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Viral Infections in Renal Transplantation

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28 papers 0 to 25 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/29596116/the-third-international-consensus-guidelines-on-the-management-of-cytomegalovirus-in-solid-organ-transplantation
#1
Camille N Kotton, Deepali Kumar, Angela M Caliendo, Shirish Huprikar, Sunwen Chou, Lara Danziger-Isakov, Atul Humar
Despite recent advances, cytomegalovirus infections remain one of the most common complications affecting solid organ transplant recipients, conveying higher risks of complications, graft loss, morbidity, and mortality. Research in the field and development of prior consensus guidelines supported by The Transplantation Society has allowed a more standardized approach to cytomegalovirus management. An international multidisciplinary panel of experts was convened to expand and revise evidence and expert opinion-based consensus guidelines on CMV management including prevention, treatment, diagnostics, immunology, drug resistance, and pediatric issues...
March 29, 2018: Transplantation
https://www.readbyqxmd.com/read/29579827/epidemiologic-study-and-genotyping-of-bk-virus-in-renal-transplant-recipients
#2
M Cobos, L Aquilia, E Garay, S Ochiuzzi, S Alvarez, D Flores, C Raimondi
BK virus (BKV) infection occurs during childhood and remains latent in the urinary tract. The virus is reactivated in immunosuppressed patients, particularly in those with cellular immunity deficiency, allowing its detection in urine and blood. Nephropathy caused by the virus in renal transplantation recipients may lead to graft failure. The purpose of this study is to know the prevalence of BKV variables in renal transplantation recipients and to evaluate their clinical evolution through molecular methods of "in house" development...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/28298471/bk-polyomavirus-clinical-aspects-immune-regulation-and-emerging-therapies
#3
REVIEW
George R Ambalathingal, Ross S Francis, Mark J Smyth, Corey Smith, Rajiv Khanna
BK polyomavirus (BKV) causes frequent infections during childhood and establishes persistent infections within renal tubular cells and the uroepithelium, with minimal clinical implications. However, reactivation of BKV in immunocompromised individuals following renal or hematopoietic stem cell transplantation may cause serious complications, including BKV-associated nephropathy (BKVAN), ureteric stenosis, or hemorrhagic cystitis. Implementation of more potent immunosuppression and increased posttransplant surveillance has resulted in a higher incidence of BKVAN...
April 2017: Clinical Microbiology Reviews
https://www.readbyqxmd.com/read/29500912/low-dose-valganciclovir-for-cytomegalovirus-prophylaxis-in-intermediate-risk-liver-transplant-recipients
#4
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
https://www.readbyqxmd.com/read/29369973/the-role-of-mtor-inhibitors-in-the-management-of-viral-infections-a-review-of-current-literature
#5
Lyndsey J Bowman, Andrew J Brueckner, Christina T Doligalski
Viruses are the leading cause of infections after solid organ transplant. The antiviral properties of mammalian target of rapamycin inhibitors (mTORis) have been ascribed to a variety of mechanisms and historical data have supported their use over other immunosuppressants for a myriad of viruses. Herein, we summarize the most current data to highlight the role of mTORis in the management of viral infections after solid organ transplant. The mTORis play a clear role in the management of cytomegalovirus, and have data supporting their potential use for BK virus and human herpesvirus 8-related Kaposi sarcoma...
February 2018: Transplantation
https://www.readbyqxmd.com/read/29315820/de-novo-donor-specific-antibody-following-bk-nephropathy-the-incidence-and-association-with-antibody-mediated-rejection
#6
Wisit Cheungpasitporn, Walter K Kremers, Elizabeth Lorenz, Hatem Amer, Fernando G Cosio, Mark D Stegall, Manish J Gandhi, Carrie A Schinstock
BACKGROUND AND OBJECTIVES: The risk of de novo donor-specific antibody (dnDSA) development following BK viremia (BKV) or nephropathy (BKN) after kidney transplant remains unclear. We aimed to evaluate the relationships among dnDSA, BKV (BK blood PCR > 15 000 copies), BKN, antibody-mediated rejection (AMR), and allograft loss. PATIENTS AND METHODS: We performed a retrospective cohort study of 904 solitary kidney transplant recipients transplanted between 10/2007 and 5/2014...
