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https://www.readbyqxmd.com/read/28817445/the-safety-of-pembrolizumab-in-metastatic-melanoma-and-rheumatoid-arthritis
#1
Akshjot Puri, Jade Homsi
Immunotherapy has been in use for the treatment of melanoma since a very long time, but only recently have the cytotoxic T-lymphocyte antigen-4 (CTLA-4) antibody ipilimumab and programmed cell death-1 inhibitors such as nivolimumab and pembrolizumab been shown to induce marked improvements in survival in patients with metastatic melanoma. An important concern arises in terms of the safety of the use of these agents in patients with autoimmune diseases, solid organ transplant recipients on immunosuppression, patients with a history of previous hepatitis B or C, and patients with HIV infections as these patients were excluded from pivotal immunotherapy studies...
August 16, 2017: Melanoma Research
https://www.readbyqxmd.com/read/28815897/multidrug-resistant-enterobacteriaceae-pseudomonas-aeruginosa-and-vancomycin-resistant-enterococci-three-major-threats-to-hematopoietic-stem-cell-transplant-recipients
#2
REVIEW
Michael J Satlin, Thomas J Walsh
Hematopoietic stem cell transplant (HSCT) recipients are uniquely threatened by the emergence of multidrug-resistant (MDR) bacteria because these patients rely on immediate active antimicrobial therapy to combat bacterial infections. This review describes the epidemiology and treatment considerations for three challenging MDR bacterial pathogens in HSCT recipients: MDR Enterobacteriaceae, including extended-spectrum β-lactamase (ESBL)-producing and carbapenem-resistant Enterobacteriaceae (CRE), Pseudomonas aeruginosa, and vancomycin-resistant Enterococcus (VRE)...
August 16, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28814517/zinc-salts-block-hepatitis-e-virus-replication-by-inhibiting-the-activity-of-viral-rna-dependent-rna-polymerase
#3
Nidhi Kaushik, Chandru Subramani, Saumya Anang, Rajagopalan Muthumohan, Shalimar, Baibaswata Nayak, C T Ranjith-Kumar, Milan Surjit
Hepatitis E virus (HEV) causes an acute, self limiting hepatitis in normal individuals and leads to chronic disease in immunocompromised individuals. HEV infection in pregnant women results in a more severe outcome, with the mortality rate going upto 30%. Though the virus usually causes sporadic infection, epidemics have been reported in developing and resource starved countries. No specific anti-viral exists against HEV. A combination of interferon and ribavirin therapy has been used to control the disease with some success...
August 16, 2017: Journal of Virology
https://www.readbyqxmd.com/read/28812869/entry-inhibitors-a-perspective-for-prevention-of-hepatitis-c-virus-infection-in-organ-transplantation
#4
Che C Colpitts, Raymond T Chung, Thomas F Baumert
Entry inhibitors are emerging as an attractive class of therapeutics for hepatitis C virus (HCV) infection. Entry inhibitors target either virion-associated factors or cellular factors necessary for infection. By blocking entry into cells, entry inhibitors prevent both the establishment of persistent reservoirs and the emergence of resistant variants during viral replication. Furthermore, entry inhibitors protect naïve cells from virus-induced alterations. Combining entry inhibitors with direct-acting antivirals (DAAs) may therefore improve treatment outcomes, particularly in the context of organ transplantation...
August 16, 2017: ACS Infectious Diseases
https://www.readbyqxmd.com/read/28811074/management-of-multidrug-resistant-gram-negative-bacilli-infections-in-solid-organ-transplant-recipients-set-gesitra-seimc-reipi-recommendations
#5
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/28809730/transplanting-kidney-allografts-from-hepatitis-c-infected-donors-into-hepatitis-c-uninfected-recipients-re-thinking-the-thinker-trial
#6
Eric M Yoshida, Trana Hussaini
In the not so distant past, organs from hepatitis C infected donors were either discarded or rarely transplanted into HCV viremic recipients - but never allocated to non-infected patients. However, the simplicity, ease and unprecedented success rates of HCV direct acting antiviral regimens has raised the possibility of utilizing such organs in an attempt to expand the donor pool. The thinker trial reports the first of such attempts. However, caution must be exercised prior to the widespread adoption of such strategy...
