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cmv in renal transplant

Rajesh Kumar Wadhwa, Aisha Nazeer, Ayesha Aslam Rai, Nasir Hassan Luck
OBJECTIVES: We investigated the incidence of gastrointestinal disorders requiring endoscopic and histopathologic diagnoses in renal transplant recipients. MATERIALS AND METHODS: In this retrospective analysis, we examined records of patients seen at the Department of Hepato-Gastroenterology and Transplantation Sciences, Sindh Institute of Urology and Trans?lantation (Karachi, Pakistan) from January 2010 to December 2014. Renal transplant recipients with gastrointestinal disorders who required endoscopy, including proctoscopy and upper and lower gastrointestinal endoscopy as per indication, were included...
March 9, 2018: Experimental and Clinical Transplantation
Mari Eriksson, Janne J Jokinen, Sanni Söderlund, Pekka Hämmainen, Jyri Lommi, Karl B Lemström
BACKGROUND: Cytomegalovirus (CMV) remains an important pathogen in solid organ transplant patients. OBJECTIVE: We executed a hybrid prophylactic and pre-emptive valganciclovir (VGCV) prophylaxis to prevent CMV infection in heart transplant patients with antithymocyteglobulin (ATG) induction and retrospectively evaluated the efficacy and safety of this regimen. METHODS: 100 adult heart transplant patients between 2004 and 2010 were included...
March 7, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Shokoufeh Savaj, Seyedeh Ghazal Hosseini, Ahad J Ghods
INTRODUCTION: Non-human leukocyte antigen antibodies are an independent risk factor for acute rejection in kidney transplant recipients. Among them, angiotensin II receptor type 1 (ART1) antibodies can induce various effects, but their clinical importance in kidney transplant recipients has not been properly explained. This study aimed to evaluate the effect of ART1 antibodies on allograft function and hypertension in stable kidney transplant recipients. MATERIALS AND METHODS: Eighty-one kidney recipients from non- human leukocyte antigen antibodies-matched donors with stable allograft function were examined for estimated glomerular filtration rate (Chronic Kidney Disease-Epidemiology Collaboration formula) and ART1 antibodies (measured using an enzyme-linked immunosorbent assay method)...
March 2018: Iranian Journal of Kidney Diseases
Salman Khan, Timothy Sullivan, Mohsin Ali, Dallas Dunn, Gopi Patel, Shirish Huprikar
BACKGROUND: Liver transplant recipients (LTR) who are seropositive for cytomegalovirus (CMV) (R+) are at intermediate-risk for CMV disease. A preventive strategy following transplant is considered standard of care. Current guidelines recommend high-dose valganciclovir (VGCV) (900 mg/day adjusted for renal function) for prophylaxis given limited data on the efficacy and safety of low-dose VGCV (450 mg/day adjusted for renal function). We describe our experience using low-dose VGCV prophylaxis for R+ LTR at our institution...
March 3, 2018: Liver Transplantation
V Aguilera, T Di Maira, I Conde, V Fornés-Ferrer, C Vinaixa, C Pallarés, A Carvalho-Gomes, A Cubells, M García, A Rubín, S Benlloch, L Gonzalez-Dieguez, J M Molina, L Puchades, X López-Labrador, M Prieto, M Berenguer
The association between cytomegalovirus (CMV) reactivation and cardiovascular risk has been reported in solid organ transplant populations; however, it has yet to be assessed in liver transplantation (LT). We aim to evaluate whether CMV reactivation is associated with cardiovascular events (CVE) in HCV-LT patients. Methods: LT patients (2010 and 2014) due to HCV cirrhosis were included. Clinically significant CMV (CS-CMV) was defined as viral load (VL)>5000 copies/mL, need of therapy or CMV disease. Baseline variables and end-point measures (CVE, survival, severe recurrent hepatitis C, de novo tumors and diabetes) were collected...
March 1, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
Prithiv Prasad, Kevin Bryan Lo, Pradhum Ram
The highest risk of opportunistic infections is from 1 to 6 months post-transplant. We report a rare case of Pneumocystis jirovecii pneumonia in a renal transplant recipient only on maintenance immunosuppression eleven years after transplant without concomitant CMV infection or recent episodes of graft rejection.