March 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29166336/valganciclovir-prophylaxis-versus-preemptive-therapy-in-cytomegalovirus-positive-renal-allograft-recipients-long-term-results-after-7-years-of-a-randomized-clinical-trial
#7
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
https://www.readbyqxmd.com/read/29025381/adenovirus-infection-as-a-cause-of-fever-of-unknown-origin-and-allograft-dysfunction-in-a-kidney-transplant-recipient
#8
Michelle Saliba, Hala Kfoury Assouf, Souodod Abbas, Pierre Abi Hanna, Gaby Kamel, Antoine Barbari
With the recent introduction of more potent modern immunosuppressive regimens in solid-organ transplant, new types of viral infections such as adenovirus are emerging as a potential cause for graft dysfunction and loss. We report a case of 41-year-old male patient with end-stage renal disease from recurrent kidney stones who underwent kidney transplant from a deceased 12-year-old female donor. He developed adenoviral infection with acute cystitis, microscopic hematuria, and necrotizing interstitial nephritis associated with graft dysfunction within the first month of the postoperative period...
October 12, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28665892/aggregating-marginal-gains-in-posttransplant-cmv-risk-stratification
#9
Simon Ball
No abstract text is available yet for this article.
October 2017: Transplantation
https://www.readbyqxmd.com/read/28609473/a-delicate-balance-between-rejection-and-bk-polyomavirus-associated-nephropathy-a-retrospective-cohort-study-in-renal-transplant-recipients
#10
Lilli Gard, Willem van Doesum, Hubert G M Niesters, Willem J van Son, Arjan Diepstra, Coen A Stegeman, Henk Groen, Annelies Riezebos-Brilman, Jan Stephan Sanders
BACKGROUND: The immunosuppressive agents mycophenolate acid (MPA) and tacrolimus (Tac) are associated with a higher incidence of BK polyomavirus nephropathy (BKPyVAN). In this observational retrospective cohort study, the frequency of BK polyomavirus (BKPyV) complications over a 24-month period was studied. METHODS: 358 renal transplant recipients (RTR) treated with MPA, with either cyclosporine A (CsA) (CsAM group) or Tac (TacM group) and mostly prednisolone, were included...
2017: PloS One
https://www.readbyqxmd.com/read/28594749/cmv-specific-t-cell-monitoring-offers-superior-risk-stratification-of-cmv-seronegative-kidney-transplant-recipients-of-a-cmv-seropositive-donor
#11
Thomas Schachtner, Maik Stein, Petra Reinke
BACKGROUND: Detectable cytomegalovirus (CMV)-specific T cells in CMV-seronegative kidney transplant recipients (KTRs) have been attributed to an absence of circulating antibodies despite CMV sensitization. The diagnostic value of CMV-specific T cells, however, needs to be implemented in risk stratification for CMV replication. METHODS: Three hundred twenty-six KTRs were studied and classified with respect to CMV serostatus and presence of CMV-specific T cells. Samples were collected pretransplantation, at +1, +2, and +3 months posttransplantation...
October 2017: Transplantation
https://www.readbyqxmd.com/read/28512328/tacrolimus-blood-level-fluctuation-predisposes-to-coexisting-bk-virus-nephropathy-and-acute-allograft-rejection
#12
Chia-Lin Shen, An-Hang Yang, Tse-Jen Lien, Der-Cherng Tarng, Chih-Yu Yang
BK virus nephropathy (BKVN) and allograft rejection are two distinct disease entities which occur at opposite ends of the immune spectrum. However, they coexist in renal transplant recipients. Predisposing factors for this coexistence remain elusive. We identified nine biopsy-proven BKVN patients with coexisting acute rejection, and 21 patients with BKVN alone. We retrospectively analyzed the dosage and blood concentrations of immunosuppressants during the 3-month period prior to the renal biopsy between the two patient groups...
May 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28513810/epstein-barr-virus-encephalitis-in-solid-organ-transplantation
#13
REVIEW
Jillian S Y Lau, Zhi Mei Low, Iain Abbott, Lani Shochet, John Kanellis, Arthur Richard Kitching, Tony M Korman
Epstein-Barr virus (EBV) is typically associated with post transplant lymphoproliferative disease (PTLD) after solid organ and stem cell transplantation. However, it is rarely associated with neurological complications. We report a case of severe encephalitis complicating primary EBV infection six months post renal transplantation, and review the literature on EBV encephalitis in solid organ transplantation in adults. A 55-year-old male presented 6 months post cadaveric renal transplant with headache, fever and confusion...
