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Complications post transplantation

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https://www.readbyqxmd.com/read/29790081/transplant-renal-vein-thrombosis-in-a-recipient-with-aberrant-venous-anatomy
#1
Lyndsey Thiessen, Sarah MacDonell, Chris Wall, Preman Jacob, Ahmed Shoker, Michael A J Moser
Renal vein thrombosis in a transplanted kidney is an uncommon but critical complication that can result in graft loss if management is delayed. A 31-year-old male with known atresia of the inferior vena cava who received a deceased donor renal transplant 7 years previously presented to hospital with severe graft site pain and a week of nausea, vomiting, and chills. Serum creatinine was markedly elevated from baseline. Sonographic examination revealed external iliac vein thrombosis with extension of the thrombus into the transplant renal vein...
May 22, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29788233/autologous-haematopoietic-stem-cell-transplantation-for-crohn-s-disease-a-retrospective-survey-of-long-term-outcomes-from-the-european-society-for-blood-and-marrow-transplantation
#2
Charlotte K Brierley, Cristina Castilla-Llorente, Myriam Labopin, Manuela Badoglio, Montserrat Rovira, Elena Ricart, Daan Dierickx, Severine Vermeire, Peter Hasselblatt, Juergen Finke, Francesco Onida, Andrea Cassinotti, Jack Satsangi, Majid Kazmi, Antonio López-Sanromán, Carsten Schmidt, Dominique Farge, Simon P L Travis, Chris J Hawkey, John A Snowden
Background/Aims: Autologous haematopoietic stem cell transplantation (AHSCT) is a therapeutic option for patients with severe, treatment-refractory Crohn's disease (CD). The evidence base for AHSCT for CD is limited, with one randomised trial (ASTIC) suggesting benefit. The aim of this study was to evaluate safety and efficacy for patients undergoing AHSCT for CD in Europe outside the ASTIC trial. Methods: We identified 99 patients in the European Society for Blood and Marrow Transplantation (EBMT) registry who were eligible for inclusion...
May 18, 2018: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29785130/human-herpesvirus-6-pneumonitis-in-a-patient-with-follicular-lymphoma-following-immunochemotherapy-with-rituximab
#3
Saeko Kuwahara-Ota, Yoshiaki Chinen, Yoshimi Mizuno, Tomoko Takimoto-Shimomura, Yayoi Matsumura-Kimoto, Kazuna Tanba, Taku Tsukamoto, Shinsuke Mizutani, Yuji Shimura, Tsutomu Kobayashi, Shigeo Horiike, Junya Kuroda
Primary infection with human herpesvirus-6 (HHV-6) commonly occurs at an early age in children, most often at 3 years of age, and is associated with childhood diseases, such as exanthema subitum, hepatitis, febrile convulsions, or encephalitis. However, the virus occasionally reactivates from its latent state in immunosuppressed adults, especially post-transplant, resulting in serious disseminated, sometimes life-threatening end-organ complications. Herein, we report a case of a 68-year-old man with relapsed follicular lymphoma who developed HHV-6 pneumonitis...
2018: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29783995/bowel-obstruction-due-to-retained-intraperitoneal-left-ventricular-assist-device-lvad-driveline
#4
Daniel Miklin, Ivy Lewis, Howard Lieberman
BACKGROUND: Left ventricular assist devices (LVAD) provide a lifesaving bridge to cardiac transplant. Utilization of these devices is increasing in the United States. When a patient undergoes cardiac transplant, the left ventricular device is surgically removed and the driveline is extracted or left tunneled in the subcutaneous tissue. Our group encountered a rare and previously unreported complication of this device: intraperitoneal infiltration of a retained driveline after cardiac transplant causing a small bowel obstruction...
May 21, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29782660/the-feared-five-fungal-infections-in-kidney-transplant-recipients-a-single-center20-year-experience
#5
Sandesh Parajuli, Alexandra Wick, Sameer Pandeya, Brad C Astor, Jeannina Smith, Arjang Djamali, Didier A Mandelbrot
Invasive fungal infections are a feared complication in kidney transplant recipients (KTRs). Here we present the University of Wisconsin experience with five invasive fungal infections - aspergillosis, cryptococcosis, histoplasmosis, blastomycosis, and coccidioidomycosis - in KTRs transplanted between 01/01/1994 and 06/30/2014. During this period there were 128 cases of fungal infections; aspergillosis was the most common (72), followed by cryptococcosis (29), histoplasmosis (14), blastomycosis (10) and coccidioidomycosis (3)...
