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CMV infection in renal transplantation

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https://www.readbyqxmd.com/read/28744628/infection-related-hospitalizations-after-kidney-transplantation-in-children-incidence-risk-factors-and-cost
#1
Julien Hogan, Christine Pietrement, Anne-Laure Sellier-Leclerc, Ferielle Louillet, Rémi Salomon, Marie-Alice Macher, Etienne Berard, Cécile Couchoud
BACKGROUND: Infection is the leading cause of death and hospitalization in renal transplant recipients. We describe posttransplant infections requiring hospitalization, their risk factors and cost in a national pediatric kidney transplantation cohort. METHODS: Data on renal transplant recipients <20 years were extracted from the French National Medicoadministrative Hospital Discharge database between 2008 and 2013 and matched with the Renal Transplant Database...
July 25, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28719361/effectiveness-of-valganciclovir-900mg-versus-450mg-for-cytomegalovirus-prophylaxis-in-renal-transplantation-a-systematic-review-and-meta-analysis
#2
Wang Xin, Yang Hui, Zhang Xiaodong, Cui Xiangli, Wang Shihui, Liu Lihong
OBJECTIVES: Valganciclovir 900 mg/day is approved for cytomegalovirus (CMV) prophylaxis, but 450 mg/day is seems also effective. We systematically reviewed the efficacy and safety of low-dose versus high-dose valganciclovir prophylaxis in renal transplantation recipients. METHODS: An electronic search was conducted up to November 29, 2016. The primary outcomes were incidences of CMV, CMV disease, mortality and opportunistic infection. The second outcomes were acute rejection, allograft loss, adverse drug reaction (ADR)...
2017: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28716027/cytomegalovirus-viraemia-and-mortality-in-renal-transplant-recipients-in-the-era-of-antiviral-prophylaxis-lessons-from-the-western-australian-experience
#3
Linda A Selvey, Wai H Lim, Peter Boan, Ramyasuda Swaminathan, Claudia Slimings, Amy E Harrison, Aron Chakera
BACKGROUND: Cytomegalovirus (CMV) establishes a lifelong infection that is efficiently controlled by the immune system; this infection can be reactivated in case of immunosuppression such as following solid organ transplantation. CMV viraemia has been associated with CMV disease, as well as increased mortality and allograft failure. Prophylactic antiviral medication is routinely given to renal transplant recipients, but reactivation during and following cessation of antiviral prophylaxis is known to occur...
July 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28708333/conversion-from-calcineurin-inhibitors-to-mtor-inhibitors-as-primary-immunosuppressive-drugs-in-pediatric-heart-transplantation
#4
Alfred Asante-Korang, Jennifer Carapellucci, Diane Krasnopero, Abigail Doyle, Brian Brown, Ernest Amankwah
There are only a few reports of successful use of mammalian target of rapamycin (mTORI) as primary immunosuppression in pediatric heart transplantation. Compared to calcineurin inhibitors, mTORI have less side effects, especially nephrotoxicity, infections, and malignancies. A retrospective study was conducted at our institution of all 170 heart transplants from 1995 to 2015. Nineteen patients were switched from tacrolimus (n=15) or cyclosporin (n=4) to everolimus (n=4) or sirolimus (n=15) due to nephrotoxicity (n=5), malignancy (n=8), EBV viremia/reactive plasmacytic changes (n=5), and immune hemolytic anemia (n=1)...
July 14, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28610622/very-late-onset-cytomegalovirus-disease-a-case-report-and-review-of-the-literature
#5
Hania Burgan, Gael Gosteli, Marc Giovannini, Reto Lienhard, Olivier Clerc
BACKGROUND: Cytomegalovirus (CMV) infection remains one of the most common and feared complications of transplantation, justifying prophylaxis or preemptive strategies guided by donor and recipient CMV serostatus. In case of seronegative donor and recipient (D-/R-), no prophylaxis is recommended. Late-onset CMV disease is usually defined as occurring after prophylaxis discontinuation in D+/R- transplant patients. CASE PRESENTATION: We are reporting the case of a D-/R- kidney Caucasian transplant recipient presenting with CMV primoinfection 12 years after renal transplant, and discuss the role of a secondary prophylaxis so late after transplantation...
