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BK viremia

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https://www.readbyqxmd.com/read/28665480/simultaneous-pancreas-kidney-transplant-recipients-are-predisposed-to-tissue-invasive-cytomegalovirus-disease-and-concomitant-infectious-complications
#1
Thomas Schachtner, Marina Zaks, Natalie M Otto, Andreas Kahl, Petra Reinke
BACKGROUND: Infections have increased in simultaneous pancreas/kidney transplant recipients (SPKTRs) with cytomegalovirus (CMV) infection being the most important viral infection with adverse impact on patient and allograft outcomes. METHODS: We studied all primary SPKTRs and deceased-donor kidney transplant recipients (KTRs) between 2008 and 2015 for the development of CMV infection. 21/62 SPKTRs (33.9%) and 90/335 KTRs (26.9%) were diagnosed with CMV infection...
June 30, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28662293/retrospective-evaluation-of-the-efficacy-and-safety-of-belatacept-with-thymoglobulin-induction-and-maintenance-everolimus-a-single-center-clinical-experience
#2
D Wojciechowski, S Chandran, J Yang, M Sarwal, F Vincenti
Belatacept use has been constrained by higher rates of acute rejection. We hypothesized that belatacept with low dose rATG and initial mycophenolate maintenance with conversion to everolimus at 1 month post-transplant ± corticosteroids would improve efficacy and maintain safety. Retrospective single center analysis of the first 44 low immunologic risk kidney transplant recipients treated with this regimen. The cohort was 59% male, mean age at transplant of 57 years. Diabetes was the most common cause of ESRD (39%)...
June 29, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28655392/outcome-of-polyomavirus-nephropathy-in-renal-transplant-patients-a-single-center-experience
#3
Nika Kojc, Andreja Aleš Rigler, Gregor Mlinšek, Damjan Kovač, Dušan Ferluga, Miha Arnol
BACKGROUND: Reduction of immunosuppression is a common therapeutic strategy in patients with polyomavirus nephropathy (PVN) but may be associated with acute rejection. This study aimed to evaluate the morphology of PVN in renal biopsies after reduction of immunosuppression. METHODS: Eight of 241 patients who received a kidney transplant between January 2012 and December 2015 presented with BK viremia and biopsy-proven PVN. Morphological evaluation according to Banff criteria and correlation with viremia and kidney function after immunosuppression reduction was performed...
June 28, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28617169/the-frequency-and-associated-factors-for-bk-virus-infection-in-a-center-performing-mainly-living-kidney-transplantations
#4
Selma Alagoz, Mert Kuskucu, Sibel Gulcicek, Serkan Feyyaz Yalin, Meric Oruc, Kenan Midilli, Erkan Yılmaz, Mehmet Riza Altiparmak, Nurhan Seyahi
PURPOSE: BK virus (BKV) nephropathy has increasingly become an important cause of morbidity in renal transplant recipients. We evaluated the frequency and associated factors for BKV infection in a center performing mainly living donor transplantations over a long time period. METHODS: One hundred consecutive renal transplant patients were included. Quarterly visits were planned to examine urine for decoy cells and to measure the BKV DNA in the blood and urine. Renal biopsy was performed in case of deteriorated allograft function...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28609473/a-delicate-balance-between-rejection-and-bk-polyomavirus-associated-nephropathy-a-retrospective-cohort-study-in-renal-transplant-recipients
#5
Lilli Gard, Willem van Doesum, Hubert G M Niesters, Willem J van Son, Arjan Diepstra, Coen A Stegeman, Henk Groen, Annelies Riezebos-Brilman, Jan Stephan Sanders
BACKGROUND: The immunosuppressive agents mycophenolate acid (MPA) and tacrolimus (Tac) are associated with a higher incidence of BK polyomavirus nephropathy (BKPyVAN). In this observational retrospective cohort study, the frequency of BK polyomavirus (BKPyV) complications over a 24-month period was studied. METHODS: 358 renal transplant recipients (RTR) treated with MPA, with either cyclosporine A (CsA) (CsAM group) or Tac (TacM group) and mostly prednisolone, were included...
2017: PloS One
https://www.readbyqxmd.com/read/28573189/outcome-in-pancreas-grafts-after-bk-virus-viremia-in-simultaneous-pancreas-kidney-transplants-a-single-center-case-report
#6
Claudia Bösmüller, Franka Messner, Christian Margreiter, Michael Rudnicki, Robert Öllinger, Dietmar Öfner, Stefan Schneeberger, Manuel Maglione
No abstract text is available yet for this article.