May 21, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29777867/antibiotic-exposure-prior-to-respiratory-viral-infection-is-associated-with-progression-to-lower-respiratory-tract-disease-in-allogeneic-hematopoietic-cell-transplant-recipients
#6
Chikara Ogimi, Elizabeth M Krantz, Jonathan L Golob, Alpana Waghmare, Catherine Liu, Wendy M Leisenring, Christopher R Woodard, Sara Marquis, Jane M Kuypers, Keith R Jerome, Steven A Pergam, David N Fredricks, Mohamed L Sorror, Janet A Englund, Michael Boeckh
INTRODUCTION: Recent publications note an association between antibiotic exposure and respiratory viral infections (RVIs). Antibiotics affect microbiota and impair immune response against RVIs in mice, and low microbiome diversity is associated with pulmonary complications including viral lower respiratory tract disease (LRTD) in hematopoietic cell transplantation (HCT) recipients. In this study, we examined whether antibiotic exposure was associated with increased risk of disease progression in RVIs post-transplantation...
May 16, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29776917/treatment-refractory-mania-with-psychosis-in-a-post-transplant-patient-on-tacrolimus-a-case-report
#7
Muaid Ithman, Kunal Malhotra, Meelie Bordoloi, Garima Singh
Bipolar affective disorder type I imparts significant morbidity and disease burden in the Population. It is characterized by occurrence of one or more manic episodes which may be preceded or followed by a depressive or hypomanic phase. About half of these manic episodes are characterized by the presence of psychotic features [1]. The condition is further complicated when patient has multiple comorbid conditions. We report here a case of a 66 year old Caucasian female, previously diagnosed with Bipolar disorder who developed treatment refractory mania with psychotic feature after being on Tacrolimus (an immunosuppressive agent) after kidney transplantation...
May 18, 2018: Clinical Medicine & Research
https://www.readbyqxmd.com/read/29773759/neutrophil-lymphocyte-ratio-and-creatinine-reduction-ratio-predict-good-early-graft-function-among-adult-cadaveric-donor-renal-transplant-recipients-single-institution-series
#8
Piotr Hogendorf, Anna Suska, Aleksander Skulimowski, Joanna Rut, Monika Grochowska, Aleksandra Wencel, Filip Dziwisz, Michał Nowicki, Dariusz Szymański, Grażyna Poznańska, Adam Durczyński, Janusz Strzelczyk
Background Delayed graft function (DGF) is a common complication following kidney transplantation and is associated with ischemia-reperfusion injury (IRI). Lymphocytes contribute to the pathogenesis of IRI and ischemia-reperfusion related delayed graft function Materials and Methods 135 Caucasian patients received a kidney graft from deceased heart-beating organ donors. We divided patients into 2 groups- patients with the eGFR>=30 on the 21st day post-transplantation (n=36) and patients with the eGFR<30 on the 21st day post-transplantation (n=99) to assess kidney graft function...
April 30, 2018: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29770706/intestinal-transplants-review-of-normal-imaging-appearance-and-complications
#9
Bashir Hakim, Daniel T Myers, Todd R Williams, Shunji Nagai, John Bonnett
Intestinal transplant (IT) is one of the least common forms of organ transplant but is increasing both in volume of cases and number of centers performing intestinal transplants, with the busiest centers in North America and Europe. IT can be performed in isolation or as part of a multivisceral transplant (MVT). Intestinal failure either in the form of short gut syndrome or functional bowel problems is the primary indication for IT. The normal post-surgical anatomy can be variable due to both recipient anatomy in regard to amount of residual bowel and status of native vasculature as well as whether the transplant is isolated or part of an multivisceral transplant...
May 17, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29770133/peripheral-blood-stem-cell-mobilization-in-healthy-donors-by-granulocyte-colony-stimulating-factor-causes-preferential-mobilization-of-lymphocyte-subsets
#10
Guro Kristin Melve, Elisabeth Ersvaer, Geir Egil Eide, Einar K Kristoffersen, Øystein Bruserud
Background: Allogeneic hematopoietic stem cell transplantation is associated with a high risk of immune-mediated post-transplant complications. Graft depletion of immunocompetent cell subsets is regarded as a possible strategy to reduce this risk without reducing antileukemic immune reactivity. Study design and methods: We investigated the effect of hematopoietic stem cell mobilization with granulocyte colony-stimulating factor (G-CSF) on peripheral blood and stem cell graft levels of various T, B, and NK cell subsets in healthy donors...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29769344/efficient-delivery-of-hcmv-t-cell-antigens-by-attenuated-sendai-virus-vectors
#11
Richard Kiener, Markus Fleischmann, Marian Alexander Wiegand, Niels A W Lemmermann, Christiane Schwegler, Christine Kaufmann, Angelique Renzaho, Simone Thomas, Eva Felder, Hans Helmut Niller, Benedikt Asbach, Ralf Wagner
Human Cytomegalovirus (HCMV) represents a major cause of clinical complications during pregnancy as well as immunosuppression and the licensing of a protective HCMV vaccine remains an unmet global need. Herein, we designed and validated novel Sendai virus (SeV) vectors delivering T cell immunogens IE-1 and pp65. To enhance vector safety, we used a replication-deficient strain (rdSeV) that infects target cells in a non-productive manner while retaining viral gene expression. In this study, we explored the impact that transduction with rdSeV has on human dendritic cells (DCs) by comparing it to the parental, replication-competent Sendai virus strain (rcSeV) as well as the poxvirus strain Modified Vaccinia Ankara (MVA)...