August 8, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28806949/case-report-of-ocular-kaposi-s-sarcoma
#7
Jing Yang, Xiao-Fang Yin, Yong-Ping Li, Shi-You Zhou
BACKGROUND: Kaposi's sarcoma (KS) is generally considered a neoplastic disorder of vascular origin and occurs in patients with acquired immunodeficiency syndrome (AIDS) or who have received immunosuppressive treatments after an organ transplant (Soulier et al., Blood 86(4):1276-80, 1995; Viejo-Borbolla and Schulz, AIDS Rev 5(4):222-9, 2003; Schulz, J Antimicrob Chemother 45(Suppl T3):15-27, 2000; Aversa et al. Crit Rev Oncol Hematol 53(3):253-65, 2005; Mbulaiteye and Engels, Int J Cancer 119(11):2685-91, 2006; Tessari et al...
August 14, 2017: BMC Ophthalmology
https://www.readbyqxmd.com/read/28806468/an-overview-of-hemophagocytic-lymphohistiocytosis
#8
Ysabella M Esteban, Jill L O de Jong, Melissa S Tesher
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening syndrome characterized by a dysregulated hyperinflammatory response associated with aberrant activation of lymphocytes and macrophages that results in hypercytokinemia. It is classically divided into two types: (1) primary or familial HLH and (2) secondary HLH. Familial HLH is generally an autosomal recessive condition, whereas secondary HLH is usually associated with infectious diseases, autoinflammatory and autoimmune diseases (where it is more commonly known as macrophage activation syndrome), malignancy, immunosuppression, hematopoietic stem cell transplantation, organ transplantation, HIV infection, and metabolic diseases...
August 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28805292/incidence-and-outcomes-of-primary-central-nervous-system-lymphoma-in-solid-organ-transplant-recipients
#9
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
#10
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/28804572/bacterial-infections-post-living-donor-liver-transplantation-in-egyptian-hepatitis-c-virus-cirrhotic-patients-a-single-center-study
#11
Mohamed F Montasser, Nadia A Abdelkader, Sara M Abdelhakam, Hany Dabbous, Iman F Montasser, Yasmine M Massoud, Waleed Abdelmoaty, Shereen A Saleh, Mohamed Bahaa, Hany Said, Mahmoud El-Meteini
AIM: To determine risk factors, causative organisms and antimicrobial resistance of bacterial infections following living-donor liver transplantation (LDLT) in cirrhotic patients. METHODS: This prospective study included 45 patients with hepatitis C virus-related end-stage liver disease who underwent LDLT at Ain Shams Center for Organ Transplant, Cairo, Egypt from January 2014 to November 2015. Patients were followed-up for the first 3 mo after LDLT for detection of bacterial infections...
July 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28802764/factors-influencing-renal-graft-survival-7-year-experience-of-a-single-center
#12
Rūta Auglienė, Eglė Dalinkevičienė, Vytautas Kuzminskis, Mindaugas Jievaltas, Laima Peleckaitė, Agnė Gryguc, Edgaras Stankevičius, Inga Arūnė Bumblytė
BACKGROUND AND OBJECTIVE: The demand for kidney transplants exceeds the existing supply. This leads to a recently growing interest of research in the area of factors that could prolong graft long-term outcomes and survival. In Lithuania, approximately 90% of kidney transplantations are from deceased donors. Donor organs are received and shared only inside the country territory in Lithuania; therefore, donor data is accurate and precise. This study was performed to present particularities of kidney transplantation data in Lithuania and to identify the effect of donor and recipient factors and histologic findings on renal graft outcomes...
July 29, 2017: Medicina
https://www.readbyqxmd.com/read/28798043/inactivation-of-porcine-endogenous-retrovirus-in-pigs-using-crispr-cas9
#13
Dong Niu, Hong-Jiang Wei, Lin Lin, Haydy George, Tao Wang, I-Hsiu Lee, Hong-Ye Zhao, Yong Wang, Yinan Kan, Ellen Shrock, Emal Lesha, Gang Wang, Yonglun Luo, Yubo Qing, Deling Jiao, Heng Zhao, Xiaoyang Zhou, Shouqi Wang, Hong Wei, Marc Güell, George M Church, Luhan Yang
Xenotransplantation is a promising strategy to alleviate the shortage of organs for human transplantation. In addition to the concern on pig-to-human immunological compatibility, the risk of cross-species transmission of porcine endogenous retroviruses (PERVs) has impeded the clinical application of this approach. Earlier, we demonstrated the feasibility of inactivating PERV activity in an immortalized pig cell line. Here, we confirmed that PERVs infect human cells, and observed the horizontal transfer of PERVs among human cells...