July 2017: New Microbiologica
https://www.readbyqxmd.com/read/28510315/bk-virus-nephropathy-revisited
#14
EDITORIAL
M Mengel
No abstract text is available yet for this article.
August 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28509373/bk-viremia-surveillance-and-outcomes-in-simultaneous-pancreas-kidney-transplant-recipients
#15
Scott G Westphal, Elizabeth R Lyden, Eric D Langewisch, Clifford D Miles
BACKGROUND: While screening for asymptomatic BK viremia (BKV) has been well studied in isolated kidney transplant recipients, there is a paucity of published outcomes in simultaneous pancreas-kidney (SPK) transplant recipients who underwent BKV screening followed by pre-emptive reduction in immunosuppression. METHODS: This is a single-center, retrospective review of 31 consecutive SPK recipients who were transplanted over a 5-year period following the initiation of a serum BKV screening protocol...
August 2017: Clinical Transplantation
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
#16
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...
August 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28418354/-clinical-and-morphological-signs-of-viral-damage-to-a-kidney-transplant
#17
S E Solovyeva, E M Paltseva, M M Morozova, M M Kaabak, N A Krainik, A V Matveev
AIM: Тo compare morphological changes and results of immunohistochemical (IHC) identification of viruses (polyomaviruses, adenoviruses, and herpesviruses) in the biopsy specimens with their clinical manifestations in recipients of renal transplants. MATERIAL AND METHODS: Morphological and IHC studies were conducted using 71 needle renal transplant biopsy specimens from patients in the study group and 10 renal biopsy specimens from those in the control group. A number of clinical indicators were estimated...
2017: Arkhiv Patologii
https://www.readbyqxmd.com/read/28376031/the-immune-response-to-epstein-barr-virus-and-implications-for-posttransplant-lymphoproliferative-disorder
#18
REVIEW
Olivia M Martinez, Sheri M Krams
Posttransplant lymphoproliferative disorder (PTLD) is a serious complication in organ transplant recipients and is most often associated with the Epstein Barr virus (EBV). EBV is a common gammaherpes virus with tropism for B lymphocytes and infection in immunocompetent individuals is typically asymptomatic and benign. However, infection in immunocompromised or immunosuppressed individuals can result in malignant B cell lymphoproliferations, such as PTLD. EBV+ PTLD can arise after primary EBV infection, or because of reactivation of a prior infection, and represents a leading malignancy in the transplant population...
September 2017: Transplantation
https://www.readbyqxmd.com/read/28371308/bk-virus-nephropathy-histological-evolution-by-sequential-pathology
#19
B J Nankivell, J Renthawa, R N Sharma, K Kable, P J O'Connell, J R Chapman
Reactivation of BK virus in renal allografts causes a destructive chronic infection. This single-center retrospective cohort study describes the evolution of BK virus allograft nephropathy (BKVAN) from 63 kidneys (from 61 patients) using sequential histopathology (454 biopsies, averaging 7.8 ± 2.6 per kidney) followed for 60.1 mo. Uninfected protocol biopsies formulated time-matched control Banff scores (n = 975). Interstitial inflammation occurred in 73% at diagnosis, correlating with viral histopathology (r = 0...
August 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28340829/impact-of-prophylaxis-vs-pre-emptive-approach-for-cytomegalovirus-infection-in-kidney-transplant-recipients
#20
O Kır, A Zeytinoğlu, B Arda, M Yılmaz, G Aşçı, H Töz
Cytomegalovirus (CMV) is the most common viral infection during the post-transplant period, and it is one of the major causes of morbidity and mortality in kidney transplantation. In this study, the incidence and impact of pre-emptive and prophylactic approaches and long-term effects on graft and patient survival of CMV infection were investigated. Among 493 adult kidney transplant recipients, pretransplant CMV IgG-negative patients and patients with a follow-up shorter than a month were excluded. The patients were divided into 2 groups: pre-emptive group (n = 187, regular screening and acyclovir 400 mg twice daily for 6 months), and prophylaxis group (n = 275, valganciclovir 450 mg/d for 3 months)...
April 2017: Transplantation Proceedings
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