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solid organ transplant infection

Juliana Gil Melgaço, Noemi Rovaris Gardinali, Vinicius da Motta de Mello, Mariana Leal, Lia Laura Lewis-Ximenez, Marcelo Alves Pinto
Hepatitis E virus (HEV) is a common etiology of acute viral hepatitis worldwide. Recombinant HEV vaccines have been developed, but only one is commercially available and licensed in China since 2011. Epidemiological studies have identified genotype 3 as the major cause of chronic infection in immunocompromised individuals. Ribavirin has been shown to be effective as a monotherapy to induce HEV clearance in chronic patients who have undergone solid organ transplant (SOT) under immunosuppressive therapy. Efforts and improvements in prevention and control have been made to reduce the instances of acute and chronic hepatitis E in endemic and nonendemic countries...
2018: BioMed Research International
Lara Danziger-Isakov, William J Steinbach, Grant Paulsen, Flor M Munoz, Leigh R Sweet, Michael Green, Marian G Michaels, Janet A Englund, Alastair Murray, Natasha Halasa, Daniel E Dulek, Rebecca Pellett Madan, Betsy C Herold, Brian T Fisher
Background: Respiratory virus infection (RVI) in pediatric solid organ transplant (SOT) recipients poses a significant risk; however, the epidemiology and effects of an RVI after pediatric SOT in the era of current molecular diagnostic assays are unclear. Methods: A retrospective observational cohort of pediatric SOT recipients (January 2010 to June 2013) was assembled from 9 US pediatric transplant centers. Charts were reviewed for RVI events associated with hospitalization within 1 year after the transplant...
March 10, 2018: Journal of the Pediatric Infectious Diseases Society
Clive M Michelo, Bram van Cranenbroek, Peran Touw, Frans H J Claas, Arnold van der Meer, Irma Joosten
Background: Antibody-mediated rejection in solid organ transplantation is an important immunological barrier to successful long-term graft survival. Next to complement activation, natural killer (NK) cells have been implicated in the process. Human cytomegalovirus (CMV), independently associated with decreased graft survival, has a strong imprint on the immune response. Here, we assessed the effect of CMV status on alloreactive NK cell reactivity. Methods: We compared antibody-mediated NK cell cytolytic activity (CD107a expression) and IFNγ production between healthy CMV-seropositive (n = 8) and CMV-seronegative (n = 11) individuals, in cocultures of NK cells with anti-HLA class I or rituximab (control) antibody-coated Raji cells...
December 2017: Transplantation Direct
Thomas Magg, Tilmann Schober, Christoph Walz, Julia Ley-Zaporozhan, Fabio Facchetti, Christoph Klein, Fabian Hauck
Epstein-Barr virus positive (EBV+ ) smooth muscle tumors (SMTs) constitute a very rare oncological entity. They usually develop in the context of secondary immunodeficiency caused by human immunodeficiency virus infection or immunosuppressive treatment after solid organ transplantation. However, in a small fraction of predominantly pediatric patients, EBV+ SMTs may occur in patients with primary immunodeficiency disorders (PIDs), such as GATA2 and CARMIL2 deficiency. In secondary immunodeficiencies and when the underlying condition can not be cured, the treatment of EBV+ SMTs is based on surgery in combination with antiretroviral and reduced or altered immunosuppressive pharmacotherapy, respectively...
2018: Frontiers in Immunology
David Moreno-Ajona, José Ramón Yuste, Paloma Martín, Jaime Gállego Pérez-Larraya
The human T-lymphotropic virus type 1 (HTLV-1) is a RNA retrovirus that infects a minimum of 5-10 million people worldwide. Transmission by cell-containing blood products and solid organ transplantation has been reported. Clinical disease occurs in about 5-10% of infected individuals and consists mainly in adult T cell leukemia and HTLV-1-associated myelopathy (HAM). We present a 54-year-old woman who underwent kidney transplant from cadaveric donor in March 2015. Donor also underwent cornea extraction for another recipient (corneal transplant protocol includes HTLV-1/2 serology)...
March 12, 2018: Journal of Neurovirology
Ilona Baraniak, Barbara Kropff, Gary R McLean, Sylvie Pichon, Fabienne Piras-Douce, Richard S B Milne, Colette Smith, Michael Mach, Paul D Griffiths, Matthew B Reeves
The human cytomegalovirus (HCMV) virion envelope protein glycoprotein B (gB) is essential for viral entry and represents a major target for humoral responses following infection. Previously, a phase-2 placebo-controlled clinical trial conducted in solid organ transplant candidates demonstrated that vaccination with gB plus MF59 adjuvant significantly increased gB ELISA antibody levels whose titer correlated directly with protection against post-transplant viremia. The aim of the current study was to investigate in more detail this protective humoral response in vaccinated seropositive transplant recipients...