June 13, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28608641/risk-factors-for-pneumocystis-pneumonia-after-the-first-6%C3%A2-months-following-renal-transplantation
#6
Emmanuel Faure, Arnaud Lionet, Eric Kipnis, Christian Noël, Marc Hazzan
Pneumocystis pneumonia (PCP) incidence was decreased in renal transplant thanks to prophylaxis, recommended during the first months after transplantation. However, many late PCP cases are observed after the first 6 months and recommendations to maintain or reintroduce prophylaxis are lacking. The objective of the study was to identify risk factors to guide the individual prescription of prophylaxis, 6 months after transplantation. Thirty-three late PCP cases were identified between 1995 and 2012 in Lille Hospital, France, and were compared to 72 randomized controls transplant recipients...
June 13, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28586095/cmv-drives-the-expansion-of-highly-functional-memory-t-cells-expressing-nk-cell-receptors-in-renal-transplant-recipients
#7
Nandini Makwana, Bree Foley, Sonia Fernandez, Silvia Lee, Ashley Irish, Hanspeter Pircher, Patricia Price
Cytomegalovirus (CMV) is a common opportunistic infection encountered in renal transplant recipients (RTRs) and may be reactivated without symptoms at any time post-transplant. We describe how active and latent CMV affect T-cell subsets in RTRs who are stable on maintenance therapy. T-cell responses to CMV were assessed in RTRs (n = 54) >2 years post-transplant, and healthy controls (n = 38). Seven RTRs had CMV DNA detectable in plasma. CMV antibody and DNA aligned with increased proportions of CD8(+) T cells and reduced CD4/CD8 ratios...
June 6, 2017: European Journal of Immunology
https://www.readbyqxmd.com/read/28583570/clinical-outcomes-in-pediatric-renal-transplant-recipients-who-received-steroid-based-immunosuppressive-regimen
#8
S Chantarogh, K Tangnararatchakit, W Tirapanich, W Viseshsindh, P Saisawat, K Pirojsakul
BACKGROUND: Although the clinical outcomes of pediatric renal transplantation (RT) in developed countries have improved significantly, the data on clinical outcomes in developing countries are wildly different. METHODS: Children and adolescents who had undergone RT at Ramathibodi Hospital between March 2001 and August 2014 were included. RESULTS: Patients were divided into 2 groups: living related donor (LRD) group (n = 13) and deceased donor (DD) group (n = 30)...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28576905/cmv-and-bkpyv-infections-in-renal-transplant-recipients-receiving-an-mtor-inhibitor-based-regimen-versus-a-cni-based-regimen-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#9
Samir G Mallat, Bassem Y Tanios, Houssam S Itani, Tamara Lotfi, Ciaran McMullan, Steven Gabardi, Elie A Akl, Jamil R Azzi
BACKGROUND AND OBJECTIVES: The objective of this meta-analysis is to compare the incidences of cytomegalovirus and BK polyoma virus infections in renal transplant recipients receiving a mammalian target of rapamycin inhibitor (mTOR)-based regimen compared with a calcineurin inhibitor-based regimen. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a comprehensive search for randomized, controlled trials up to January of 2016 addressing our objective. Other outcomes included acute rejection, graft loss, serious adverse events, proteinuria, wound-healing complications, and eGFR...
June 2, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28573901/a-case-report-of-parvovirus-b19-infection-in-a-renal-allograft
#10
Diana M Oramas, Suman Setty, Vijay Yeldandi, Julio Cabrera, Tushar Patel
Parvovirus B19 infection is undiagnosed in recipients undergoing solid organ transplantation. It is usually responsible for unexplained acute and chronic red blood cell aplasia that does not respond to erythropoietin therapy. Cases of parvovirus B19 infection associated with pancytopenia, solid organ dysfunction, and allograft rejection have been described in the literature. The deterioration of the immune system as a result of severe immunotherapy favors the reactivation of a previous infection or the acquisition of a new one...
June 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28544101/belatacept-combined-with-transient-calcineurin-inhibitor-therapy-prevents-rejection-and-promotes-improved-long-term-renal-allograft-function
#11
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 and 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) with 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
#12
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
#13
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-a-retrospective-study
#14
Wouter T Lollinga, Lilli Rurenga-Gard, Willem van Doesum, Rik van Bergen, Arjan Diepstra, Judith M Vonk, Annelies Riezebos-Brilman, H G M Niesters, Willem J van Son, Jacob van den Born, Jan-Stephan Sanders
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. A total of 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). Estimated glomerular filtration rate (eGFR) was analyzed between 1 and 36 months post-transplantation with Kruskal-Wallis test, linear regression, and a linear mixed-effects model...
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
#15
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
#16
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
#17
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
#18
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...
June 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
#19
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...
August 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
#20
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...
August 2017: Journal of Medical Virology
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