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cmv post liver transplant

Baning Ye, Hong Zhao
Objective Human cytomegalovirus (HCMV) infection is common after bone marrow transplantation (BMT), and it increases morbidity and mortality for transplant recipients. HCMV infection may cause hepatitis and elevate the liver enzymes aspartate transferase (AST) and alanine transferase (ALT). This study aimed to analyse the associations between liver enzyme levels and infection with HCMV antigenaemia after BMT. Methods Data from 30 patients after BMT were collected at different time points (0.5, 1.0, 1.5, 2.0, 2...
April 2017: Journal of International Medical Research
A Verma, K Palaniswamy, G Cremonini, N Heaton, A Dhawan
The complications and outcome associated with late CMV infection and disease on the graft are poorly characterized in PLT recipients. We studied the overall incidence, risk factors, and outcome of late CMV infection and disease (infection 6 months after transplant) in 180 PLT recipients admitted between 2008 and 2011 at the King's College Hospital. Antiviral prophylaxis of intravenous ganciclovir was given only to the D+R- group starting at day 7 post-transplant. The remaining groups (D-R+, D+R+, and D-R-) received pre-emptive therapy when they have CMV viremia above cut-off value and treatment for symptomatic CMV infection...
May 2017: Pediatric Transplantation
C Martin-Gandul, S Stampf, D Héquet, N J Mueller, A Cusini, C van Delden, N Khanna, K Boggian, C Hirzel, P Soccal, H H Hirsch, M Pascual, P Meylan, O Manuel
We assessed the impact of antiviral preventive strategies on the incidence of herpes simplex virus (HSV) and varicella-zoster virus (VZV) infections in a nationwide cohort of transplant recipients. Risk factors for the development of HSV or VZV infection were assessed by Cox proportional hazards regression. We included 2781 patients (56% kidney, 20% liver, 10% lung, 7.3% heart, 6.7% others). Overall, 1264 (45%) patients received antiviral prophylaxis (ganciclovir or valganciclovir, n = 1145; acyclovir or valacyclovir, n = 138)...
December 31, 2016: American Journal of Transplantation
Pooja Yadav, Shehla Khalil, Bijay Ranjan Mirdha
BACKGROUND & OBJECTIVES: Diarrhoea is the main clinical manifestation caused by intestinal parasitic infections in patients, with special reference to transplant recipients who require careful consideration to reduce morbidity and mortality. Further, molecular characterization of some important parasites is necessary to delineate the different modes of transmission to consider appropriate management strategies. We undertook this study to investigate the intestinal parasitic infections in transplant recipients with or without diarrhoea, and the genotypes of the isolated parasites were also determined...
August 2016: Indian Journal of Medical Research
Francesco Fontana, Gianni Cappelli
BACKGROUND: Acute pancreatitis (AP) following KT is a rare and often fatal complication of the early post-transplant period. Common causative factors for AP are rare after KT; anti-rejection drugs as CyA, prednisone and MMF have been implicated, although evidence is not strong and we found no reports on possible causative role for mTOR inhibitors. CASE PRESENTATION: A 55-year-old Caucasian man with end-stage renal disease due to idiopathic membrano-prolipherative glomerulonephritis underwent single kidney transplantation (KT) from cadaveric donor...
October 28, 2016: BMC Nephrology
Angela Chiereghin, Evangelia Petrisli, Matteo Ravaioli, Maria Cristina Morelli, Gabriele Turello, Diego Squarzoni, Giulia Piccirilli, Simone Ambretti, Liliana Gabrielli, Antonio Daniele Pinna, Maria Paola Landini, Tiziana Lazzarotto
Infections continue to be one of the leading causes of morbidity and mortality in liver transplant recipients. We retrospectively reviewed the symptomatic infectious episodes that occurred during the first year post-transplant to determine time of onset, causative pathogens and cell-mediated immunity response patterns. Ninety-eight of the 202 (48.5%) recipients enrolled developed at least one infectious episode. The total number of infectious episodes was 135: 77 (57.1%) bacterial, 45 (33.3%) viral and 13 (9...
February 2017: Medical Microbiology and Immunology
Munehiro Furuichi, Takeo Fujiwara, Akinari Fukuda, Mureo Kasahara, Isao Miyairi
BACKGROUND: Cytomegalovirus (CMV) is 1 of the most common causes of infection after solid organ transplantation with symptomatic disease occurring at an incidence of 20-40% without preventative measures. While CMV donor+/recipient- serostatus is well known to be a risk factor, there is little data about other risk factors for CMV infection in the setting of pediatric liver transplantation (LT). We hypothesized that fulminant hepatic failure (FHF) may be a risk factor for CMV infection given anecdotal reports of complications associated with FHF...
