Epidemiology of de novo malignancies after solid-organ transplantation: Immunosuppression, infection and other risk factors

2014 ◽  
Vol 28 (8) ◽  
pp. 1251-1265 ◽  
Author(s):  
Pierluca Piselli ◽  
Diana Verdirosi ◽  
Claudia Cimaglia ◽  
Ghil Busnach ◽  
Lucia Fratino ◽  
...  
Keyword(s):  
Risk Factors ◽  
Organ Transplantation ◽  
De Novo ◽  
Solid Organ Transplantation ◽  
Solid Organ

scholarly journals A Combined HLA Molecular Mismatch and Expression Analysis for Evaluating HLA-DPB1 de novo Donor-Specific Antibody Risk in Pediatric Solid Organ Transplantation: Implications for Solid Organ & Hematopoietic Stem Cell Transplantation

2020 ◽  
Author(s):  
Mengkai Shieh ◽  
Tristan J. Hayeck ◽  
Anh Dinh ◽  
Jamie L. Duke ◽  
Nilesh Chitnis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Organ Transplantation ◽  
Cell Transplantation ◽  
Specific Antibody ◽  
De Novo ◽  
Strong Association ◽  
Multivariable Analysis ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Hematopoietic Stem

ABSTRACTBackgroundHLA molecular mismatch (MM) has been shown to be a risk factor for de novo donor-specific antibody (dnDSA) development in solid organ transplantation (SOT). HLA expression differences have also been associated with adverse outcomes in hematopoietic cell transplantation. We sought to study both MM and expression in assessing dnDSA risk.MethodsOne-hundred-and-three HLA-DP-mismatched SOT pairs were retrospectively analysed. MM was computed using amino acids (aa), eplets and, supplementarily, Grantham/Epstein scores. DPB1 alleles were classified as rs9277534-A (low-expression) or -G (high-expression)–linked. To determine the associations between risk factors and dnDSA, logistic regression, linkage disequilibrium (LD) and population-based analyses were performed.ResultsA high-risk AA:GX (recipient:donor) expression combination (X=A or G) demonstrated strong association with DP-dnDSA (p=0.001). MM was also associated with DP-dnDSA when evaluated by itself (eplet_p=0.007, aa_p=0.003, Grantham_p=0.005, Epstein_p=0.004). When attempting to determine the relative individual effects of the risk factors in multivariable analysis, only AA:GX expression status retained a strong association (RR=18.6, p=0.007 with eplet; RR=15.8, p=0.02 with aa), while MM was no longer significant (eplet_p=0.56, aa_p=0.51). Importantly, these risk factors are correlated, due to LD between the expression-tagging SNP and polymorphisms along HLA-DPB1.ConclusionsThe MM and expression risk factors each appear to be strong predictors of DP-dnDSA and to possess clinical utility; however, the two risk factors are closely correlated. These metrics may represent distinct ways of characterizing a common overlapping dnDSA risk profile, but they are not independent. Further, we demonstrate the importance and detailed implications of LD effects in risk assessment of dnDSA and possibly transplantation overall.

De Novo Allergy and Immune-Mediated Disorders Following Solid-Organ Transplantation—Prevalence, Natural History, and Risk Factors

2018 ◽  
Vol 196 ◽  
pp. 154-160.e2 ◽  
Author(s):  
Nufar Marcus ◽  
Achiya Z. Amir ◽  
Eyal Grunebaum ◽  
Anne Dipchand ◽  
Diane Hebert ◽  
...  
Keyword(s):  
Risk Factors ◽  
Natural History ◽  
Organ Transplantation ◽  
De Novo ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Immune Mediated

scholarly journals Incidence and Risk Factors for Hepatocellular Carcinoma After Solid Organ Transplantation

2008 ◽  
Vol 86 (6) ◽  
pp. 784-790 ◽  
Author(s):  
Christopher J. Hoffmann ◽  
Aruna K. Subramanian ◽  
Andrew M. Cameron ◽  
Eric A. Engels
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Solid Organ

De Novo Malignancy After Solid Organ Transplantation in Children

2009 ◽  
Vol 41 (2) ◽  
pp. 674-675 ◽  
Author(s):  
D. Debray ◽  
V. Baudouin ◽  
F. Lacaille ◽  
M. Charbit ◽  
C. Rivet ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
De Novo ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
De Novo Malignancy