May 16, 2018: Journal of Virology
https://www.readbyqxmd.com/read/29767845/final-results-from-a-defibrotide-treatment-ind-study-for-patients-with-hepatic-veno-occlusive-disease-sinusoidal-obstruction-syndrome
#12
Nancy A Kernan, Stephan Grupp, Angela R Smith, Sally Arai, Brandon Triplett, Joseph H Antin, Leslie Lehmann, Tsiporah Shore, Vincent T Ho, Nancy Bunin, Massimo Iacobelli, Wei Liang, Robin Hume, William Tappe, Robert Soiffer, Paul Richardson
Hepatic veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) is a potentially life-threatening complication of haematopoietic stem cell transplant (HSCT) conditioning and chemotherapy. Defibrotide is approved for treatment of hepatic VOD/SOS with pulmonary or renal dysfunction [i.e., multi-organ dysfunction (MOD)] after HSCT in the United States and severe VOD/SOS after HSCT in patients aged older than 1 month in the European Union. Defibrotide was available as an investigational drug by an expanded-access treatment programme (T-IND; NCT00628498)...
May 16, 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29767478/the-effect-of-share-35-on-biliary-complications-an-interrupted-time-series-analysis
#13
J N Fleming, D J Taber, D Axelrod, K D Chavin
The purpose of the Share 35 allocation policy was to improve liver transplant waitlist mortality, targeting high MELD waitlisted patients. However, policy changes may also have unintended consequences that must be balanced with the primary desired outcome. We performed an interrupted time series assessing the impact of Share 35 on biliary complications in a select national liver transplant population using the Vizient CDB/RM™ database. Liver transplants that occurred between October 2012 and September 2015 were included...
May 16, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29765236/methicillin-resistant-staphylococcus-aureus-bacteremia-among-liver-transplant-recipients-epidemiology-and-associated-risk-factors-for-morbidity-and-mortality
#14
REVIEW
Taohua Liu, Yuezhong Zhang, Qiquan Wan
Bacteremia due to Staphylococcus aureus , especially methicillin-resistant S. aureus (MRSA), complicates the clinical course of liver transplantation and is associated with high morbidity and mortality. Intravascular catheters had been reported to be the most frequent source of MRSA bacteremia. Among bacteremic liver recipients, 26.3%-100% of S. aureus were MRSA. Previous studies identified pre-transplant and post-transplant acquired S. aureus carriage, greater severity of liver disease, hepatocellular carcinoma and infection with immuno-modulatory viruses as predictors of S...
2018: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29765143/other-immunomodulatory-agent-related-lymphoproliferative-diseases-a-single-center-series-of-72-biopsy-confirmed-cases
#15
Lukas Marcelis, Charlien Berghen, Alexandra De Zutter, Pauline Biesemans, Peter Vandenberghe, Gregor Verhoef, Olivier Gheysens, Xavier Sagaert, Daan Dierickx, Thomas Tousseyn
Ongoing development of new drugs, as well as novel indications in the treatment of autoimmune diseases leads to the increasing use of immunomodulatory and immunosuppressive drugs. Immunomodulatory agent-related lymphoproliferative disorders are a known and potentially life threatening complication of chronic administration of these drugs, but are less well characterized compared with post-transplant lymphoproliferative disorders. The heterogeneous drug targets, various underlying disease indications, different drug combinations used and relatively low incidence render data collection and interpretation difficult...