May 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28562595/pre-transplant-immune-factors-may-be-associated-with-bk-polyomavirus-reactivation-in-kidney-transplant-recipients
#7
David DeWolfe, Jinal Gandhi, Matthew R Mackenzie, Thomas A Broge, Evelyn Bord, Amaara Babwah, Didier A Mandelbrot, Martha Pavlakis, Francesca Cardarelli, Raphael Viscidi, Anil Chandraker, Chen S Tan
BK polyomavirus (BKPyV) reactivation in kidney transplant recipients can lead to allograft damage and loss. The elements of the adaptive immune system that are permissive of reactivation and responsible for viral control remain incompletely described. We performed a prospective study evaluating BKPyV-specific T-cell response, humoral response and overall T-cell phenotype beginning pre-transplant through one year post-transplant in 28 patients at two centers. We performed an exploratory analysis of risk factors for the development of viremia and viruria as well as compared the immune response to BKPyV in these groups and those who remained BK negative...
2017: PloS One
https://www.readbyqxmd.com/read/28557148/the-impact-of-recipient-bkv-shedding-before-transplant-on-bkv-viruria-dnaemia-and-nephropathy-post-transplant-a-prospective-study
#8
P S Verghese, D O Schmeling, E A Filtz, A J Matas, H H Balfour
We previously demonstrated that detectable BKV replication in donor urine pretransplant was significantly associated with post-transplant recipient BKV viremia. In this 4-year prospective study, we assessed whether recipient BKV replication pretransplant was associated with post-transplant viremia/BKV nephropathy. We studied 220 primary adult and pediatric organ transplant recipients for 490 person-years and 2100 clinical visits. BKV viruria was detectable in 28 (16%), 26 adults and two children; and viremia in none pretransplant...
August 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28553047/de-novo-collapsing-glomerulopathy-in-renal-allograft-in-association-with-bk-virus-nephropathy-in-a-child-and-stabilization-of-renal-function-by-elimination-of-viremia
#9
D N Gera, M K Shah, V A Ghodela, V B Kute, H L Trivedi
Well-recognized association between HIV 1 infection and collapsing glomerulopathy (CG) raises the possibility that intrarenal infection by other viruses may also contribute to the development of this lesion in native or post-transplant kidneys. There is evidence in literature about association of these lesions with cytomegalovirus, Epstein-Barr virus, hepatitis C virus, and parvovirus B19 infections. Here, we present a case report of post-transplant BK virus nephropathy in a male child who was found to have CG in subsequent biopsy 2 months later...
May 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28544101/belatacept-combined-with-transient-calcineurin-inhibitor-therapy-prevents-rejection-and-promotes-improved-long-term-renal-allograft-function
#10
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/28510315/bk-virus-nephropathy-revisited
#11
EDITORIAL
M Mengel
No abstract text is available yet for this article.
August 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28509373/bk-viremia-surveillance-and-outcomes-in-simultaneous-pancreas-kidney-transplant-recipients
#12
Scott G Westphal, Elizabeth R Lyden, Eric D Langewisch, Clifford D Miles
BACKGROUND: While screening for asymptomatic BK viremia (BKV) has been well studied in isolated kidney transplant recipients, there is a paucity of published outcomes in simultaneous pancreas-kidney (SPK) transplant recipients who underwent BKV screening followed by pre-emptive reduction of immunosuppression. METHODS: This is a single-center, retrospective review of 31 consecutive SPK recipients who were transplanted over a five year period following the initiation of a serum BKV screening protocol...
May 16, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28492728/evaluation-of-the-predisposition-and-clinical-impact-of-bk-virus-replication-in-kidney-transplant-patients
#13
Elviani B Moura, Silvia V Petzhold, Augusto R Amaral, Luciane M Deboni, Paulo H C DE França
The BK virus (BKV) produces a subclinical kidney infection in immunocompetent individuals. However, viremia may occur in kidney transplant patients with ongoing immunosuppression. BKV-associated nephropathy (BKVN) has no specific treatment and is a leading cause of organ transplant loss. In this study, we evaluated the predisposition and the clinical impact of BKV replication in kidney transplant patients during post-transplant monitoring in a reference institution in Brazil. Demographic, clinical and laboratory data generated during routine outpatient follow-up were retrospectively collected...
May 2017: Anais da Academia Brasileira de Ciências
https://www.readbyqxmd.com/read/28452096/kidney-transplant-after-hematopoietic-cell-transplant-in-pediatrics-infectious-and-immunosuppressive-considerations
#14
Christen L Ebens, Angela R Smith, Priya S Verghese
Pediatric patients requiring kidney transplant after hematopoietic cell transplant receive multiple courses of immunosuppression placing them at risk for infection. To elucidate potential risk factors for infection, we compared the immunosuppressive regimens and infectious complications of pediatric kidney transplant recipients at a single institution who had previously undergone hematopoietic cell transplant from different donors to similar patients reported in the literature. Among the initial four post-hematopoietic cell transplant kidney transplant patients reviewed, viremia episodes were universal, including BK virus, Epstein-Barr virus, and human herpesvirus-6, with one death from presumed BK virus encephalitis...