June 2018: Medical Mycology Case Reports
Anupma Kaul, Shashi Kumar, Dharmendra Bhaduaria, Vinita Agrawal, R K Sharma, Narayan Prasad, Amit Gupta, Rishi Kumar
Reactivation of cytomegalovirus (CMV) and BK polyomavirus (BKV) can result in virus-associated tubulointerstitial nephritis in renal allografts. All those renal biopsies reported as viral cytopathic were isolated and examined by two independent renal histopathologists from our institute and classified as CMV, BKV, and CMV-BKV coinfection-associated viral cytopathic changes with confirmation through polymerase chain reaction technology in either serum or urine or both. All twenty patients were categorized as 10 in CMV, four in BKV, and six were in CMV-BKV coinfection...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
A L Herzog, C Kalogirou, C Wanner, K Lopau
INTRODUCTION: Data suggest an additional role of T cells in antibody-mediated rejections. In 2001 a protocol for AB0-incompatible kidney transplantation based on B-cell-depleting anti-CD20 antibody rituximab, antigen-specific blood group IgG immunoadsorption, intravenous immunoglobulins, and triple immunosuppression was introduced in Europe, which used induction therapy with the use of interleukin-2 receptor antibody (IL2-RA) basiliximab. We used thymoglobulin in AB0-incompatible patients as induction in the face of high immunologic risk...
January 2018: Transplantation Proceedings
K Nanmoku, T Shinzato, T Kubo, T Shimizu, T Kimura, T Yagisawa
BACKGROUND: The main challenge with cytomegalovirus (CMV) prophylaxis in IgG donor-positive/recipient-negative (D+/R-) kidney transplant recipients is late-onset CMV disease. We evaluated a novel protocol for the prevention of late-onset CMV infection and disease in D+/R- organ recipients. METHODS: Our prospective, observational, cohort study included 100 adult kidney transplant recipients. Prophylaxis with low-dose valganciclovir (450 mg/d, 3 times a week for 6 months) was administered to D+/R- recipients...
January 2018: Transplantation Proceedings
Brett Pierce, Chad L Richardson, Lisa Lacloche, Anne Allen, Michael G Ison
BACKGROUND: Infection with cytomegalovirus (CMV) is an important cause of morbidity and mortality following solid organ transplantation. Resistance to ganciclovir can rarely develop via mutations in UL97 or UL54. There are limited published studies assessing the safety and efficacy of foscarnet for the management of ganciclovir-resistant or refractory cytomegalovirus infection and many centers are reluctant to utilize this important therapy because of concerns about toxicity. METHODS: Solid organ recipients transplanted between January 1, 2006 and December 31, 2014 who received at least 1 dose of foscarnet were retrospectively reviewed to assess treatment outcomes, tolerability, and safety of foscarnet...
January 30, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Rafael Mendes da Silva, Flavio Geraldo Rezende de Freitas, Antonio Tonete Bafi, Hélio Tedesco Silva Junior, Bartira de Aguiar Roza
INTRODUCTION: The lungs are often involved in a variety of complications after kidney transplantation. Acute respiratory failure (ARF) is one of the most serious manifestations of pulmonary involvement. OBJECTIVE: To describe the main causes of ARF in kidney transplant patients who require intensive care and identify the factors associated with mortality. METHODS: This retrospective study evaluated adult patients with ARF admitted to the intensive care unit of a center with high volume of transplants from August 2013 to August 2015...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Claudia Rosso Felipe, Alexandra Nicolau Ferreira, Adrieli Bessa, Tamiris Abait, Priscilla Ruppel, Mayara Ivani de Paula, Liliane Hiramoto, Laila Viana, Suelen Martins, Marina Cristelli, Wilson Aguiar, Juliana Mansur, Geovana Basso, Helio Tedesco Silva Junior, Jose Medina Pestana
Cytomegalovirus (CMV) infection in kidney transplantation has changed its clinical spectrum, mostly due to the current and more effective immunosuppression. In the absence of preventive strategies it is associated with significant morbi-mortality. OBJECTIVE: This study evaluated the incidence of CMV events and its effect on outcomes of kidney transplantation in recipients without pharmacological prophylaxis or targeted preemptive treatment. RESULTS: The study cohort comprised 802 recipients of kidney transplants between 04/30/2014 and 04/30/2015...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Nilesh Tejura, Alexandra Sonyey
Adrenal insufficiency is a rare manifestation of tissue-invasive cytomegalovirus (CMV) disease. CMV is one of the leading opportunistic pathogens affecting renal transplant recipients. Its prevalence in the adrenal glands of autopsied AIDS cases has been well documented. We report a rare case of CMV-associated adrenal insufficiency in a renal transplant recipient.
2018: IDCases
Alessandra Soriano, Nazareno Smerieri, Stefano Bonilauri, Loredana De Marco, Alberto Cavazza, Carlo Salvarani
Granulomatosis with polyangiitis (GPA) is a small-vessel necrotizing granulomatous vasculitis typically involving upper airways, lungs, and kidneys, which may lead to end-organ damage and life-threatening complications. Major infections during GPA course represent a considerable concern in the management of the disease. Cytomegalovirus (CMV) infection and disease are rare but significant complications in the course of GPA being associated with high morbidity and mortality rates. Colonic perforation due to CMV colitis is exceedingly rare and has so far almost exclusively been documented in HIV, renal transplant, and systemic lupus erythematosus patients...
