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https://www.readbyqxmd.com/read/28610622/very-late-onset-cytomegalovirus-disease-a-case-report-and-review-of-the-literature
#1
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-months-following-renal-transplantation
#2
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/28605108/perforation-of-the-gallbladder-in-a-patient-with-acute-cytomegalovirus-cholecystitis-shortly-following-renal-transplantation
#3
Yuki Imaoka, Masahiro Ohira, Kohei Ishiyama, Kentaro Ide, Tsuyoshi Kobayashi, Hiroyuki Tahara, Hideki Ohdan
A 74-year-old man with end-stage renal failure secondary to diabetes received a living donor renal transplant (cytomegalovirus [CMV]-seropositive recipient from a CMV-seropositive donor). Computed tomography scan revealed a gallbladder with hemorrhage. On postoperative day 27, cholecystography revealed gallbladder perforation; he underwent an emergency operation. Histological examination of the gallbladder wall was positive for multiple viral inclusion bodies. We report a very rare case of both hemorrhagic and perforated CMV cholecystitis within a month following renal transplantation...
June 12, 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
#4
Nandina 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...
June 6, 2017: European Journal of Immunology
https://www.readbyqxmd.com/read/28583570/clinical-outcomes-in-pediatric-renal-transplant-recipients-who-received-steroid-based-immunosuppressive-regimen
#5
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
#6
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...
June 2, 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
#7
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...
June 1, 2017: International Journal of Surgical Pathology
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
#8
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/28553043/unusual-case-of-acute-lung-injury-in-a-renal-allograft-recipient
#9
U Anandh, S Marda
A renal allograft recipient developed cough with hemoptysis on the 1(st) postoperative day. A chest X-ray was performed which was suggestive of fluid overload. His fluid was restricted and diuretics were added. On the same day, his pulmonary infiltrates worsened and a computed tomography (CT) of the chest was carried out, which was suggestive of the right lower lobe consolidation and left pleural effusion. He underwent a bronchoscopy and the lavage was sent for cultures, which did not grow any infective organism...
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/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) to a historical cohort receiving a tacrolimus-based protocol (n=205)...
May 23, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28503279/incidence-and-risk-factors-for-cytomegalovirus-in-kidney-transplant-patients-in-babol-northern-iran
#11
Arefeh Babazadeh, Mostafa Javanian, Farshid Oliaei, Roghayeh Akbari, Abazar Akbarzadepasha, Ali Bijani, Mahmoud Sadeghi
BACKGROUND: Cytomegalovirus (CMV) disease is an important cause of death and possibly transplant rejection in kidney transplant (KT) patients. This study was conducted to investigate the incidence and risk factors of CMV disease in kidney transplant patients. METHODS: All end-stage renal disease (ESRD) patients who underwent kidney transplantation during 1998-2014 and their donors were assessed. All samples were followed-up for approximately 70 months. CMV was identified by polymerase chain reaction (PCR) and/or PP65 antigen in peripheral blood leukocytes along with clinical manifestations...
2017: Caspian Journal of Internal Medicine
https://www.readbyqxmd.com/read/28461110/granzyme-b-producing-b-cells-in-renal-transplant-patients
#12
Jiqiao Zhu, Ye Zeng, Sebastian Dolff, Anja Bienholz, Monika Lindemann, Alexandra Brinkhoff, Manfred Schedlowski, Shilei Xu, Ming Sun, Hana Guberina, Julia Kirchhof, Andreas Kribben, Oliver Witzke, Benjamin Wilde
OBJECTIVES: A separate subset of Granzyme B (GrB) producing B-cells regulating T-cell mediated immunity has been identified. In the present study, we investigated the role of GrB(+) B-cells in renal transplant patients (RTX). METHODS: 12 healthy controls (HC) and 26 RTX patients were enrolled. In addition, 19 healthy volunteers treated with cyclosporine A (CsA) were enrolled. GrB(+) B-cells were determined via flow cytometry. RESULTS: RTX Patients showed a diminished fraction of GrB(+) B-cells as compared to HC...
April 28, 2017: Clinical Immunology: the Official Journal of the Clinical Immunology Society
https://www.readbyqxmd.com/read/28457362/pre-emptive-therapy-for-the-treatment-of-cytomegalovirus-after-kidney-transplantation
#13
R Pretagostini, L Poli, Q Lai, G Russo, F Nudo, M Garofalo, F Melandro, A Gaeta, C Nazzari, C Fazio, E Di Simone, V Vullo, P B Berloco
BACKGROUND: Cytomegalovirus (CMV) represents the leading cause of viral infection in kidney transplantation patients. The aim of the present study was to evaluate the efficacy and safety of pre-emptive anti-CMV therapy. MATERIALS AND METHODS: We performed a retrospective analysis based on data from 227 consecutive patients transplanted from 2010 to 2015, of whom 38 (16.6%) were from a living donor, considering: incidence of rejection, CMV organ localization, and graft and patient survival...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28456447/antithymocyte-globulins-in-renal-transplantation-from-lymphocyte-depletion-to-lymphocyte-activation-the-doubled-edged-sword
#14
REVIEW
Jamal Bamoulid, Thomas Crépin, Cécile Courivaud, Jean-Michel Rebibou, Philippe Saas, Didier Ducloux
Compelling data suggest that lymphocyte depletion following T cell depleting therapy may induce prolonged CD4 T cell lymphopenia and trigger lymphocyte activation in some patients. These profound and non-reversible immune changes in T cell pool subsets are the consequence of both impaired thymic renewal and peripheral homeostatic proliferation. Chronic viral challenges by CMV play a major role in these immune alterations. Even when the consequences of CD4 T cell lymphopenia have been now well described, recent studies shed new light on the clinical consequences of immune activation...