March 8, 2018: Journal of Infectious Diseases
Gaye Ulubay, Ebru Ayvazoglu Soy, Irem Serifoglu, Fisun Sozen, Gokhan Moray, Mehmet Haberal
OBJECTIVES: Despite improved success with solid-organ transplant procedures, recipients remain at risk for infections, including pneumonia, due to their immunosuppressive regimens. In solid-organ transplant patients, clinical findings of pneumonia can be nonspecific, and diagnosis of pneumonia may be difficult as several conditions (drug lung, hypervolemia, infections, hemorrhage) can led to pulmonary infiltrates, mimicking pneumonia in these patients. The role of mean platelet volume, a predictor of inflammatory disease, with elevated values inversely correlated with inflammatory problems, in the diagnosis of pneumonia has not yet been investigated in solid-organ transplant patients...
March 2018: Experimental and Clinical Transplantation
Fikret Şahintürk, Hamiyet Demirkaya, Ümit Akın Dere, Erkin Sönmez, Nur Altınörs, Gökhan Moray, Mehmet Haberal
Neurologic complications after solid-organ transplant reveal a great spectrum of pathologies. Intracranial hemorrhages, cerebral ischemic lesions, infarctions, lymphoproliferative disorders, and infections, including aspergillosis, have been observed after liver transplant. Fungi constitute nearly 5% of all central nervous system infections, mainly occurring in immunocompromised patients. The most common causative agent is Aspergillus species. It presents either as maxillary sinusitis or pulmonary infection...
March 2018: Experimental and Clinical Transplantation
Irem Serifoglu, Balam Er Dedekarginoglu, Serife Savas Bozbas, Sule Akcay, Mehmet Haberal
OBJECTIVES: Acinetobacter baumannii, depending on the immune status of the host, may result in one of the most serious hospital infections. Infections involving A. baumannii infection have been recently rising. However, little is known about the clinical features of A. baumannii infection in solid-organ transplant recipients. We aimed to share our clinical experiences with A. baumannii infection in our transplant recipients. MATERIALS AND METHODS: Between 2011 and 2017, 41 solid-organ transplant patients developed A...
March 2018: Experimental and Clinical Transplantation
Sibel Kara, Nazan Sen, Ebru Kursun, Hakan Yabanoğlu, Sedat Yıldırım, Şule Akçay, Mehmet Haberal
OBJECTIVES: Pulmonary infections are a significant cause of morbidity and mortality in solid-organ transplant recipients despite enhanced facilities for perioperative care. The aim of this study was to evaluate the demographic characteristics, clinical course, and outcomes of renal transplant recipients with pneumonia. MATERIALS AND METHODS: The medical records of all renal transplant recipients from January 2010 to December 2014 were retrospectively reviewed, and patients diagnosed with pneumonia according to Centers for Disease Control and Prevention criteria were evaluated...
March 2018: Experimental and Clinical Transplantation
Alessia Gallo, Monica Miele, Ester Badami, Pier Giulio Conaldi
Patients following solid organ transplantation show a higher risk of developing cancer compared to the general population. Elevated risk is likely due to the interplay of a combination of factors, such as chronic inflammation, coexisting medical conditions, immunosuppressive regimen and persistent infection with oncogenic viruses. In addition, the tumor microenvironment plays a pivotal role in cancer progression, by driving recruitment and in situ differentiation of anti-inflammatory cells of the adaptive and innate immune system such as regulatory T cells, Th17, Dendritic Cells, Myeloid Derived Suppressor Cells, Type 2 Macrophages...
February 16, 2018: Cellular Immunology
Eros Marín, Maria Cristina Cuturi, Aurélie Moreau
Over the past century, solid organ transplantation has been improved both at a surgical and postoperative level. However, despite the improvement in efficiency, safety, and survival, we are still far from obtaining full acceptance of all kinds of allograft in the absence of concomitant treatments. Today, transplanted patients are treated with immunosuppressive drugs (IS) to minimize immunological response in order to prevent graft rejection. Nevertheless, the lack of specificity of IS leads to an increase in the risk of cancer and infections...
2018: Frontiers in Immunology
Raphael Steiner, Robert Kridel, Emiliano Giostra, Thomas McKee, Rita Achermann, Nicolas Mueller, Oriol Manuel, Michael Dickenmann, Macé M Schuurmans, Laurence de Leval, Thomas Fehr, Marianne Tinguely, Isabelle Binet, Sergio Cogliatti, Eugenia Haralamvieva, Michael Koller, The Swiss Transplant Cohort Study Stcs, Pierre-Yves Dietrich
BACKGROUND: Post-transplant lymphoproliferative disorder (PTLD) is a potentially life-threatening complication of transplantation occurring in the setting of immunosuppression and oncogenic viral infections. However, little is known about the cumulative incidence, histological subtypes, risk determinants and outcome of PTLD in solid organ transplant (SOT) recipients in Switzerland. METHODS: This retrospective observational study investigated adult SOT recipients from two sequential cohorts, the pre-SCTS (Swiss Transplant Cohort Study) series, with data collected from January 1986 to April 2008, and the STCS series, with data collected from May 2008 to December 2014 in Switzerland...