January 4, 2018: Clinical Rheumatology
Sócrates Bezerra de Matos, Roberto Meyer, Fernanda Washington de Mendonça Lima
BACKGROUND: Cytomegalovirus (CMV) is the main infectious agent causative of morbidity and mortality in transplant recipients. This study aimed to describe the occurrence and clinical features of CMV infection, and the optimum antigenemia assay cutoff associated with symptomatic infection. MATERIALS AND METHODS: This was a cohort study that investigated 87 patients undergoing renal transplantation. The patients were monitored with the CMV antigenemia assay performed weekly for the first 3 months post-transplantation and subsequently, when CMV infection was suspected clinically...
December 2017: Infection & Chemotherapy
Bernhard Banas, Dominik Steubl, Lutz Renders, Dominik Chittka, Miriam C Banas, Thomas Wekerle, Martina Koch, Oliver Witzke, Anja Mühlfeld, Claudia Sommerer, Antje Habicht, Christian Hugo, Thomas Hünig, Monika Lindemann, Traudel Schmidt, Anne Rascle, Sascha Barabas, Ludwig Deml, Ralf Wagner, Bernhard K Krämer, Bernd Krüger
Impaired cytomegalovirus (CMV)-specific cell-mediated immunity (CMV-CMI) is a major cause of CMV reactivation and associated complications in solid-organ transplantation. Reliably assessing CMV-CMI is desirable to individually adjust antiviral and immunosuppressive therapy. This study aimed to evaluate the suitability of T-Track® CMV, a novel IFN-γ ELISpot assay based on the stimulation of peripheral blood mononuclear cells with pp65 and IE-I CMV proteins, to monitor CMV-CMI following kidney transplantation...
December 28, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
K M Hadiuzzaman, S F Islam, M O Faroque, R M Hossain, M Munirunnessa, S I Selim, M Morshed
Over a period of two years thirty five renal allograft recipients & donors were evaluated to find out the aetiology of early renal allograft dysfunction, in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from March 2010 to February 2012. A comparison was made between dysfunction & functioning graft group. Mean age of recipients were (36.4±9.4) years, mean age of donors were (41.7±8.3) years, with a male and female ratio of 3:1. Fifty percent recipients showed one heliotype match, ninety percent recipients were anti CMV antibody IgG positive, few were anti CMV antibody IgM positive...
October 2017: Mymensingh Medical Journal: MMJ
F P Tillmann, M Schmitz, L C Rump, I Quack
BACKGROUND: This study aimed to evaluate the impact of 5 mg of prednisolone/day on HbA1c levels and its association with the development of pre-diabetes and new-onset diabetes mellitus (NODAT) in non-diabetic first renal transplant recipients on long-term follow-up. METHODS: Four hundred patients were analysed on an average of 4.1 ± 3.0 years after successful transplantation: 96 (24%) were steroid-free and 304 (76%) treated with 5 mg of prednisolone/day combined with cyclosporine A (CsA) or tacrolimus (Tac) as part of their immunosuppressive protocol...
December 2, 2017: International Urology and Nephrology
Oliver Witzke, Martin Nitschke, Michael Bartels, Heiner Wolters, Gunter Wolf, Petra Reinke, Ingeborg A Hauser, Ulrich Alshuth, Volker Kliem
BACKGROUND: The VIPP study compared valganciclovir prophylaxis with preemptive treatment regarding efficacy, safety and long-term graft outcome in CMV-positive (R+) renal transplant recipients. METHODS: Multicenter, open-label, randomized clinical study with a 12-month study phase and a follow-up of up to 84 months. Patients in the prophylaxis group received 2x450 mg/day oral valganciclovir for 100 days adjusted to renal function. Preemptive treatment with 2x900 mg/day valganciclovir was initiated at a viral load of ≥400 CMV copies/mL (PCR) and maintained over ≥14 days, followed by secondary prophylaxis...
November 22, 2017: Transplantation
Burç Dedeoglu, Nicolle H R Litjens, Annelies E de Weerd, Frank Jmf Dor, Mariska Klepper, Derek Reijerkerk, Carla C Baan, Michiel G H Betjes
Background: The T-cell composition within the lymph node (LN) of end-stage renal disease (ESRD) patients differs from the composition within the circulation. Activation of the alloreactive T-cell response within secondary lymphoid organs is important after organ transplantation. However, to date no data are present on LN T-cell subsets and the risk for acute rejection after kidney transplantation. Methods: T cells from LNs of ESRD patients were analyzed for frequency of recent thymic emigrants, relative telomere length, expression of differentiation markers, and were related to the development of early acute rejection (EAR), occurring within 3 months after renal transplantation (RT)...
2017: Frontiers in Immunology
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