CNS or Bone Marrow Involvement As Risk Factors for Poor Survival in Post-Transplantation Lymphoproliferative Disorders in Children After Solid Organ Transplantation

2007 ◽  
Vol 25 (31) ◽  
pp. 4902-4908 ◽  
Author(s):  
Britta Maecker ◽  
Thomas Jack ◽  
Martin Zimmermann ◽  
Hashim Abdul-Khaliq ◽  
Martin Burdelski ◽  
...  
Keyword(s):  
Risk Factors ◽  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Stage Iv ◽  
Solid Organ ◽  
Event Free Survival ◽  
Poor Survival ◽  
Post Transplantation ◽  
Free Survival ◽  
Stage Iv Disease

Purpose To identify prognostic factors of survival in pediatric post-transplantation lymphoproliferative disorder (PTLD) after solid organ transplantation. Patients and Methods A multicenter, retrospective case analysis of 55 pediatric solid organ graft recipients (kidney, liver, heart/lung) developing PTLD were reported to the German Pediatric-PTLD registry. Patient charts were analyzed for tumor characteristics (histology, immunophenotypes, cytogenetics, Epstein-Barr virus [EBV] detection), stage, treatment, and outcome. Probability of overall and event-free survival was analyzed in defined subgroups using univariate and Cox regression analyses. Results PTLD was diagnosed at a median time of 29 months after organ transplantation, with a significantly shorter lag time in liver (0.83 years) versus heart or renal graft recipients (3.33 and 3.10 years, respectively; P = .001). The 5-year overall and event-free survival was 68% and 59%, respectively, with 59% of patients surviving 10 years. Stage IV disease with bone marrow and/or CNS involvement was associated independently with poor survival (P = .0005). No differences in outcome were observed between early- and late-onset PTLD, monomorphic or polymorphic PTLD, and EBV-positive or EBV-negative PTLD, respectively. Patients with Burkitt or Burkitt-like PTLD and c-myc translocations had short survival (< 1 year). Conclusion Stage IV disease is an independent risk factor for poor survival in pediatric PTLD patients. Prospective multicenter trials are needed to delineate additional risk factors and to assess treatment approaches for pediatric PTLD.

Chronic transplant dysfunction and transplant arteriosclerosis: new insights into underlying mechanisms

2003 ◽  
Vol 5 (2) ◽  
pp. 1-23 ◽  
Author(s):  
Jan-Luuk Hillebrands ◽  
Jan Rozing
Keyword(s):  
Risk Factors ◽  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Pathogenetic Mechanisms ◽  
Sequence Of Events ◽  
Long Term Treatment ◽  
Chronic Transplant Dysfunction ◽  
Transplant Arteriosclerosis

Although effective in the short-term, clinical solid-organ transplantation has not achieved its goals as a long-term treatment for patients with end-stage organ failure. Development of so-called chronic transplant dysfunction (CTD) is now recognised as the predominant cause of allograft loss long-term (after the first post-operative year) following transplantation. CTD has the remarkable histological feature that the luminal areas of intragraft arteries become obliterated, predominantly with vascular smooth muscle cells intermingled with some inflammatory cells. The development of this transplant vasculopathy, referred to as transplant arteriosclerosis (TA), is a multifactorial process and many risk factors have been identified. However, the precise pathogenetic mechanisms leading to TA are largely unknown and, as a result, current prevention and treatment protocols are inadequate. This review discusses the risk factors for TA and current views on the pathogenetic mechanisms leading to this vasculopathy. We argue here that host-derived cells contribute to the development of these vascular lesions, and propose that TA results from a normal vascular repair process that proceeds beyond the needs of functional repair. Guided by the proposed sequence of events, we finally discuss possible directions for future intervention strategies to prevent TA after solid-organ transplantation.

Rates and Risk Factors for Nonadherence to the Medical Regimen After Adult Solid Organ Transplantation

2007 ◽  
Vol 83 (7) ◽  
pp. 858-873 ◽  
Author(s):  
Mary Amanda Dew ◽  
Andrea F. DiMartini ◽  
Annette De Vito Dabbs ◽  
Larissa Myaskovsky ◽  
Jennifer Steel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Medical Regimen
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