March 8, 2018: Swiss Medical Weekly
João Bruno Ribeiro Machado Lisboa, Guilherme de Abreu Rodrigues, Diego Corsetti Mondadori, João Paulo Cassiano de Macedo, Orival De Freitas Filho, Paulo Manuel Pêgo-Fernades
The diagnosis and treatment of tuberculosis (TB) in transplanted receivers presents several challenges. TB is an opportunistic infection with high morbidity and mortality in solid organs of transplanted patients, therefore, the diagnosis difficulties. A case of a 30-year-old male, heart transplanted patient, who after being submitted to mediastinoscopy, obtained a result of lymph node TB.
January 2018: International Journal of Mycobacteriology
Giacomo Veronese, Enrico Ammirati, Maria Cristina Moioli, Rossella Baldan, Carlo Andrea Orcese, Gisele De Rezende, Silvio Veronese, Gabriella Masciocco, Enrico Perna, Giovanna Travi, Massimo Puoti, Manlio Cipriani, Simon Tiberi, Daniela Cirillo, Maria Frigerio
BACKGROUND: Pneumocystis jirovecii pneumonia (PJP) outbreaks are described in solid organ transplant recipients. Few reports suggest interhuman transmission with important infection control implications. We described a large PJP outbreak in heart transplant (HTx) recipients. METHODS: Six cases of PJP occurred in HTx recipients within 10 months in our hospital. Demographics, clinical characteristics, treatment and outcomes were described. To identify contacts among individuals a review of all dates of out-patient visits and patient hospitalizations was performed...
March 7, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Robin K Avery, Fernanda P Silveira, Kaitlin Benedict, Angela Ahlquist Cleveland, Carol A Kauffman, Mindy G Schuster, Erik R Dubberke, Shahid Husain, David Paterson, Tom Chiller, Peter Pappas
BACKGROUND: Most studies of post-transplant CMV infection have focused on either solid organ or hematopoietic cell transplant (HCT) recipients. A large prospective cohort study involving both lung and HCT recipients provided an opportunity to compare the epidemiology and outcomes of CMV infections in these two groups. METHODS: Patients were followed for 30 months in a 6-center prospective cohort study. Data on demographics, CMV infections, tissue-invasive disease, recurrences, rejection, and immunosuppression were recorded...
March 7, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
W A Werbel, M G Ison, M P Angarone, A Yang, V Stosor
BACKGROUND: Pneumocystis jirovecii pneumonia (PJP) affected 5-15% of solid organ transplant (SOT) recipients prior to universal prophylaxis, classically with trimethoprim-sulfamethoxazole (TMP-SMX). Guidelines generally recommend 6-12 months of prophylaxis post SOT, yet optimal duration and robust PJP risk stratification have not been established. METHODS: A retrospective, single-center, case-control study of PJP among SOT recipients from January 1998 to December 2013 was conducted...
March 7, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Davut Eren, Eray Eroglu, Aysegul Ulu Kilic, Mustafa Altay Atalay, Necati Mumcu, Murat Hayri Sipahioglu, Ozlem Canoz, Ayse Nedret Koc, Oktay Oymak
Skin infections caused by Paecilomyces species have been rarely described in patients with solid organ transplantation. Cutaneous manifestations are highly variable and include erythematous macules, nodules, pustules, and vesicular and necrotic lesions. The diagnosis of these infections is generally made by examination of a skin biopsy. Management of these fungal infections is difficult due to the immunocompromised state of the patients. Moreover, antifungal therapy and immunosuppressive drug interactions should be considered during treatment management...
March 7, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
M Serrano-Alonso, F Guillen-Grima, P Martin-Moreno, G Rabago, J Manrique, M Garcia-Del-Barrio, G Reina, J Torre-Cisneros, M Fernandez-Alonso, J I Herrero
BACKGROUND: Cytomegalovirus (CMV) is the most important viral pathogen in solid organ transplant (SOT) recipients. The role of secondary CMV prophylaxis in this population remains unclear. METHODS: Retrospective cohort study in a single center. SOT recipients treated for CMV infection from 2007 to 2014 were studied to determine the efficacy and safety of secondary prophylaxis and its impact on graft loss and mortality. The outcome variable was CMV replication in the first 3 months after the end of therapy...
March 7, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
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
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