August 10, 2017: Science
https://www.readbyqxmd.com/read/28796391/impact-of-carbapenem-resistant-klebsiella-pneumoniae-cr-kp-infections-in-kidney-transplantation
#14
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
#15
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/28795150/the-effects-of-tacrolimus-on-t-cell-proliferation-are-short-lived-a-pilot-analysis-of-immune-function-testing
#16
Benjamin L Laskin, Jing Jiao, H Jorge Baluarte, Sandra Amaral, Susan L Furth, Tatiana Akimova, Wayne W Hancock, Matthew H Levine, Peter P Reese, Ulf H Beier
BACKGROUND: Optimal immunosuppression after organ transplant should balance the risks of rejection, infection, and malignancy while minimizing barriers to adherence including frequent or time-sensitive dosing. There is currently no reliable immune function assay to directly measure the degree of immunosuppression after transplantation. METHODS: We developed an immune function assay to mea//sure T-cell proliferation after exposure to immunosuppression in vivo. We tested the assay in mice, and then piloted the approach using single time point samples, 11 pediatric kidney transplant recipients prescribed tacrolimus, mycophenolate, and prednisone 6 months to 5 years posttransplant, with no history of rejection, opportunistic infection, or cancer...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28790293/-critical-care-managements-after-lung-transplantation
#17
Masaki Anraku
Lung transplantation is a viable treatment option for patients with end-stage lung diseases such as interstitial pneumonia/pulmonary fibrosis, emphysema, pulmonary hypertension, and so on. Collecting available clinical, physiological, serological, and surgical information of both donor and recipient is vital when planning relevant postoperative managements. The goal of the managements is to keep the transplanted lung (s) functional while preventing/treating infection, rejection, and ischemiareperfusion lung injury...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28776154/sleeve-gastrectomy-after-liver-transplantation-feasibility-and-outcomes
#18
Michael Osseis, Andrea Lazzati, Chady Salloum, Concepcion Gomez Gavara, Philippe Compagnon, Cyrille Feray, Chetana Lim, Daniel Azoulay
BACKGROUND: Knowledge regarding the feasibility and safety of sleeve gastrectomy (SG) in obese liver transplant recipients is scarce. We report our experience of sleeve gastrectomy following liver transplantation (LT). METHODS: All patients who had undergone LT and subsequently underwent SG at our institution were retrospectively reviewed. Surgical outcomes, liver and kidney function tests, outcomes of obesity-related comorbidities, and excess weight loss were analyzed...
August 3, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28774697/emerging-issues-challenges-and-changing-epidemiology-of-fungal-disease-outbreaks
#19
REVIEW
Kaitlin Benedict, Malcolm Richardson, Snigdha Vallabhaneni, Brendan R Jackson, Tom Chiller
Several high-profile outbreaks have drawn attention to invasive fungal infections (IFIs) as an increasingly important public health problem. IFI outbreaks are caused by many different fungal pathogens and are associated with numerous settings and sources. In the community, IFI outbreaks often occur among people without predisposing medical conditions and are frequently precipitated by environmental disruption. Health-care-associated IFI outbreaks have been linked to suboptimal hospital environmental conditions, transmission via health-care workers' hands, contaminated medical products, and transplantation of infected organs...
July 31, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28774674/concurrent-hepatic-tuberculosis-and-hepatic-graft-versus-host-disease-in-an-allogeneic-hematopoietic-stem-cell-transplant-recipient-a-case-report
#20
Z Zhao, W Q Leow
BACKGROUND: Infection and graft-versus-host disease (GVHD) are among the most common complications after hematopoietic stem cell transplantation (HSCT). With well-known risk factors including allogeneic HSCT and GVHD, tuberculosis (TB) has a higher incidence and shorter survival rate in HSCT recipients than in the general population. CASE REPORT: A 55-year-old Indonesian female with a history of latent TB was found to have acute myeloid leukemia 3 months after allogeneic HSCT...
July 31, 2017: Transplantation Proceedings
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