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https://www.readbyqxmd.com/read/28811074/management-of-multidrug-resistant-gram-negative-bacilli-infections-in-solid-organ-transplant-recipients-set-gesitra-seimc-reipi-recommendations
#1
REVIEW
J M Aguado, J T Silva, M Fernández-Ruiz, E Cordero, J Fortún, C Gudiol, L Martínez-Martínez, E Vidal, L Almenar, B Almirante, R Cantón, J Carratalá, J J Caston, E Cercenado, C Cervera, J M Cisneros, M G Crespo-Leiro, V Cuervas-Mons, J Elizalde-Fernández, M C Fariñas, J Gavaldà, M J Goyanes, B Gutiérrez-Gutiérrez, D Hernández, O Len, R López-Andujar, F López-Medrano, P Martín-Dávila, M Montejo, A Moreno, A Oliver, A Pascual, E Pérez-Nadales, A Román-Broto, R San-Juan, D Serón, A Solé-Jover, M Valerio, P Muñoz, J Torre-Cisneros
Solid organ transplant (SOT) recipients are especially at risk of developing infections by multidrug resistant (MDR) Gram-negative bacilli (GNB), as they are frequently exposed to antibiotics and the healthcare setting, and are regulary subject to invasive procedures. Nevertheless, no recommendations concerning prevention and treatment are available. A panel of experts revised the available evidence; this document summarizes their recommendations: (1) it is important to characterize the isolate's phenotypic and genotypic resistance profile; (2) overall, donor colonization should not constitute a contraindication to transplantation, although active infected kidney and lung grafts should be avoided; (3) recipient colonization is associated with an increased risk of infection, but is not a contraindication to transplantation; (4) different surgical prophylaxis regimens are not recommended for patients colonized with carbapenem-resistant GNB; (5) timely detection of carriers, contact isolation precautions, hand hygiene compliance and antibiotic control policies are important preventive measures; (6) there is not sufficient data to recommend intestinal decolonization; (7) colonized lung transplant recipients could benefit from prophylactic inhaled antibiotics, specially for Pseudomonas aeruginosa; (8) colonized SOT recipients should receive an empirical treatment which includes active antibiotics, and directed therapy should be adjusted according to susceptibility study results and the severity of the infection...
July 26, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28805561/kcnj11-and-kcnq1-gene-polymorphisms-are-not-associated-with-post-transplant-diabetes-mellitus-in-kidney-allograft-recipients-treated-with-tacrolimus
#2
E Dabrowska-Zamojcin, M Tarnowski, M Szydlowski, M Romanowski, V Dziedziejko, K Safranow, L Domanski, A Pawlik
Post-transplant diabetes mellitus (PTDM) is a metabolic disorder occurring after solid organ transplantation during the therapy with calcineurin inhibitors. ATP-sensitive potassium channels KCNJ11 and KCNQ1 play an important role in the regulation of insulin secretion by β cells and development of diabetes mellitus. Numerous studies have confirmed the association between KCNJ11 and KCNQ1 gene polymorphisms and type 2 diabetes. The aim of this study was to examine the association between KCNJ11 and KCNQ1 gene polymorphisms and posttransplant diabetes mellitus in kidney allograft recipients treated with tacrolimus...
2017: Folia Biologica (Praha)
https://www.readbyqxmd.com/read/28805292/incidence-and-outcomes-of-primary-central-nervous-system-lymphoma-in-solid-organ-transplant-recipients
#3
Parag Mahale, Meredith S Shiels, Charles F Lynch, Eric A Engels
Primary central nervous system lymphoma (PCNSL) risk is greatly increased in immunosuppressed HIV-infected people. Using data from the United States transplant registry linked with 17 cancer registries (1987-2014), we studied PCNSL and systemic non-Hodgkin lymphoma (NHL) in 288,029 solid organ transplant recipients. Transplant recipients had elevated incidence for PCNSL compared with the general population (standardized incidence ratio=65.1; N=168), and this elevation was stronger than for systemic NHL (standardized incidence ratio=11...
August 14, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28805270/histoplasmosis-in-transplant-recipients
#4
REVIEW
Kiran Gajurel, Reshika Dhakal, Stan Deresinski
Histoplasma capsulatum is a dimorphic fungus that most often causes asymptomatic infection in the immunocompetent population. In immunocompromised patients, including solid organ transplant (SOT) and hematopoietic cell transplant (HCT) recipients, however, it is likely to cause severe life-threatening infection. Post-transplant histoplasmosis (PTH) in SOT is uncommon with an incidence of ≤ 1% and is even rarer in HCT patients. The majority of PTH in SOT is diagnosed in the first 2 years following transplantation...
