Increased Risk of Advanced Colonic Adenomas and Timing of Surveillance Colonoscopy Following Solid Organ Transplantation

2021 ◽  
Author(s):  
Motaz H. Ashkar ◽  
Jacqueline Chen ◽  
Corey Shy ◽  
Jeffrey S. Crippin ◽  
Chien-Huan Chen ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Surveillance Colonoscopy ◽  
Colonic Adenomas ◽  
Increased Risk

Tu1843 INCREASED RISK OF ADVANCED COLONIC ADENOMAS AND TIMING OF SURVEILLANCE COLONOSCOPY FOLLOWING SOLID ORGAN TRANSPLANTATION.

2020 ◽  
Vol 158 (6) ◽  
pp. S-1184-S-1185
Author(s):  
Motaz Ashkar ◽  
Jacqueline Chen ◽  
Corey Shy ◽  
Jeffrey S. Crippin ◽  
Chien-Huan Chen ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Surveillance Colonoscopy ◽  
Colonic Adenomas ◽  
Increased Risk

scholarly journals Exploring the Epidemiology of Cancer after Solid Organ Transplantation (EpCOT): an observational cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e043731
Author(s):  
Adnan Sharif ◽  
Javeria Peracha ◽  
David Winter ◽  
Raoul Reulen ◽  
Mike Hawkins
Keyword(s):  
Organ Transplantation ◽  
Record Linkage ◽  
Solid Organ Transplantation ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Study Cohort ◽  
Solid Organ ◽  
Post Transplantation ◽  
Increased Risk ◽  
Risk Of Cancer

IntroductionSolid organ transplant patients are counselled regarding increased risk of cancer (principally due to their need for lifelong immunosuppression) and it ranks as one of their biggest self-reported worries. Post-transplantation cancer is common, associated with increased healthcare costs and emerging as a leading cause of post-transplant mortality. However, epidemiology of cancer post-transplantation remains poorly understood, with limitations including translating data from different countries and national data being siloed across different registries and/or data warehouses.Methods and analysisStudy methodology for Epidemiology of Cancer after Solid Organ Transplantation involves record linkage between the UK Transplant Registry (from NHS Blood and Transplant), Hospital Episode Statistics (for secondary care episodes from NHS Digital), National Cancer Registry (from cancer registration data hosted by Public Health England) and the National Death Registry (from NHS Digital). Deterministic record linkage will be conducted by NHS Digital, with a fully anonymised linked dataset available for analysis by the research team. The study cohort will consist of up to 85 410 solid organ transplant recipients,who underwent a solid organ transplant in England between 1 January 1985 and 31 December 2015, with up-to-date outcome data.Ethics and disseminationThis study has been approved by the Confidentiality Advisory Group (reference: 16/CAG/0121), Research Ethics Committee (reference: 15/YH/0320) and Institutional Review Board (reference: RRK5471). The results of this study will be presented at national and international conferences, and manuscripts with results will be submitted for publication in high-impact peer-reviewed journals. The information produced will also be used to develop national evidence-based clinical guidelines to inform risk stratification to enable risk-based clinical follow-up.Trial registration numberNCT02991105.

Solid Organ Transplantation (SOT) Does Not Increase Incidence Rate for Colonic Adenomas

2015 ◽  
Vol 110 ◽  
pp. S589
Author(s):  
Nicole C. Vissichelli ◽  
Adam P. Sima ◽  
Shadab M. Siddiqui ◽  
George Smallfield
Keyword(s):  
Incidence Rate ◽  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Colonic Adenomas

scholarly journals Pancytopenia caused by allopurinol and azathioprine interaction in a heart transplant patient: a case report

2020 ◽  
Vol 4 (6) ◽  
pp. 1-4
Author(s):  
Jason Feinman ◽  
Brett Rollins ◽  
Johanna Contreras ◽  
Aditya Parikh
Keyword(s):  
Organ Transplantation ◽  
Health Care Providers ◽  
Heart Transplant ◽  
Solid Organ Transplantation ◽  
Orthotopic Heart Transplantation ◽  
Solid Organ ◽  
Care Providers ◽  
Active Metabolites ◽  
Increased Risk ◽  
Severe Pancytopenia

Abstract Background Azathioprine is an immunosuppressive now less commonly prescribed after orthotopic heart transplantation. Patients with solid organ transplantation are at increased risk for numerous comorbidities including gout. Co-administration of allopurinol for gout prophylaxis and azathioprine increases the risk for severe myelosuppression due to drug–drug interactions. Case summary A 57-year-old male with a history of heart transplant 6 years prior presented with a month of severe fatigue and shortness of breath. His admission laboratory values were notable for severe pancytopenia. Medical workup revealed no haematologic malignancy, viral infection, or other consumptive process. After extensive review, it was discovered that the patient was taking excessive allopurinol for gout. His haematologic abnormalities resolved following discontinuation of allopurinol and treatment with filgrastim and romiplostim and was able to be discharged from the hospital. Discussion Azathioprine and allopurinol can potentially cause profound cytopenias due to the increased production of the active metabolites of azathioprine. Given the association between gout and solid organ transplantation, recognition of the risks of medication interaction as well as communication amongst health care providers and between providers and their patients is paramount.