August 5, 2016: Transplantation
Lisa Rausch, Christian Koenecke, Hans-Friedrich Koch, Alexander Kaltenborn, Nikos Emmanouilidis, Lars Pape, Frank Lehner, Viktor Arelin, Ulrich Baumann, Harald Schrem
BACKGROUND: Post-transplant lymphoproliferative disorder (PTLD) adversely affects patients' long-term outcome. METHODS: The paired t test and McNemar's test were applied in a retrospective 1:1 matched-pair analysis including 36 patients with PTLD and 36 patients without PTLD after kidney or liver transplantation. Matching criteria were age, gender, indication, type of transplantation, and duration of follow-up. All investigated PTLD specimen were histologically positive for EBV...
2016: Transplantation Research
Yun-Wei Guo, Hua-Ying Gu, Kodjo-Kunale Abassa, Xian-Yi Lin, Xiu-Qing Wei
Although gastroduodenal ulcers are common in solid organ transplant patients, there are few reports on multiple giant ulcers in the distal ileum and ileocecal valve caused by immunosuppressants Herein, we report on a liver transplant recipient and a renal transplant recipient with multiple large ulcers in the distal ileum and ileocecal valve who rapidly achieved ulcer healing upon withdrawal of sirolimus or tacrolimus and administration of thalidomide. In case 1, a 56-year-old man with primary hepatocellular carcinoma had received a liver transplantation...
June 28, 2016: World Journal of Gastroenterology: WJG
Fredric D Gordon, David S Goldberg, Nathan P Goodrich, Anna S F Lok, Elizabeth C Verna, Nazia Selzner, R Todd Stravitz, Robert M Merion
Primary sclerosing cholangitis (PSC) recurs in 15%-25% of patients transplanted for PSC. In the United States, PSC transplant patients are more likely to receive an organ from a living donor (LD) than patients without PSC. Our aims were to (1) compare risk of PSC recurrence in LD versus deceased donor recipients and (2) identify risk factors for PSC recurrence. There were 241 living donor liver transplantations (LDLTs) and 65 deceased donor liver transplantation (DDLT) patients transplanted between 1998 and 2013 enrolled in the Adult-to-Adult Living Donor Liver Transplantation Cohort Study who were evaluated...
September 2016: Liver Transplantation
Bassem Hamandi, Shahid Husain, Paul Grootendorst, Emmanuel A Papadimitropoulos
There is limited literature describing the clinical and microbiological characteristics of solid-organ transplant recipients requiring hospitalization for infectious complications. This study reports on the rate and timing of these syndromes and describes the associated microbiological epidemiology. This prevalence cohort study evaluated solid-organ transplant recipients requiring hospitalization during 2007-2011. We reported infectious complications requiring hospitalization in 603 of 1414 readmissions at a rate of 0...
September 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
Jae Geun Lee, Juhan Lee, Jung Jun Lee, Seung Hwan Song, Man Ki Ju, Gi Hong Choi, Myoung Soo Kim, Jin Sub Choi, Soon Il Kim, Dong Jin Joo
Acute cellular rejection after liver transplantation (LT) can be treated with steroid pulse therapy, but there is no ideal treatment for steroid-resistant acute rejection (SRAR). We aimed to determine the feasibility and potential complications of rabbit anti-thymocyte globulin (rATG) application to treat SRAR in liver transplant recipients. We retrospectively reviewed medical records of 429 recipients who underwent LT at Severance Hospital between January 2010 and March 2015. We compared clinical features and graft survival between patients with steroid-sensitive acute rejection (SSAR; n = 23) and SRAR (n = 11)...
June 2016: Medicine (Baltimore)
M Fernández-Ruiz, J T Silva, F López-Medrano, L M Allende, R San Juan, F Cambra, I Justo, E Paz-Artal, C Jiménez, J M Aguado
BACKGROUND: Monitoring of peripheral blood lymphocyte subpopulation (PBLS) counts might be useful for estimating the risk of infection after liver transplantation (LT). METHODS: We prospectively measured total lymphocyte and PBLS counts at baseline and post-transplant months 1 and 6 in 92 LT recipients. PBLS were enumerated by single-platform 6-color flow cytometry technology. Areas under receiver operating characteristic (ROC) curves were used to evaluate the accuracy of different PBLS for predicting cytomegalovirus (CMV) disease and overall opportunistic infection (OI)...
August 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Toru Ikegami, Tomoharu Yoshizumi, Yuji Soejima, Hideaki Uchiyama, Ken Shirabe, Yoshihiko Maehara
BACKGROUND: The use of ABO incompatible (ABOi) graft in living donor liver transplantation (LDLT) has not been an established procedure worldwide. METHODS: Four hundred and eight adult LDLTs, using ABOi (n=19) and non-ABOi (n=389) grafts, were performed as a single center experience. RESULTS: In ABOi-LDLT group (n=19), median isoagglutinin titer before plasma exchange (PE) at LDLT and after LDLT (max) was ×256, ×32 and ×32, respectively...