August 14, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28804667/skin-limited-graft-versus-host-disease-after-pancreatic-transplantation
#5
Muneeb Ilyas, Elika Hoss, David J DiCaudo, Hasan Khamash, Mark R Pittelkow, Amit Sharma
INTRODUCTION: The phenomenon of graft-versus-host disease, a solid organ transplant recipient, is a rare development with a very poor prognosis. CASE PRESENTATION: A 40-year-old woman with type 1 diabetes developed cutaneous graft-versus-host disease following second pancreas transplantation. CONCLUSION: The development of a nonspecific rash in the early posttransplant period following a pancreas transplant warrants suspicion for graft-versus-host disease...
2017: Case Reports in Transplantation
https://www.readbyqxmd.com/read/28801922/prophylaxis-with-enoxaparin-for-prevention-of-venous-thromboembolism-after-lung-transplantation-a-retrospective-study
#6
Berta Sáez-Giménez, Cristina Berastegui, Helena Sintes, Javier Perez, Ana Figueredo, Manuel López Meseguer, Víctor Monforte, Carlos Bravo, Amparo Santamaría, Maria Antonia Ramon, Susana Gómez, Antonio Roman
BACKGROUND: Venous thromboembolism (VTE) is a frequent complication after solid organ transplantation (SOT) and, specifically, after lung transplantation (LT). The objectives of this study were to evaluate prophylaxis with enoxaparin and to describe risk factors for VTE after LT. METHODS: We retrospectively reviewed the clinical records of 333 patients who underwent LT in our institution between 2009 and 2014. We compared 2 consecutive cohorts, one that received enoxaparin only during post-transplant hospital admissions and a second cohort that received 90-day extended prophylaxis with enoxaparin...
August 12, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28797445/characteristics-and-long-term-outcomes-of-head-and-neck-squamous-cell-carcinoma-after-solid-organ-transplantation
#7
Samer Alsidawi, Katharine A Price, Ashish V Chintakuntlawar, Gustavo F Westin, Joaquin J Garcia, Daniel J Ma, Scott H Okuno
INTRODUCTION: Immunosuppression after solid organ transplant prevents graft rejection, but leads to increased incidence of various malignancies including head and neck squamous cell carcinoma (HNSCC). Outcomes of patients with post-transplant HNSCC are unknown. MATERIALS AND METHODS: We retrospectively identified patients who developed HNSCC after solid organ transplant between 1995 and 2010. Adults with pathology-proven HNSCC and adequate follow up were included...
September 2017: Oral Oncology
https://www.readbyqxmd.com/read/28796885/photodynamic-therapy-is-more-effective-than-imiquimod-for-actinic-keratosis-in-organ-transplant-recipients-a-randomized-intra-individual-controlled-trial
#8
K Togsverd-Bo, C Halldin, C Sandberg, H Gonzalez, A M Wennberg, S S Sørensen, H C O Wulf, M Haedersdal
BACKGROUND: Actinic keratoses (AKs) in solid organ transplant recipients (OTRs) are difficult-to-treat pre-malignancies and comparison of topical therapies is therefore warranted. OBJECTIVES: In an intra-individual study to compare efficacy and safety of field treatment with methyl aminolevulinate photodynamic therapy (MAL-PDT) and imiquimod (IMIQ) for AKs in OTRs. MATERIALS AND METHODS: OTRs (n=35) with 572 AKs (grade I-III) in two similar areas in the face, scalp, dorsal hands or forearms were included...
August 10, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28796391/impact-of-carbapenem-resistant-klebsiella-pneumoniae-cr-kp-infections-in-kidney-transplantation
#9
Giovanni Varotti, Ferdinando Dodi, Alessia Terulla, Gregorio Santori, Gabriele Mariottini, Massimo Bertocchi, Anna Marchese, Iris Fontana
BACKGROUND: Carbapenem-resistant Klebsiella pneumoniae (CR-KP) infections in solid organ transplant patients are progressively increasing and are associated with worse outcomes, although potential risk factors and therapeutic strategies are still not well defined. METHODS: We conducted a retrospective matched-pair analysis in which we compared 26 recipients CR-KP-positive after kidney transplantation (KT) with 52 CR-KP-negative patients transplanted in the same period, during a CR-KP outbreak occurred in our hospital...