Safety of Peritoneal Dialysis after Nonrenal Solid-Organ Transplantation

2018 ◽  
Vol 38 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Anne Buffet ◽  
Sonia Guillouët ◽  
Thierry Lobbedez ◽  
Maxence Ficheux ◽  
Antoine Lanot ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Replacement Therapy ◽  
Organ Transplantation ◽  
Previous History ◽  
Solid Organ Transplantation ◽  
Prior History ◽  
Solid Organ ◽  
Increased Risk ◽  
Significant Difference ◽  
History Of

Background End-stage renal disease is a well-known complication after solid-organ transplantation, mostly as a result of calcineurin-inhibitor therapy. Among recipients of solid-organ transplants other than kidneys, peritoneal dialysis (PD) has been considered an accessory technique as an increased risk of infectious complications has been reported. The aim of our study was to evaluate the outcome of patients with a liver, heart, or lung transplant who underwent PD for replacement therapy. Methods This was a retrospective, monocentric study. Every adult patient starting PD between January 1, 2001, and December 31, 2016, at our center was included. The history of previous solid-organ transplantation was determined. For the statistical analysis, we considered 2 groups of patients: 1 group having a history of transplantation of an organ other than the kidney (lung, heart, liver), and 1 group that was starting dialysis without any prior history of organ transplantation. Patients who had previously undergone kidney transplantation were excluded. The events of interest were the first peritonitis episode, death, and PD failure, defined as transfer to hemodialysis. Results A total of 383 patients started PD during this period, 13 of whom had a history of organ transplantation. We found no significant difference between the solid-organ transplantation patients and those without a history of transplantation in terms of the occurrence of peritonitis (HR [hazard ratio] 0.91 [0.37 – 2.22]), death (HR 0.83 [0.26 – 2.63]), and PD failure (HR 1.01 [0.32 – 3.22]). Conclusion Peritoneal dialysis appears to be an effective replacement therapy for patients with a previous history of solid-organ transplantation.

Donor Graft Cytomegalovirus Serostatus and the Risk of Arterial and Venous Thrombotic Events in Seronegative Recipients After Non-Thoracic Solid Organ Transplantation

2020 ◽  
Author(s):  
Sara Belga ◽  
Clayton MacDonald ◽  
Diana Chiang ◽  
Dima Kabbani ◽  
Soroush Shojai ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Cox Regression ◽  
Solid Organ Transplantation ◽  
Group Versus ◽  
Opportunistic Pathogen ◽  
Incidence Rates ◽  
Solid Organ ◽  
University Of Alberta ◽  
Increased Risk ◽  
The Impact

Abstract Background Cytomegalovirus (CMV) is the most common opportunistic pathogen, following solid organ transplantation (SOT), that leads to direct and indirect effects. The aim of this study was to assess the impact of CMV exposure at transplantation on the rate of posttransplant thrombotic events (TEs). Methods We conducted a retrospective cohort study of patients transplanted at the University of Alberta Hospital between July 2005 and January 2018. We included adult SOT CMV-seronegative recipients at transplantation who received an allograft from either a seropositive donor (D+/R-) or a seronegative donor (D-/R-). Results A total of 392 SOT recipients were included: 151 (39%) liver, 188 (48%) kidney, 45 (11%) pancreas, and 8 (2%) other transplants. The mean age was 47 years, 297 (76%) were males, and 181 (46%) had a CMV D+/R- donor. Patients in the CMV D+/R- cohort were slightly older (51 years versus 48 years in the D-/R- cohort; P = .036), while other variables, including cardiovascular risk factors and pretransplant TEs, were not different between groups. Overall, TEs occurred in 35 (19%) patients in the CMV D+/R- group, versus 21 (10%) in the CMV D-/R- group, at 5 years of follow-up (P = .008); the incidence rates per 100 transplant months were 5.12 and 1.02 in the CMV D+/R- and CMV D-/R- groups, respectively (P = .003). After adjusting for potential confounders with a Cox regression model, a CMV D+/R- transplantation was independently associated with an increased risk of a TE over 5 years (adjusted hazard ratio, 3.027; 95% confidence interval, 1.669–5.488). Conclusions A CMV D+/R- transplantation is associated with an increased risk of a TE posttransplantation.

scholarly journals Posttransplant Lymphoproliferative Disease after Pediatric Solid Organ Transplantation

2013 ◽  
Vol 2013 ◽  
pp. 1-14 ◽  
Author(s):  
Martin Mynarek ◽  
Tilmann Schober ◽  
Uta Behrends ◽  
Britta Maecker-Kolhoff
Keyword(s):  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Treatment Strategies ◽  
Lymphoproliferative Disease ◽  
Treatment Modalities ◽  
Solid Organ ◽  
Increased Risk ◽  
Posttransplant Lymphoproliferative Disease ◽  
New Treatment ◽  
Anti Cd20

Patients after solid organ transplantation (SOT) carry a substantially increased risk to develop malignant lymphomas. This is in part due to the immunosuppression required to maintain the function of the organ graft. Depending on the transplanted organ, up to 15% of pediatric transplant recipients acquire posttransplant lymphoproliferative disease (PTLD), and eventually 20% of those succumb to the disease. Early diagnosis of PTLD is often hampered by the unspecific symptoms and the difficult differential diagnosis, which includes atypical infections as well as graft rejection. Treatment of PTLD is limited by the high vulnerability towards antineoplastic chemotherapy in transplanted children. However, new treatment strategies and especially the introduction of the monoclonal anti-CD20 antibody rituximab have dramatically improved outcomes of PTLD. This review discusses risk factors for the development of PTLD in children, summarizes current approaches to therapy, and gives an outlook on developing new treatment modalities like targeted therapy with virus-specific T cells. Finally, monitoring strategies are evaluated.

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