Prevalence and Long-Term Outcomes of Solid Organ Transplant in Children with Intellectual Disability

Abstract Background Invasive fungal infection (IFI) in solid-organ transplant (SOT) recipients is associated with significant morbidity and mortality. The long-term probability of post-transplant IFI is poorly understood. Methods We conducted a population-based cohort study using linked administrative healthcare databases from Ontario, Canada to determine the incidence rate, 1-, 5- and 10-year cumulative probability of IFI-related hospitalization, and 1-year post-IFI all-cause mortality in SOT recipients from 2002 to 2016. We also examined post-IFI death-censored graft failure in renal transplant patients. Results We included 9326 SOT recipients (median follow-up 5.35 years). Overall, the incidence of IFI was 8.3 per 1000 person-years (95% confidence interval [CI]: 7.5–9.1). The 1-year cumulative probability of IFI was 7.4% (95% CI: 5.8–9.3%), 5.4% (95% CI: 3.6–8.1%), 1.8% (95% CI: 1.3–2.5%), 1.2% (95% CI: 0.5–3.2%), and 1.1% (95% CI: 0.9–1.4%) for lung, heart, liver, kidney-pancreas, and kidney-only transplant recipients, respectively. Lung transplant recipients had both the highest incidence rate and the highest 10-year probability of IFI: 43.0 per 1,000 person-years (95% CI: 36.8–50.0) and 26.4% (95% CI: 22.4–30.9%), respectively. Lung transplantation was also associated with the highest 1-year cumulative probability of post-IFI all-cause mortality (40.2%,95% CI: 33.1–48.3%). Among kidney transplant recipients, the 1-year probability of death-censored graft failure after IFI was 9.8% (95% CI: 6.0–15.8%). Conclusion The 1-year cumulative probability of IFI varies widely among SOT recipients. Lung transplantation was associated with the highest incidence of IFI with considerable 1-year all-cause mortality. The findings of this study considerably improved our understanding of the long-term probability of post-transplant IFI. Disclosures All authors: No reported disclosures.

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Eosinophilic Pustular Folliculitis: Association with Long-Term Immunosuppressant Use in a Solid Organ Transplant Recipient

Annals of Dermatology ◽

10.5021/ad.2014.26.4.520 ◽

2014 ◽

Vol 26 (4) ◽

pp. 520 ◽

Cited By ~ 1

Author(s):

Byung Wook Kim ◽

Ji Hyun Lee ◽

Chong Hyun Won ◽

Sung Eun Chang ◽

Mi Woo Lee ◽

...

Keyword(s):

Transplant Recipient ◽

Organ Transplant ◽

Solid Organ Transplant ◽

Organ Transplant Recipient ◽

Solid Organ Transplant Recipient ◽

Solid Organ

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Antibody-Mediated Rejection in Solid Organ Transplant

AACN Advanced Critical Care ◽

10.4037/aacnacc2016366 ◽

2016 ◽

Vol 27 (3) ◽

pp. 316-323

Author(s):

Michael Petty

Keyword(s):

Immune System ◽

Transplant Rejection ◽

Organ Transplant ◽

Solid Organ Transplant ◽

Solid Organ ◽

Antibody Mediated Rejection ◽

End Stage ◽

Transplanted Organs ◽

Broad Overview

Within a little more than a decade, the transplant of human organs for end-stage organ disease became a reality. The early barriers to successful long-term graft and patient survival were related to the inability to effectively control the immune system such that it would not attack the donor tissue but would still recognize and destroy invading organisms and cells. As immunosuppressive therapy has been refined and proper matching of donors and recipients has been improved, hyperacute rejection has become a rare occurrence and acute rejection has been markedly controlled. However, antibody-mediated rejection remains an important impediment to increased survival of transplanted organs. This article provides readers with a broad overview of the immune system, discusses mechanisms of transplant rejection, and details prevention, detection, and treatment of antibody-mediated rejection in solid organ transplant.

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