August 10, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28795981/summary-of-the-british-transplantation-society-uk-guidelines-for-hepatitis-e-and-solid-organ-transplantation
#10
Stuart McPherson, Ahmed M Elsharkawy, Michael Ankcorn, Samreen Ijaz, James Powell, Ian Rowe, Richard Tedder, Peter A Andrews
The incidence and prevalence of hepatitis E virus (HEV) infection has increased in many developed countries over the last decade, predominantly due to infection with genotype 3 (G3) HEV. Infection with HEV G3 is important in transplant recipients because it can persist in immunosuppressed individuals, leading if untreated to the development of chronic hepatitis and significant liver fibrosis. The British Transplantation Society (BTS) has developed Guidelines for "Hepatitis E & Solid Organ Transplantation" to inform clinical teams and patients about hepatitis E, to help increase the recognition of persistent hepatitis E infection, and to provide clear guidance on its management...
August 9, 2017: Transplantation
https://www.readbyqxmd.com/read/28792686/viral-surveillance-using-pcr-during-treatment-of-aml-and-all
#11
Stephanie B Dixon, Adam Lane, Maureen M O'Brien, Karen C Burns, Jennifer L Mangino, Erin H Breese, Michael J Absalon, John P Perentesis, Christine L Phillips
BACKGROUND: While viral surveillance of cytomegalovirus (CMV), Epstein-Barr virus (EBV), and adenovirus using PCR is routine in patients undergoing hematopoetic stem cell transplant and solid organ transplant, the utility in the nontransplant pediatric leukemia population is unknown. Our institution screens patients with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) for viral DNAemia by PCR as part of clinical care. PROCEDURE: This retrospective chart review included patients treated for newly diagnosed or relapsed AML or ALL between April 2010 and September 2014...
August 9, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28780363/effect-of-voriconazole-on-risk-of-nonmelanoma-skin-cancer-after-hematopoietic-cell-transplantation
#12
Lawrence F Kuklinski, Shufeng Li, Margaret R Karagas, Wen-Kai Weng, Bernice Y Kwong
BACKGROUND: Voriconazole has previously been associated with increased risk for cutaneous squamous cell carcinoma (SCC) in solid organ transplant recipients. Less is known about the risk in patients after hematopoietic cell transplantation (HCT). OBJECTIVE: We evaluated the effect of voriconazole on the risk for nonmelanoma skin cancer (NMSC), including SCC and basal cell carcionoma, among those who have undergone allogeneic and autologous HCT. METHODS: In all, 1220 individuals who had undergone allogeneic HCT and 1418 who had undergone autologous HCT were included in a retrospective cohort study...
August 2, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28771459/solid-organ-transplant-transmitted-tuberculosis-linked-to-a-community-outbreak-california-2015
#13
Alexander Kay, Pennan M Barry, Pallavi Annambhotla, Carol Greene, Martin Cilnis, Peter Chin-Hong, Nicholas Arger, Louise McNitt, Nikole Neidlinger, Neha Shah, Sridhar V Basavaraju, Matthew Kuehnert, Tambi Shaw
In the spring of 2015, a local health department (LHD) in county A notified the California Department of Public Health (CDPH) about three adults with close ties to one another and a congregate community site who had received diagnoses of tuberculosis (TB) disease within a 3-month period. Subsequent review revealed matching TB genotypes indicating that the cases were likely part of a chain of TB transmission. Only three TB cases in California in the preceding 2 years shared this same genotype. One of those three previous cases occurred in a lung-transplant recipient who had no identified epidemiologic links to the outbreak...
August 4, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28767907/retinal-changes-in-solid-organ-and-bone-marrow-transplantation-patients
#14
Fernando Korn Malerbi, Sergio Henrique Teixeira, Luis Gustavo Gondo Hirai, Nilson Hideo Matsudo, Adriano Biondi Monteiro Carneiro
Objective: To evaluate retinal changes in patients who underwent solid organ or bone marrow transplantation. Methods: A retrospective analysis of medical records of patients evaluated from February 2009 to December 2016. All patients included underwent funduscopy. Clinical and demographic data regarding transplantation and ophthalmological changes were collected. Results: A total of 126 patients were analyzed; of these, 108 underwent transplantation and 18 were in the waiting list...
April 2017: Einstein
https://www.readbyqxmd.com/read/28761769/tacrolimus-induced-type-iv-renal-tubular-acidosis-following-liver-transplantation
#15
Christopher Schmoyer, Suraj Mishra, Frank Fulco
Calcineurin inhibitors remain an integral component of immunosuppressive therapy regimens following solid organ transplantation. Although nephrotoxicity associated with these agents is well documented, type IV renal tubular acidosis is a rare and potentially underreported complication following liver transplantation. Hepatologists must be able to recognize this adverse effect as it can lead to fatal hyperkalemia. We describe a case of tacrolimus-induced hyperkalemic type IV renal tubular acidosis in a patient following an orthotopic liver transplant for alcoholic cirrhosis...
