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https://www.readbyqxmd.com/read/27935212/hemophilia-liver-transplantation-observational-study-hots
#1
Margaret V Ragni, Abhinav Humar, Peter G Stock, Emily A Blumberg, Bijan Eghtesad, John J Fung, Valentina Stosor, Nicholas Nissen, Michael T Wong, Kenneth E Sherman, Donald M Stablein, Burc Barin
: Hepatitis C (HCV) infection is the leading cause of liver disease in hemophilia. In those with HIV/HCV co-infection, the rate of liver disease progression is greater than in HCV mono-infected individuals. Despite antiretroviral therapy which slows HCV liver disease progression, some require transplantation. Whether transplant outcomes are worse in hemophilic (H) than non-hemophilic (NH) candidates is unknown. In order to determine rates and predictors of pre- and post-transplant survival, we conducted a retrospective observational study utilizing United Network for Organ Sharing (UNOS) national transplant registry data, comparing HCV+ H and NH candidates...
December 9, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/27933693/heart-transplantation-in-children-with-intellectual-disability-an-analysis-of-the-unos-database
#2
Alexander N Goel, Amit Iyengar, Kenneth Schowengerdt, Andrew C Fiore, Charles B Huddleston
Heart transplantation in children with intellectual disability (ID) is an issue of debate due to the shortage of available donor organs. We sought to perform the first large-scale retrospective cohort study describing the prevalence and outcomes of heart transplantation in this population. The United Network of Organ Sharing database was queried from 2008 to 2015 for pediatric patients (age <19 years) receiving first, isolated heart transplant. Recipients were divided into three subgroups: definite ID, probable ID, and no ID...
December 9, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27932434/rapidly-progressing-dual-infection-with-aspergillus-and-rhizopus-when-soil-inhabitants-become-deadly-invaders
#3
Milind Bhagat, Alwyn Rapose
We present a case report of a 61-year-old patient with acute pulmonary and cerebral infections with Aspergillus and Rhizopus. The only risk factor for invasive fungal disease was high-dose corticosteroids used to treat her chronic obstructive pulmonary disease exacerbation. She had rapid progression and succumbed to her infections within 2 weeks of diagnosis in spite of aggressive antifungal therapy and surgery. To the best of our knowledge, this is the first reported case of rapidly fatal dual infection with Aspergillus and Rhizopus Our case highlights the role of high-dose corticosteroids as a risk factor for invasive fungal disease in patients without traditional risk factors like haematological malignancies, solid organ transplantation or uncontrolled diabetes...
December 8, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27932175/first-attempt-of-sequential-living-donor-liver-and-hematopoietic-stem-cell-transplantation-in-a-child-with-advanced-hepatocellular-carcinoma-case-report
#4
J A Picoraro, N Ovchinsky, M Martinez, S J Lobritto, P Satwani, R Ramphal, M S Cairo, T Kato
Effective therapeutic options for advanced hepatocellular carcinoma are limited. Hematopoietic stem cell transplantation may offer a graft-versus-tumor effect. Combined liver and hematopoietic stem cell transplantation from the same donor with preparatory conditioning may promote tolerogenicity to the liver allograft and offers the potential for immunosuppression withdrawal. We report our experience with the use of this approach in a pediatric patient with invasive hepatocellular carcinoma and pulmonary metastases who underwent a living-donor liver transplantation followed by reduced-toxicity myeloablative conditioning and hematopoietic stem cell transplant from the same parental donor...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932169/invasive-aspergillosis-of-the-stomach-and-co-infection-with-candida-krusei-in-a-patient-with-terminal-liver-failure-a-case-report
#5
B Sulik-Tyszka, W Figiel, M Krawczyk, M Wróblewska