August 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28422412/histological-evolution-of-bk-virus-associated-nephropathy-importance-of-integrating-clinical-and-pathological-findings
#15
C B Drachenberg, J C Papadimitriou, M R Chaudhry, R Ugarte, M Mavanur, B Thomas, C Cangro, N Costa, E Ramos, M R Weir, A Haririan
Long-term clinicopathological studies of BK-associated nephropathy (PyVAN) are not available. We studied 206 biopsies (71 patients), followed 3.09 ± 1.46 years after immunosuppression reduction. The biopsy features (% immunostain for PyV large T ag + staining and inflammation ± acute rejection) were correlated with viral load dynamics and serum creatinine to define the clinicopathological status (PyVCPS). Incidence of acute rejection was 28% in the second biopsy and 50% subsequently (25% mixed T cell-mediated allograft rejection (TCMR) + antibody-mediated allograft rejection (AMR); rejection overall affected 38% of patients (>50% AMR)...
August 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28405598/clearance-of-bk-virus-nephropathy-by-combination-antiviral-therapy-with-intravenous-immunoglobulin
#16
Kathy Kable, Carmen D Davies, Philip J O'connell, Jeremy R Chapman, Brian John Nankivell
BACKGROUND: Reactivation of BK polyoma virus causes a destructive virus allograft nephropathy (BKVAN) with graft loss in 46%. Treatment options are limited to reduced immunosuppression and largely ineffective antiviral agents. Some studies suggest benefit from intravenous immunoglobulin (IVIG). METHODS: We evaluated effectiveness of adjuvant IVIG to eliminate virus from blood and tissue, in a retrospective, single-center cohort study, against standard-of-care controls...
April 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28399927/bk-viruria-and-viremia-in-children-with-systemic-lupus-erythematosus
#17
Nirupama Gupta, Cuong Q Nguyen, Renee F Modica, Melissa E Elder, Eduardo H Garin
BACKGROUND: BK virus (BKV) is a ubiquitous polyoma virus that lies dormant in the genitourinary tract once acquired in early childhood. In states of cellular immunodeficiency, the virus can reactivate to cause hemorrhagic cystitis and nephritis. Children with systemic lupus erythematosus (SLE) have an increased risk of developing infectious complications secondary to their immunocompromised state from the administration of several immuno-modulatory drugs. Currently, there are no data regarding the prevalence of BK viruria or viremia in children with SLE...
April 11, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28371243/infection-rates-in-tacrolimus-versus-cyclosporine-treated-pediatric-kidney-transplant-recipients-on-a-rapid-discontinuation-of-prednisone-protocol-1-year-analysis
#18
Sarah J Kizilbash, Michelle N Rheault, Ananta Bangdiwala, Arthur Matas, Srinath Chinnakotla, Blanche M Chavers
AR is lower in pKTx recipients on Tac vs CsA. Data comparing infection outcomes for children treated with these agents are limited. We retrospectively studied infection outcomes in 96 pKTx recipients on a RDP. PS, DCGS, AR, and infection-free survival were assessed using Kaplan-Meier/log-rank tests and proportional hazards models. There were no differences in 1-year PS, DCGS, or AR between Tac and CsA recipients. After adjusting for AR, the hazard of CMV viremia was 4.0 times higher (95%CI: 1.04, 15.5; P = ...
June 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28355579/stability-of-bk-polyomavirus-igg-seroreactivity-and-its-correlation-with-preceding-viremia
#19
Herman F Wunderink, Els van der Meijden, Caroline S van der Blij-de Brouwer, Hans L Zaaijer, Aloys C M Kroes, Erik W van Zwet, Joris I Rotmans, Mariet C W Feltkamp
BACKGROUND: Recently we showed that the level of BK polyomavirus (BKPyV) IgG seroreactivity in kidney donors predicted viremia and BKPyV-associated nephropathy in kidney transplant recipients (KTRs). This observation could be explained by assuming a direct association between BKPyV seroreactivity and the amount of persistent infectious virus in the renal allograft. OBJECTIVES: Since the renal BKPyV reservoir is probably sowed by viremia during primary BKPyV infection, we systematically analysed the dynamics of BKPyV IgG seroreactivity in relation to preceding BKPyV viremia in KTRs and healthy individuals...
March 19, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28344057/ruxolitinib-as-salvage-therapy-in-steroid-refractory-acute-graft-versus-host-disease-in-pediatric-hematopoietic-stem-cell-transplant-patients
#20
Pooja Khandelwal, Ashley Teusink-Cross, Stella M Davies, Adam S Nelson, Christopher E Dandoy, Javier El-Bietar, Rebecca A Marsh, Ashish R Kumar, Michael S Grimley, Sonata Jodele, Kasiani C Myers
We describe our retrospective clinical experience with ruxolitinib for steroid-refractory acute graft-versus-host disease (GVHD) in pediatric allogeneic hematopoietic stem cell transplant (HSCT) patients. Ruxolitinib was administered orally at 5 mg twice daily for children ≥ 25 kg or 2.5 mg twice daily if <25 kg. We excluded patients who received new immune suppressive agents within 2 weeks before initiation of ruxolitinib from response analysis. Patients were called a treatment failure if ruxolitinib was stopped before completion of 4 weeks of therapy because of adverse effects and not because of progression of acute GVHD...
July 2017: Biology of Blood and Marrow Transplantation
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