April 2016: Hepatobiliary Surgery and Nutrition
Rafael Zaragoza, José María Aguado, Ricard Ferrer, Alejandro H Rodríguez, Emilio Maseda, Pedro Llinares, Santiago Grau, Patricia Muñoz, Jesús Fortún, Mercedes Bouzada, Juan Carlos Del Pozo, Rafael León
BACKGROUND: Although over the past decade the management of invasive fungal infection has improved, considerable controversy persists regarding antifungal prophylaxis in solid organ transplant recipients. AIMS: To identify the key clinical knowledge and make by consensus the high level recommendations required for antifungal prophylaxis in solid organ transplant recipients. METHODS: Spanish prospective questionnaire, which measures consensus through the Delphi technique, was conducted anonymously and by e-mail with 30 national multidisciplinary experts, specialists in invasive fungal infections from six national scientific societies, including intensivists, anesthetists, microbiologists, pharmacologists and specialists in infectious diseases that responded to 12 questions prepared by the coordination group, after an exhaustive review of the literature in the last few years...
October 2016: Revista Iberoamericana de Micología
Yin Lau Su, Richard J Woodman, Mauricio F Silva, Kate Muller, John Libby, John W Chen, Robert Padbury, Alan J Wigg
BACKGROUND AND AIMS: Concerns exist about outcomes of liver transplantation (LT) from low volume centres, especially for hepatitis C (HCV) patients. The aim of the study was to assess patient outcomes as well as their predictors post LT for HCV in a small volume Australian unit (< 25 LTs/year), comparing these with the average outcomes obtained from national and international transplant registries. Patients transplanted for HCV at the South Australian Liver Transplant Unit between 1992 and 2012 were studied...
March 2016: Annals of Hepatology
Qi Ling, Xiao Xu, Haiyang Xie, Kai Wang, Penghui Xiang, Runzhou Zhuang, Tian Shen, Jian Wu, Weilin Wang, Shusen Zheng
BACKGROUND/AIMS: New-onset diabetes after transplantation (NODAT) is a serious complication of liver transplantation (LT). The present study aimed to investigate the risk factors of NODAT by a national survey using the China Liver Transplant Registry database. PATIENTS: A total of 10 204 non-pre-existing diabetic patients undergone primary LT between January 2000 and December 2013 were included. Risk factors were identified by logistic regression analysis. RESULTS: NODAT occurred in 24...
May 2016: Liver International: Official Journal of the International Association for the Study of the Liver
Ajit P Limaye, Corinna La Rosa, Jeff Longmate, Don J Diamond
BACKGROUND: Immune measurements that distinguish solid organ transplantation (SOT) recipients who control cytomegalovirus (CMV) infection from those who progress to CMV-disease (CMV-dz) may be clinically useful in guiding tailored prevention strategies. We previously reported that elevated plasma levels of the immune-modulator IL-10 are associated with late CMV-dz. Here we evaluate whether IL-10 levels measured soon after prophylaxis discontinuation are predictive of CMV-dz risk. METHODS: Plasma IL-10 levels were quantitatively measured by ELISA kit in 40 D/R SOT patients...
January 2016: Transplantation
Irmeli Lautenschlager, Raisa Loginov, Heikki Mäkisalo, Krister Höckerstedt
BACKGROUND: Cytomegalovirus (CMV) can cause severe infections in transplanted patients. To prevent CMV infection, most liver centers use prophylaxis for CMV-seronegative recipients receiving an organ from a seropositive donor (D+/R-). Valganciclovir is mostly given for 3-6 months after transplantation. However, the patients may develop primary CMV infection after the cessation of prophylaxis and late-onset CMV disease may occur. OBJECTIVES: A prospective long-term follow-up of CMV (D+/R-) adult liver transplant recipients after 3 months valganciclovir prophylaxis was investigated...
October 2015: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
Siddharth Sood, Craig Haifer, Lijia Yu, Julie Pavlovic, Paul J Gow, Robert M Jones, Kumar Visvanathan, Peter W Angus, Adam G Testro
Cytomegalovirus (CMV) can reactivate following liver transplantation. Management of patients currently considered low risk based on pretransplant serology remains contentious, with universal prophylaxis and preemptive strategies suffering from significant deficiencies. We hypothesized that a CMV-specific T cell assay performed early after transplant as part of a preemptive strategy could better stratify "low-risk" (recipient seropositive) patients. We conducted a prospective, blinded, observational study in 75 adult recipients...
December 2015: Liver Transplantation
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