Invasive aspergillosis (IA) is diagnosed almost exclusively in immunocompromised patients. It is located mainly in the lungs or paranasal sinuses, but occasionally other organs and the gastrointestinal tract may also be affected either alone or as a part of a disseminated disease. The main risk factors predisposing to IA are neutropenia, immunosuppressive and steroid therapy, as well as severe underlying disease. Despite progress in diagnostics and therapy of IA, it is still characterized by a high mortality rate...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932160/successful-short-term-intravenous-treatment-of-disseminated-nocardia-farcinica-infection-with-severe-hyponatremia-after-kidney-transplantation-a-case-report
#6
A L Herzog, C Wanner, K Lopau
BACKGROUND: Nocardia is a genus of gram-positive Actinomycetes that are ubiquitous in decaying organic material, soil, and water. Some Nocardia species can infect humans, mainly by airborne transmission. Several reports describe disseminated infections, which are rare and mostly affect strongly immunocompromised patients because intact T-cell-mediated immunity is the major protective mechanism. CASE REPORT: We report a case of disseminated pulmonary, cerebral, and cutaneous infection with Nocardia farcinica in a 66-year-old kidney transplant recipient treated with low-dose triple immunosuppression...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932112/short-term-outcome-of-untreated-versus-treated-asymptomatic-bacteriuria-in-renal-transplant-patients
#7
N Arencibia, M L Agüera, C Rodelo, I López, M Sánchez-Agesta, A Hurtarte, M D Navarro, A Rodríguez-Benot
BACKGROUND: Infection of the urinary tract (UTI) is the most common form of bacterial infection in renal transplant patients, but its management is still controversial. We compared symptomatic and asymptomatic bacteriuria, treated or untreated, during two different months (summer or winter). METHODS: This longitudinal, prospective study involved routine urine cultures collected during September 2014 or March 2015. Demographic, clinical, and microbiological characteristics from the patients with positive urine cultures were described...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931582/liver-transplantation-for-hepatitis-b-in-early-adulthood-analysis-of-the-united-network-for-organ-sharing-database
#8
G Rifai, A Anani, I A Hanouneh, B Mohamad, A Matloob, R Lopez, N N Zein, N Alkhouri
BACKGROUND: Chronic hepatitis B virus (HBV) infection has a mild course in most children that may delay initiation of treatment even when indicated. Unfortunately, a small number of cases can progress rapidly to cirrhosis, which may require liver transplantation (LT) in early adulthood. The aim of this study was to assess the characteristics of HBV-positive young adults who received LT and to evaluate post-transplant outcomes including patient and graft survival and differences between pre- and post-implementation of Model for End-stage Liver Disease (MELD) prioritization...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27929758/determinants-of-influenza-vaccination-among-solid-organ-transplant-recipients-attending-sicilian-reference-centre
#9
Vincenzo Restivo, Giovanni Vizzini, Alessandra Mularoni, Cinzia Di Benedetto, Santi Mauro Gioè, Francesco Vitale
In solid organ transplant recipients, influenza infection is commonly associated with higher morbidity and mortality than immunocompetent hosts. Therefore, in these subjects influenza vaccination is of paramount importance. The main objective of the study was to assess compliance to vaccination and analyze factors associated with influenza vaccination of solid organ transplant recipients admitted to the Sicilian solid organ transplant Reference Center IRCCS-ISMETT in Palermo during 2014-2015 influenza season...
December 8, 2016: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/27927037/clinical-hepatotoxicity-associated-with-antifungal-agents
#10
Ioannis Kyriakidis, Athanasios Tragiannidis, Silke München, Andreas H Groll
Invasive fungal diseases (IFDs) are a leading cause of morbidity and mortality among immunocompromised patients with bone marrow failure syndromes, hematological malignancies, hematopoietic stem cell transplantation (HSCT), those admitted in intensive care units (ICUs) and those with prolonged febrile neutropenia. IFDs occur in a setting of multiple morbidities and are associated with case fatality rates between 30 and 70%. Along with the development of classes and compounds, the last two decades have seen substantial improvements in the prevention and management of these infections and an overall increased use of antifungal agents...