May 15, 2018: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/29764898/clinical-presentation-and-outcome-in-a-contemporary-cohort-of-patients-with-acute-myocarditis-the-multicenter-lombardy-registry
#16
Enrico Ammirati, Manlio Cipriani, Claudio Moro, Claudia Raineri, Daniela Pini, Paola Sormani, Riccardo Mantovani, Marisa Varrenti, Patrizia Pedrotti, Cristina Conca, Antonio Mafrici, Aurelia Grosu, Daniele Briguglia, Silvia Guglielmetto, Giovanni Battista Perego, Stefania Colombo, Salvatore Ivan Caico, Cristina Giannattasio, Alberto Maestroni, Valentina Carubelli, Marco Metra, Carlo Lombardi, Jeness Campodonico, Piergiuseppe Agostoni, Giovanni Peretto, Laura Scelsi, Annalisa Turco, Giuseppe Di Tano, Carlo Campana, Armando Belloni, Fabrizio Morandi, Andrea Mortara, Antonio Cirò, Michele Senni, Antonello Gavazzi, Maria Frigerio, Fabrizio Oliva, Paolo G Camici
Background -There is controversy regarding outcome of patients with acute myocarditis (AM), and lack of data on how patients admitted with suspected AM are managed. We report characteristics, in-hospital management and long-term outcome of patients with AM based on a retrospective multi-center registry from 19 Italian hospitals. Methods -A total of 684 patients with suspected AM and recent onset of symptoms (<30 days) were screened between May 2001 and February 2017. Patients >70 years and those older than 50 years without coronary angiography were excluded...
May 15, 2018: Circulation
https://www.readbyqxmd.com/read/29764389/comparison-of-hyperdry-amniotic-membrane-transplantation-and-conjunctival-autografting-for-primary-pterygium
#17
Xin Pan, Daguang Zhang, Zhifang Jia, Zhehui Chen, Yuetian Su
BACKGROUND: The purpose of this study was to evaluate the safety and effectiveness of the hyperdry amniotic membrane transplantation compared with conjunctival autografting for the treatment of primary pterygium. METHODS: One hundred and forty-one eyes from 130 patients with primary pterygium were treated with excision followed by hyperdry amniotic membrane or conjunctival autografting after random selection. Seventy-nine eyes from 71 patients received hyperdry amniotic membrane transplantation (HD-AM group), and 62 eyes from 59 patients received conjunctival autografting (CG group)...
May 15, 2018: BMC Ophthalmology
https://www.readbyqxmd.com/read/29763611/risk-of-glaucoma-surgery-after-corneal-transplant-surgery-in-medicare-patients
#18
Chengjie Zheng, Fei Yu, Victoria L Tseng, Flora Lum, Anne L Coleman
PURPOSE: Glaucoma is a well-documented complication of corneal transplants, contributing significantly to ultimate visual loss. Reported incidence of glaucoma following corneal transplants is highly variable, and definitions of post-transplant glaucoma are inconsistent. Here we use glaucoma surgery as a more rigid and specific endpoint to compare rates following different corneal transplant surgeries. DESIGN: Retrospective cohort study METHODS: A 5% random sample of Medicare beneficiaries from 2010-2013 was obtained and patients were identified with Current Procedural Terminology (CPT) codes for penetrating keratoplasty (PK), endothelial keratoplasty (EK), anterior lamellar keratoplasty (ALK), and keratoprosthesis (KPro)...
May 12, 2018: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/29760372/a-review-of-induction-with-rabbit-antithymocyte-globulin-in-pediatric-heart-transplant-recipients
#19
Martin Schweiger, Andreas Zuckermann, Andres Beiras-Fernandez, Michael Berchtolld-Herz, Udo Boeken, Jens Garbade, Stephan Hirt, Manfred Richter, Arjang Ruhpawar, Jan Dieter Schmitto, Felix Schönrath, Rene Schramm, Uwe Schulz, Markus J Wilhelm, Markus J Barten
Pediatric heart transplantation (pHTx) represents only a small proportion of cardiac transplants. Due to these low numbers, clinical data relating to induction therapy in this special population are far less extensive than for adults. Induction is used more widely in pHTx than in adults, mainly because of early steroid withdrawal or complete steroid avoidance. Antithymocyte globulin (ATG) is the most frequent choice for induction in pHTx, and rabbit antithymocyte globulin (rATG, Thymoglobulin®) (Sanofi Genzyme) is the most widely-used ATG preparation...
May 15, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29757424/continuous-monitoring-of-kidney-transplant-perfusion-with-near-infrared-spectroscopy
#20
Georgia Malakasioti, Stephen D Marks, Tom Watson, Fariba Williams, Mariesa Taylor-Allkins, Nizam Mamode, Justin Morgan, Wesley N Hayes
Background: Current reliance on clinical, laboratory and Doppler ultrasound (DUS) parameters for monitoring kidney transplant perfusion in the immediate post-operative period in children risks late recognition of allograft hypoperfusion and vascular complications. Near-infrared spectroscopy (NIRS) is a real-time, non-invasive technique for monitoring tissue oxygenation percutaneously. NIRS monitoring of kidney transplant perfusion has not previously been validated to the gold standard of DUS...
May 11, 2018: Nephrology, Dialysis, Transplantation
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