vδ2(-) and Vδ2(+) γδ T-cells were examined in peripheral blood cells using flow cytometry...
February 15, 2017: Journal of Medical Virology
https://www.readbyqxmd.com/read/28088953/-research-of-mhla-g-and-the-receptor-expression-with-kidney-rejection-and-cmv-active-infection-following-kidney-transplantation
#11
L L Bi, Y Gao, Y J Sun, X R Kong, X Y He, X H Ma, W H Zhang, L Xiao, B Y Shi
Objective: To study the expression of membrane HLA-G (mHLA-G) and the receptor immunoglobulin-like transcript 2(ILT2) on lymphocyte and find their association with rejection and cytomegalovirus (CMV) infection after renal transplantation. Methods: A total of 88 cases of renal transplant recipients for the first time from February 2014 to February 2016 were studied in this work. Recipients can be divided into rejection group (n=12) and stable renal function group (n=41) according to whether rejection occurred...
January 10, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27938472/post-transplant-immune-activation-innocent-bystander-or-insidious-culprit-of-post-transplant-accelerated-atherosclerosis
#12
Didier Ducloux, Jamal Bamoulid, Thomas Crepin, Jean-Michel Rebibou, Cecile Courivaud, Philippe Saas
Cardiovascular disease is a major cause of morbidity, disability, and mortality in kidney transplant patients. Cumulative reports indicate that the excessive risk of cardiovascular events is not entirely explained by the increased prevalence of traditional cardiovascular risk factors. Atherosclerosis is a chronic inflammatory disease and it has been postulated that post-transplant immune disturbances may explain the gap between the predicted and observed risks of cardiovascular events. However, whereas concordant data suggest that innate immunity contributes to the posttransplant accelerated atherosclerosis, only few arguments plead for a role of adaptive immunity...
October 27, 2016: Cell Transplantation
https://www.readbyqxmd.com/read/27849440/use-of-cidofovir-for-cytomegalovirus-disease-refractory-to-ganciclovir-in-solid-organ-recipients
#13
Hugo Bonatti, Costi D Sifri, Clara Larcher, Stefan Schneeberger, Camille Kotton, Christian Geltner
BACKGROUND: Solid organ transplantation (SOT) frequently is complicated by cytomegalovirus (CMV) infections. Cidofovir (CDV) is active against CMV, including many ganciclovir (GCV)-resistant mutants, but often is considered to be too nephrotoxic for use after organ transplantation. PATIENTS AND METHODS: Seven males and two females (median age 50.1 years), including two kidney/pancreas, four lung, one small bowel, and two hand recipients, received CDV for refractory CMV disease...
February 2017: Surgical Infections
https://www.readbyqxmd.com/read/27775825/impact-of-type-of-calcineurin-inhibitor-on-post-transplant-tuberculosis-single-center-study-from-india
#14
Sanjay K Agarwal, Dipankar Bhowmik, Sandeep Mahajan, Soumita Bagchi
INTRODUCTION: Tuberculosis (TB) is an important cause of morbidity and mortality in renal transplant recipients. Immunosuppressive drugs are one of the most important risk factor for post-transplant tuberculosis (PTTB). A paucity of data exists about the impact of the type of calcineurin inhibitor on PTTB. METHODS: In this retrospective study, all adult patients on calcineurin inhibitor-based immunosuppression were included. Patients receiving TB chemoprophylaxis were excluded...
February 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27761671/preemptive-kidney-transplantation-a-propensity-score-matched-cohort-study
#15
Masayoshi Okumi, Yasuyuki Sato, Kohei Unagami, Toshihito Hirai, Hideki Ishida, Kazunari Tanabe
BACKGROUND: The reasons for improved outcomes associated with preemptive kidney transplantation (PKT) are incompletely understood, and post-transplant complications have been scarcely investigated. METHODS: We evaluated the outcomes of PKT in both unmatched (n = 1060) and propensity score matched cohorts (n = 186) of adults who underwent living kidney transplant between 2000 and 2014. Outcomes were estimated glomerular filtration rate (eGFR), biopsy-proven rejection, cytomegalovirus (CMV) infection, post-transplant diabetes mellitus (PTDM), cardiovascular disease (CVD), graft failure (non-censored for death), and malignancy...