December 7, 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27926593/cost-effectiveness-of-direct-acting-anti-viral-treatment-in-hepatitis-c-infected-liver-transplant-candidates-with-compensated-cirrhosis-and-hepatocellular-carcinoma
#11
James Salazar, Varun Saxena, James G Kahn, John P Roberts, Neil Mehta, Michael Volk, Jennifer C Lai
BACKGROUND: HCV(+) donors represent an effective strategy to increase liver donor availability to HCV-infected recipients. However, many HCV(+) transplant candidates are now receiving treatment with direct acting anti-virals (DAA) that lower the risk of posttransplant HCV recurrence but could make the patient ineligible for HCV(+) livers. METHODS: We compared pretransplant DAA treatment versus deferred DAA treatment using a cost-effectiveness decision analysis model to estimate incremental cost-effectiveness ratios (ICERs; cost per quality-adjusted life year [QALY] gained) from the societal perspective across a range of HCV(+) liver availability rates...
December 6, 2016: Transplantation
https://www.readbyqxmd.com/read/27916030/-short-term-outcomes-of-lung-transplant-recipients-using-organs-from-brain-death-donors
#12
W X He, C Jiang, X G Liu, W Huang, C Chen, L Jiang, B Yang, K Wu, Q K Chen, Y Yang, Y M Yu, G N Jiang
Objective: To assess short-term outcomes after lung transplantation with organs procured following brain death. Methods: Between April 2015 and July 2016, all 17 recipients after lung transplantation using organs from brain death donors (DBD) at Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine were enrolled in this study. All patients were male, aging (60±7) years, including 11 chronic obstructive pulmonary disease, 5 idiopathic pulmonary fibrosis, 1 silicosis...
December 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27915963/kidney-transplant-recipients-requiring-critical-care-admission-within-one-year-of-transplant
#13
Okechukwu O Okidi, David Van Dellen, Cassandra Sobajo, Angela Summers, John R Greer, Titus Augustine
OBJECTIVES: Kidney transplant is the gold standard for treatment of renal failure. With the increasing age of the recipient population, which carries significant comorbidities, and the use of more marginal organs, there is potential for increased critical care admissions. In this study, we investigated the incidence, indications, and outcomes of patients admitted to critical care within 1 year of transplant. We also aimed to identify any precipitating factors or events that may trigger these admissions, as well as establish variables that could affect mortality...
December 2, 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27914462/recombinant-mhc-tetramers-for-isolation-of-virus-specific-cd8-cells-from-healthy-donors-potential-approach-for-cell-therapy-of-posttransplant-cytomegalovirus-infection
#14
A S Vdovin, S Y Filkin, P R Yefimova, S A Sheetikov, N M Kapranov, Y O Davydova, E S Egorov, E G Khamaganova, M Y Drokov, L A Kuzmina, E N Parovichnikova, G A Efimov, V G Savchenko
Patients undergoing allogeneic hematopoietic stem cell transplantation have a high risk of cytomegalovirus reactivation, which in the absence of T-cell immunity can result in the development of an acute inflammatory reaction and damage of internal organs. Transfusion of the virus-specific donor T-lymphocytes represents an alternative to a highly toxic and often ineffective antiviral therapy. Potentially promising cell therapy approach comprises transfusion of cytotoxic T-lymphocytes, specific to the viral antigens, immediately after their isolation from the donor's blood circulation without any in vitro expansion...
November 2016: Biochemistry. Biokhimii︠a︡
https://www.readbyqxmd.com/read/27911112/treatment-of-alpha-and-beta-herpesvirus-infections-in-solid-organ-transplant-recipients
#15
C L Abad, R R Razonable
Human herpesviruses frequently cause infections in solid organ transplant (SOT) recipients. Areas covered: We provide an overview of the clinical impact of alpha and beta herpesviruses and highlight the mechanisms of action, pharmacokinetics, clinical indications, and adverse effects of antiviral drugs for the management of herpes simplex virus, varicella zoster virus and cytomegalovirus. We comprehensively evaluated key clinical trials that led to drug approval, and served as the foundation for management guidelines...
