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CMV infection in renal transplantation

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https://www.readbyqxmd.com/read/29319768/the-current-burden-of-cytomegalovirus-infection-in-kidney-transplant-recipients-receiving-no-pharmacological-prophylaxis
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/29208861/etiology-of-early-renal-allograft-dysfunction-and-comparison-between-dysfunction-and-function-group-a-single-center-study
#4
K M Hadiuzzaman, S F Islam, M O Faroque, R M Hossain, M Munirunnessa, S I Selim, M Morshed
Over a period of two years thirty five renal allograft recipients & donors were evaluated to find out the aetiology of early renal allograft dysfunction, in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from March 2010 to February 2012. A comparison was made between dysfunction & functioning graft group. Mean age of recipients were (36.4±9.4) years, mean age of donors were (41.7±8.3) years, with a male and female ratio of 3:1. Fifty percent recipients showed one heliotype match, ninety percent recipients were anti CMV antibody IgG positive, few were anti CMV antibody IgM positive...
October 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29166336/valganciclovir-prophylaxis-versus-preemptive-therapy-in-cytomegalovirus-positive-renal-allograft-recipients-long-term-results-after-7-years-of-a-randomized-clinical-trial
#5
Oliver Witzke, Martin Nitschke, Michael Bartels, Heiner Wolters, Gunter Wolf, Petra Reinke, Ingeborg A Hauser, Ulrich Alshuth, Volker Kliem
BACKGROUND: The VIPP study compared valganciclovir prophylaxis with preemptive treatment regarding efficacy, safety and long-term graft outcome in CMV-positive (R+) renal transplant recipients. METHODS: Multicenter, open-label, randomized clinical study with a 12-month study phase and a follow-up of up to 84 months. Patients in the prophylaxis group received 2x450 mg/day oral valganciclovir for 100 days adjusted to renal function. Preemptive treatment with 2x900 mg/day valganciclovir was initiated at a viral load of ≥400 CMV copies/mL (PCR) and maintained over ≥14 days, followed by secondary prophylaxis...
November 22, 2017: Transplantation
https://www.readbyqxmd.com/read/28986189/prevention-of-cytomegalovirus-reactivation-in-haploidentical-stem-cell-transplantation
#6
Aimee E Hammerstrom, Lindsey R Lombardi, Sai Ravi Pingali, Gabriela Rondon, Julianne Chen, Denái R Milton, Roy F Chemaly, Richard E Champlin, Alison Gulbis, Stefan O Ciurea
Cytomegalovirus (CMV) infection can increase the morbidity and mortality after allogeneic hematopoietic cell transplantation (HCT). Because of a higher degree of immunosuppression, haploidentical transplant recipients may be at an increased risk of viral infections, particularly CMV. We retrospectively analyzed 86 haploidentical HCT recipients at our institution to determine whether a more intensified antiviral strategy would reduce the incidence of CMV reactivation compared with a traditional antiviral prophylaxis regimen...
October 3, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28979335/incidence-of-ganciclovir-resistance-in-cmv-positive-renal-transplant-recipients-and-its-association-with-ul97-gene-mutations
#7
Hamid Reza Aslani, Shadi Ziaie, Jamshid Salamzadeh, Sara Zaheri, Fariba Samadian, Shayan Mastoor-Tehrani
Human cytomegalovirus (CMV) remains the most common infection affecting organ transplant recipients. Despite advances in the prophylaxis and acute treatment of CMV, it remains an important pathogen affecting the short- and long-term clinical outcome of solid organ transplant recipient. The emergence of CMV resistance in a patient reduces the clinical efficacy of antiviral therapy, complicates therapeutic and clinical management decisions, and in some cases results in loss of the allograft and/or death of the patient...
2017: Iranian Journal of Pharmaceutical Research: IJPR
https://www.readbyqxmd.com/read/28946964/cytomegalovirus-infection-after-kidney-transplantation-and-long-term-graft-loss
#8
María Ovidia López-Oliva, Julio Flores, Rosario Madero, Fernando Escuin, María José Santana, Teresa Bellón, Rafael Selgas, Carlos Jiménez
BACKGROUND: Despite the use of prevention strategies, cytomegalovirus (CMV) infection is the most common viral complication after renal transplant and its impact on long-term outcomes is still open to debate. OBJECTIVE: To evaluate the incidence of CMV infection and disease during the use of prevention strategies in our centre and to analyse the association between CMV infection and long-term patient and graft survival and other potentially clinical events related with CMV...
September 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28943566/deep-ulcers-in-the-ileum-associated-with-mycophenolate-mofetil
#9
Akira Sonoda, Kurato Wada, Kazuhiro Mizukami, Kensuke Fukuda, Mitsutaka Shuto, Kazuhisa Okamoto, Ryo Ogawa, Tadayoshi Okimoto, Kazunari Murakami
A 54-year-old man was treated with mycophenolate mofetil (MMF) after undergoing living donor renal transplantation. Two years later, he experienced repeated episodes of diarrhea, and his C-reactive protein (CRP) level was found to be 12.63 mg/dL. Ileocolonoscopy showed multiple deep, punched-out ulcers that were similar to Behçet's disease (BD) and cytomegalovirus (CMV) in the ileum. CMV infection was suspected. However, anti-cytomegalovirus agents were ineffective. The patient was subsequently diagnosed with gastrointestinal toxicity of MMF and MMF was switched to mizoribine...
November 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28867309/b-cell-activating-factor-baff-reflects-patients-immunological-risk-profile-after-kidney-transplantation
#10
A Schuster, B Jung, J Hofbauer, L Kühne, D Zecher, B Banas, T Bergler
The B-cell activating factor BAFF plays an important role in the development and maturation of B-lymphocytes, which can contribute to the generation of donor-specific antibodies and thus may influence graft function and graft survival. Inconsistent data on the role of BAFF levels after renal transplantation for the formation of donor-specific antibodies and the contribution for allograft rejection exist. The aim of the current study was to determine to what extent the degree of pre-immunization is reflected by each patient's BAFF levels before transplantation and in the follow-up...
September 1, 2017: Transplant Immunology
https://www.readbyqxmd.com/read/28744628/infection-related-hospitalizations-after-kidney-transplantation-in-children-incidence-risk-factors-and-cost
#11
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...
December 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
#12
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
#13
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
#14
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)...
October 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28610622/very-late-onset-cytomegalovirus-disease-a-case-report-and-review-of-the-literature
#15
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
#16
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
#17
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...
August 2017: European Journal of Immunology
https://www.readbyqxmd.com/read/28583570/clinical-outcomes-in-pediatric-renal-transplant-recipients-who-received-steroid-based-immunosuppressive-regimen
#18
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
#19
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...
August 7, 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
#20
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...
October 2017: International Journal of Surgical Pathology
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