COVID-19 and Solid Organ Transplantation: Role of Anti-SARS-CoV-2 Monoclonal Antibodies

Solid organ transplantation represents one of the most important achievements in history of medicine. Over the last decades, the increasing number of transplants has not been of the same extent of the number of patients in the waiting lists. Live donation has been implemented in order to reduce the gap between supply and demand. From an ethical standpoint, the donation process from a live donor seems to violate the traditional first rule of medicine—primum non nocere because inevitably exposes healthy persons to a risk in order to benefit another person. In the chapter will be presented the crucial role of ethics and specific ethical issues in the different forms of live donation, such as financial incentives for living donation, reimbursement in unrelated live donation, minor sibling-to-sibling organ donation. The ethical aspects of live donor organ transplantation are continuously evolving; in order to make this strategy more beneficial and lifesaving, everyone involved in the process should make every possible effort with in mind the best interests of the patients.

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Monoclonal Antibodies in Solid Organ Transplantation

Pharmaceutical Biotechnology ◽

10.3109/9781420044386-18 ◽

2007 ◽

pp. 365-375

Author(s):

Nicole Weimert ◽

Rita Alloway

Keyword(s):

Monoclonal Antibodies ◽

Organ Transplantation ◽

Solid Organ Transplantation ◽

Solid Organ

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The role of the clinical microbiology laboratory in solid organ transplantation programs

Enfermedades Infecciosas y Microbiología Clínica ◽

10.1016/s0213-005x(12)70076-9 ◽

2012 ◽

Vol 30 ◽

pp. 2-9 ◽

Cited By ~ 2

Author(s):

José L. Pérez ◽

Josefina Ayats ◽

María de Oña ◽

Tomàs Pumarola

Keyword(s):

Organ Transplantation ◽

Clinical Microbiology ◽

Solid Organ Transplantation ◽

Clinical Microbiology Laboratory ◽

Solid Organ ◽

Microbiology Laboratory

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Calcineurin Inhibitor-Based Immunosuppression and COVID-19: Results from a Multidisciplinary Cohort of Patients in Northern Italy

Microorganisms ◽

10.3390/microorganisms8070977 ◽

2020 ◽

Vol 8 (7) ◽

pp. 977 ◽

Cited By ~ 3

Author(s):

Lorenzo Cavagna ◽

Elena Seminari ◽

Giovanni Zanframundo ◽

Marilena Gregorini ◽

Angela Di Matteo ◽

...

Keyword(s):

Organ Transplantation ◽

Calcineurin Inhibitor ◽

Clinical Course ◽

Solid Organ Transplantation ◽

Calcineurin Inhibitors ◽

Infectious Complications ◽

Study Data ◽

Solid Organ ◽

The North

The role of immunosuppression in SARS-CoV-2-related disease (COVID-19) is a matter of debate. We here describe the course and the outcome of COVID-19 in a cohort of patients undergoing treatment with calcineurin inhibitors. In this monocentric cohort study, data were collected from the COVID-19 outbreak in Italy up to 28 April 2020. Patients were followed at our hospital for solid organ transplantation or systemic rheumatic disorders (RMDs) and were on calcineurin inhibitor (CNI)-based therapy. Selected patients were referred from the North of Italy. The aim of our study was to evaluate the clinical course of COVID-19 in this setting. We evaluated 385 consecutive patients (220 males, 57%; median age 61 years, IQR 48–69); 331 (86%) received solid organ transplantation and 54 (14%) had a RMD. CNIs were the only immunosuppressant administered in 47 patients (12%). We identified 14 (4%) COVID-19 patients, all transplanted, mainly presenting with fever (86%) and diarrhea (71%). Twelve patients were hospitalized and two of them died, both with severe comorbidities. No patients developed acute respiratory distress syndrome or infectious complications. The surviving 10 patients are now fully recovered. The clinical course of COVID-19 patients on CNIs is generally mild, and the risk of superinfection seems low.

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Deciphering the role of eosinophils in solid organ transplantation

American Journal of Transplantation ◽

10.1111/ajt.15660 ◽

2019 ◽

Vol 20 (4) ◽

pp. 924-930

Author(s):

Oscar Okwudiri Onyema ◽

Yizhan Guo ◽

Atsushi Hata ◽

Daniel Kreisel ◽

Andrew E. Gelman ◽

...

Keyword(s):

Organ Transplantation ◽

Solid Organ Transplantation ◽

Solid Organ

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Role of Chemotherapy and Rituximab for Treatment of Posttransplant Lymphoproliferative Disorder in Solid Organ Transplantation

Annals of Pharmacotherapy ◽

10.1345/aph.1k175 ◽

2007 ◽

Vol 41 (10) ◽

pp. 1648-1659 ◽

Cited By ~ 28

Author(s):

Jin-Joo Lee ◽

Masha SH Lam ◽

Amy Rosenberg

Keyword(s):

Organ Transplantation ◽

Lymphoproliferative Disorder ◽

Disease Onset ◽

Solid Organ Transplantation ◽

Response Rates ◽

Data Sources ◽

Solid Organ ◽

Posttransplant Lymphoproliferative Disorder ◽

Early Disease

Objective: To evaluate the role of chemotherapy and/or rituximab for treatment of posttransplant lymphoproliferative disorder (PTLD) in solid organ transplantation. Data Sources: A MEDLINE search (1966–May 2007) was conducted using the key words posttransplant lymphoproliferative disorder, solid organ transplantation, chemotherapy, and rituximab. References of relevant articles and abstracts from recent hematology, oncology, and transplantation scientific meetings (2004–May 2007) were also reviewed. Study Selection and Data Extraction: Prospective and retrospective studies identified from the data sources were evaluated, and all information deemed relevant was included for this review. Data Synthesis: Overall response rates ranged from 53% to 68%, 25% to 83%, and 74% to 100% for rituximab monotherapy, chemotherapy, and chemotherapy plus rituximab, respectively. Positive response to treatment was influenced by prognostic factors, including presence of Epstein-Barr virus in tumor cells, normal lactate dehydrogenase levels, good performance status, early disease onset after transplantation, and early disease stages. These factors in study patients likely contribute to the variability in response rates seen between treatment options. Severe adverse effects, ranging from grade 3 neutropenia to infection resulting in death, occurred more frequently in patients receiving chemotherapy than in patients receiving only rituximab. Conclusions: Although reduction in immunosuppressive medications remains the first-line therapy for PTLD treatment, many cases do not respond to this treatment alone, especially monomorphic or more aggressive cases of lymphoma. Therefore, it is reasonable to begin active treatment including rituximab and/or chemotherapy initially, along with reduction in immunosuppression in many cases. Further prospective, comparative studies are urgently needed to confirm the efficacy of these treatment strategies as well as to clarify which subset of patients may benefit most from them.

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