December 2, 2016: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27910193/use-of-organs-from-donors-with-bloodstream-infection-pneumonia-and-influenza-results-of-a-survey-of-infectious-diseases-practitioners
#16
Sanjay R Mehta, Cathy Logan, Camille N Kotton, Deepali Kumar, Saima Aslam
BACKGROUND: Potential organ donors may be admitted with an infection to an intensive care unit, or contract a nosocomial infection during their stay, increasing the risk of potential transmission to the recipient. Because of a lack of practice guidelines and large-scale data on this topic, we undertook a survey to assess the willingness of transplant infectious diseases (ID) physicians to accept such organs. METHODS: We performed a 10-question survey of ID providers from the American Society of Transplantation Infectious Disease Community of Practice to determine the scope of practice regarding acceptance of organs from donors with bloodstream infection, pneumonia, and influenza prior to organ procurement, as well as management of such infections following transplantation...
December 2, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27909648/fc%C3%AE-receptors-in-solid-organ-transplantation
#17
REVIEW
Tomas Castro-Dopico, Menna R Clatworthy
In the current era, one of the major factors limiting graft survival is chronic antibody-mediated rejection (ABMR), whilst patient survival is impacted by the effects of immunosuppression on susceptibility to infection, malignancy and atherosclerosis. IgG antibodies play a role in all of these processes, and many of their cellular effects are mediated by Fc gamma receptors (FcγRs). These surface receptors are expressed by most immune cells, including B cells, natural killer cells, dendritic cells and macrophages...
2016: Current Transplantation Reports
https://www.readbyqxmd.com/read/27905900/prevalence-clinical-and-economic-burden-of-mucormycosis-related-hospitalizations-in-the-united-states-a-retrospective-study
#18
Dimitrios P Kontoyiannis, Hongbo Yang, Jinlin Song, Sneha S Kelkar, Xi Yang, Nkechi Azie, Rachel Harrington, Alan Fan, Edward Lee, James R Spalding
BACKGROUND: Mucormycosis is a rare but devastating fungal infection primarily affecting immunocompromised patients such as those with hematological malignancy, bone marrow and solid organ transplantation, and patients with diabetes, and, even more rarely, immunocompetent patients. The objective of this study was to assess the prevalence and burden, both clinical and economic, of mucormycosis among hospitalized patients in the U.S. METHODS: This is a retrospective study using the Premier Perspective(TM) Comparative Database, with more than 560 participating hospitals covering 104 million patients (January 2005-June 2014)...
December 1, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27904062/promising-therapies-for-fungal-infection-based-on-the-study-to-elucidate-mechanisms-to-cope-with-stress-in-candida-species
#19
Kazuyuki Hirai, Tatsuya Inukai, Hironobu Nakayama
In recent years, the incidence of fungal infections has been increasing, particularly among patients with immune systems compromised by human immunodeficiency virus infection, organ transplantation, and/or chemotherapy for cancer. Current therapies for treating systemic fungal infection have limited effectiveness and have created problems of adverse reactions and drug resistance. These issues therefore motivate us to develop novel antifungals. Elucidation of stress response mechanisms and virulence factors in pathogenic fungi is required in developing an effective antifungal strategy...
2016: Medical Mycology Journal
https://www.readbyqxmd.com/read/27903025/-antifungal-medication-new-substances-new-experiences
#20
Dieter Buchheidt, Wolf-Karsten Hofmann
The incidence of life threatening invasive fungal infections in patients with hematological malignancies during intensive chemotherapy or after hematopoetic stem cell transplantation, patients after solid organ transplantation, ICU patients and premature infants is rising. Mortality rates of invasive fungal infections, caused by Aspergillus species or mucormycetes, may reach 100%, in spite of considerable progress in diagnosis, antifungal prophylaxis and therapy. Comprehensive, profound knowledge of specific diagnostic and current treatment algorithms is essential to improve the prognosis of patients suffering from systemic fungal infections; this article encompasses recent developments in the field of antifungal treatment...
November 2016: Deutsche Medizinische Wochenschrift
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