2017: Case Reports in Hepatology
https://www.readbyqxmd.com/read/28760896/evaluation-of-posaconazole-serum-concentrations-from-delayed-release-tablets-in-patients-at-high-risk-for-fungal-infections
#16
Alan Chin, Steven A Pergam, David N Fredricks, Andrew N Hoofnagle, Kelsey K Baker, Rupali Jain
Purpose: To determine the frequency of patients who achieved a therapeutic drug level after receiving posaconazole (PCZ) delayed release tablets (DRT) for prophylaxis or treatment of invasive fungal infections (IFIs), and to examine the effect of demographic traits and treatment characteristics on PCZ serum levelsMethods: A retrospective single-center study was conducted on high-risk inpatients at the University of Washington Medical Center (UWMC) that obtained PCZ for either treatment or prophylaxis from August 1(st) 2014 and August 31(st), 2015...
July 31, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28759103/contribution-of-solid-organ-transplant-recipients-to-the-pediatric-non-hodgkin-lymphoma-burden-in-the-united-states
#17
Elizabeth L Yanik, Meredith S Shiels, Jodi M Smith, Christina A Clarke, Charles F Lynch, Amy R Kahn, Lori Koch, Karen S Pawlish, Eric A Engels
BACKGROUND: Pediatric solid organ transplant recipients have a 100 to 200 times higher risk of non-Hodgkin lymphoma (NHL) than the general pediatric population. Consequently, transplant-related NHL may contribute considerably to the pediatric NHL burden in the United States. METHODS: A cohort study using a linkage between the US transplant registry and 16 cancer registries was conducted. Cancer incidence rates were calculated for people less than 20 years old in the transplant and general populations...
July 31, 2017: Cancer
https://www.readbyqxmd.com/read/28759053/the-eukaryotic-gut-virome-in-hematopoietic-stem-cell-transplantation-new-clues-in-enteric-graft-versus-host-disease
#18
Jérôme Legoff, Matthieu Resche-Rigon, Jerome Bouquet, Marie Robin, Samia N Naccache, Séverine Mercier-Delarue, Scot Federman, Erik Samayoa, Clotilde Rousseau, Prescillia Piron, Nathalie Kapel, François Simon, Gérard Socié, Charles Y Chiu
Much attention has been focused on the role of the bacterial microbiome in human health, but the virome is understudied. Although previously investigated in individuals with inflammatory bowel diseases or solid-organ transplants, virome dynamics in allogeneic hematopoietic stem cell transplantation (HSCT) and enteric graft-versus-host disease (GVHD) remain unexplored. Here we characterize the longitudinal gut virome in 44 recipients of HSCT using metagenomics. A viral 'bloom' was identified, and significant increases were demonstrated in the overall proportion of vertebrate viral sequences following transplantation (P = 0...
July 31, 2017: Nature Medicine
https://www.readbyqxmd.com/read/28758635/cluster-distinguishing-genotypic-and-phenotypic-diversity-of-carbapenem-resistant-gram-negative-bacteria-in-solid-organ-transplantation-patients-a-comparative-study
#19
Theodoros Karampatakis, Anastasia Geladari, Lida Politi, Charalampos Antachopoulos, Elias Iosifidis, Olga Tsiatsiou, Aggeliki Karyoti, Vasileios Papanikolaou, Athanassios Tsakris, Emmanuel Roilides
PURPOSE: Solid-organ transplant recipients may display high rates of colonization and/or infection by multidrug-resistant bacteria. We analysed and compared the phenotypic and genotypic diversity of carbapenem-resistant (CR) strains of Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii isolated from patients in the Solid Organ Transplantation department of our hospital. METHODOLOGY: Between March 2012 and August 2013, 56 CR strains from various biological fluids underwent antimicrobial susceptibility testing with VITEK 2, molecular analysis by PCR amplification and genotypic analysis with pulsed-field gel electrophoresis (PFGE)...
July 31, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28757117/-caracterization-of-hla-allo-immunization-and-clinical-impact-in-transfusion-and-organ-transplantation
#20
F Delbos, A Cesbron
Allo-immunizations against HLA antigens are known to be deleterious in transfusion and organ transplantation. The development of new tests based on solid phase assays for screening and identification of HLA antibodies in particular those using Luminex(®) bead based technology has completely changed the way of allo-immunization monitoring because of their extreme sensitivity. They allow a better characterization of these antibodies, identification of acceptable antigens and the use of virtual cross-matches...
July 27, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
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