October 19, 2016: Clinical and Experimental Nephrology
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
#16
MULTICENTER STUDY
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...
February 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/27721964/correlation-between-cmv-infection-and-post-transplantation-new-onset-diabetes-mellitus
#17
I Dedinská, Ľ Laca, J Miklušica, D Kantárová, P Galajda, M Mokáň
BACKGROUND: New-onset diabetes mellitus after transplantation (NODAT) is a well-known complication of transplantation. OBJECTIVE: To determine the correlation between CMV infection and NODAT. METHODS: Retrospectively, we detected CMV replication (PCR) in every month after renal transplantation in the first 12 months of the procedure in a homogenous group of patients from the immunosuppression point of view. RESULTS: In 167 patients (64 with NODAT and 103 in the control group), the average amount of CMV viremia was not significantly different between the NODAT and the control group (p=0...
2016: International Journal of Organ Transplantation Medicine
https://www.readbyqxmd.com/read/27716059/il-23-plasma-level-is-strongly-associated-with-cmv-status-and-reactivation-of-cmv-in-renal-transplant-recipients
#18
Mahmoud Sadeghi, Imad Lahdou, Gerhard Opelz, Arianeb Mehrabi, Martin Zeier, Paul Schnitzler, Volker Daniel
BACKGROUND: Cytomegalovirus seropositivity is an independent risk factor for atherosclerosis in patients with ESRD. Donor CMV seropositivity is associated with higher graft loss. Dendritic cells, macrophages and Th17 lymphocytes are defined as producers of IL-23. IL-23 is thought to be involved in the promotion of Th17 cell polarization. Latent CMV-induced Th17 might be involved in the pathogenesis of CMV infection in patients with ESRD. We aimed to evaluate associations of Th17-dependent cytokines with ESRD, CMV status and post-transplant outcome in kidney transplantation...
October 3, 2016: BMC Immunology
https://www.readbyqxmd.com/read/27703835/strongyloides-hyperinfection-syndrome-combined-with-cytomegalovirus-infection
#19
Fatehi Elnour Elzein, Mohammed Alsaeed, Sulafa Ballool, Ashraf Attia
The mortality in Strongyloides hyperinfection syndrome (SHS) is alarmingly high. This is particularly common in bone marrow, renal, and other solid organ transplant (SOT) patients, where figures may reach up to 50-85%. Immunosuppressives, principally corticosteroids, are the primary triggering factor. In general, the clinical features of Strongyloides stercoralis hyperinfection are nonspecific; therefore, a high index of suspicion is required for early diagnosis and starting appropriate therapy. Although recurrent Gram-negative sepsis and meningitis have been previously reported, the combination of both cytomegalovirus (CMV) and strongyloidiasis had rarely been associated...
2016: Case Reports in Transplantation
https://www.readbyqxmd.com/read/27639246/multicenter-evaluation-of-efficacy-and-safety-of-low-dose-versus-high-dose-valganciclovir-for-prevention-of-cytomegalovirus-disease-in-donor-and-recipient-positive-d-r-renal-transplant-recipients
#20
Seth Heldenbrand, Chenghui Li, Rosemary P Cross, Kelly A DePiero, Travis B Dick, Kara Ferguson, Miae Kim, Erin Newkirk, Jeong M Park, Janice Sudaria-Kerr, Eric M Tichy, Kimi R Ueda, Renee Weng, Jesse Wisniewski, Steven Gabardi
BACKGROUND: The cytomegalovirus (CMV) donor-positive/recipient-positive (D+/R+) population is the largest proportion of renal transplant recipients (RTR). Guidelines for prevention of CMV in the intermediate-risk D+/R+ population include prophylaxis with valganciclovir (VGCV) 900 mg/day for 3 months. This study is the first head-to-head analysis, to our knowledge, comparing the efficacy and safety CMV prophylaxis of VGCV 450 vs 900 mg/day for 3 months in D+/R+ RTR. METHODS: A multicenter, retrospective analysis evaluated 478 adult RTR between January 2008 and October 2011...
December 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
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