February 17, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28432714/high-human-cytomegalovirus-dnaemia-early-post-transplantation-associates-with-irreversible-and-progressive-loss-of-renal-function-a-retrospective-study
#15
Wouter T Lollinga, Lilli Rurenga-Gard, Willem van Doesum, Rik van Bergen, Arjan Diepstra, Judith M Vonk, Annelies Riezebos-Brilman, H G M Niesters, Willem J van Son, Jacob van den Born, Jan-Stephan Sanders
Transplant recipients are prone to viral infections, which could affect renal transplantation outcome. Our aim was to assess the effects of early human cytomegalovirus (CMV) DNAemia on transplant renal function. A total of 264 (age 50.9 ± 13.5; male 55%) renal transplantation recipients undergoing preemptive anti-CMV therapy were retrospectively categorized based on early (<3 months post-Tx) CMV peak viral load (PVL); PVL ≤ 536, PVL536-6310, or PVL > 6310 International Units/ml (IU/ml). Estimated glomerular filtration rate (eGFR) was analyzed between 1 and 36 months post-transplantation with Kruskal-Wallis test, linear regression, and a linear mixed-effects model...
April 22, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28406085/a-single-center-kidney-transplant-experience-among-ten-caucasian-females-with-end-stage-renal-disease-due-to-scleroderma%C3%A2
#16
Nishkarsh Saxena, Arjang Djamali, Brad C Astor, Maha Mohamed, Didier Mandelbrot, Sandesh Parajuli
There is limited information on kidney transplant recipients with end-stage renal disease (ESRD) due to scleroderma. We conducted an observational study on kidney transplant recipients with ESRD due to scleroderma who received kidney transplant at our center between 01/1994 and 06/2013. During the study period, there were 10 kidney transplant recipients, all of whom were Caucasian females. Seven of them were living-donor kidney transplant recipients, and the mean age at time of transplant was 56.6 ± 11.99 years...
April 13, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28384413/comparative-effectiveness-of-tacrolimus-based-steroid-sparing-versus-steroid-maintenance-regimens-in-kidney-transplantation-results-from-discrete-event-simulation
#17
Vibha C A Desai, Yann Ferrand, Teresa M Cavanaugh, Christina M L Kelton, J Jaime Caro, Jens Goebel, Pamela C Heaton
BACKGROUND: Corticosteroids used as immunosuppressants to prevent acute rejection (AR) and graft loss (GL) following kidney transplantation are associated with serious cardiovascular and other adverse events. Evidence from short-term randomized controlled trials suggests that many patients on a tacrolimus-based immunosuppressant regimen can withdraw from steroids without increased AR or GL risk. OBJECTIVES: To measure the long-term tradeoff between GL and adverse events for a heterogeneous-risk population and determine the optimal timing of steroid withdrawal...
April 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28370833/infectious-complications-in-indigenous-renal-transplant-recipients-in-western-australia
#18
Peter Boan, Ramyasuda Swaminathan, Ashley Irish
BACKGROUND: Infectious complications remain a significant risk following renal transplantation. AIMS: To examine the burden and pattern of infection following renal transplantation in Aboriginal and Torres Strait Islanders (ATSI) compared to non-ATSI. METHODS: Retrospective cohort study of 141 consecutive adult renal transplant recipients in Western Australia between 2005 and 2011. We determined baseline serological status for relevant organisms, the number of patients with specific infections and infectious admission in the first year post transplantation and the rate of infectious death during follow up...
April 3, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28369203/risk-factors-and-outcomes-of-ganciclovir-resistant-cytomegalovirus-infection-in-solid-organ-transplant-recipients
#19
C E Fisher, J L Knudsen, E D Lease, K R Jerome, R M Rakita, M Boeckh, A P Limaye
Background: Ganciclovir-resistant (ganR)-CMV is an emerging and important problem in solid-organ transplant (SOT) recipients. Only through direct comparison of ganR- and ganciclovir-sensitive (ganS)-CMV infection can risk factors and outcomes attributable specifically to ganciclovir resistance be appropriately determined. Methods: We performed a retrospective, case-control (1:3) study of SOT recipients with genotypically-confirmed ganR-CMV (n=37) and ganS-CMV infection (n=109), matched by donor/recipient CMV serostatus, year and organ transplanted, and clinical manifestation...
March 29, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28368496/characterization-of-human-cytomegalovirus-genome-diversity-in-immunocompromised-hosts-by-whole-genomic-sequencing-directly-from-clinical-specimens
#20
E Hage, G S Wilkie, S Linnenweber-Held, A Dhingra, N M Suárez, J J Schmidt, P Kay-Fedorov, E Mischak-Weissinger, A Heim, A Schwarz, T F Schulz, A J Davison, T Ganzenmueller
Background: Advances in next-generation sequencing (NGS) technologies allow comprehensive studies of genetic diversity over the entire genome of human cytomegalovirus (HCMV), a significant pathogen for immunocompromised individuals. Methods: NGS was performed on target-enriched sequence libraries prepared directly from a variety of clinical specimens (blood, urine, breast-milk, respiratory samples, biopsies and vitreous humor) obtained longitudinally or from different anatomical compartments from 20 HCMV-infected patients (renal transplant recipients, stem cell transplant recipients and congenitally infected children)...
March 27, 2017: Journal of Infectious Diseases
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