scholarly journals Prevention and Treatment of Infectious Complications After Solid Organ Transplantation in Children

2010 ◽  
Vol 57 (2) ◽  
pp. 459-479 ◽  
Author(s):  
Upton Allen ◽  
Michael Green
Keyword(s):  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Infectious Complications ◽  
Solid Organ ◽  
Prevention And Treatment

Cytomegalovirus in Solid Organ Transplant Recipients: Clinical Updates, Challenges and Future Directions

2020 ◽  
Vol 26 (28) ◽  
pp. 3497-3506
Author(s):  
Raymund R. Razonable
Keyword(s):  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Cmv Infection ◽  
Future Directions ◽  
Prevention And Treatment ◽  
Solid Organ Transplant Recipients

Cytomegalovirus is the classic opportunistic infection after solid organ transplantation. This review will discuss updates and future directions in the diagnosis, prevention and treatment of CMV infection in solid organ transplant recipients. Antiviral prophylaxis and pre-emptive therapy are the mainstays of CMV prevention, but they should not be mutually exclusive and each strategy should be considered depending on a specific situation. The lack of a widely applicable viral load threshold for diagnosis and preemptive therapy is emphasized as a major factor that should pave the way for an individualized approach to prevention. Valganciclovir and intravenous ganciclovir remain as drugs of choice for CMV management, and strategies for managing drug-resistant CMV infection are enumerated. There is increasing use of CMV-specific cell-mediated immune assays to stratify the risk of CMV infection after solid organ transplantation, and their potential role in optimizing CMV prevention and treatment efforts is discussed.

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

2020 ◽  
Vol 8 (7) ◽  
pp. 977 ◽  
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.

scholarly journals Current Practices on Diagnosis, Prevention and Treatment of Post-Transplant Lymphoproliferative Disorder in Pediatric Patients after Solid Organ Transplantation: Results of ERN TransplantChild Healthcare Working Group Survey

Children ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 661
Author(s):  
Alastair Baker ◽  
Esteban Frauca Remacha ◽  
Juan Torres Canizales ◽  
Luz Yadira Bravo-Gallego ◽  
Emer Fitzpatrick ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Treatment Modalities ◽  
Multidisciplinary Teams ◽  
Solid Organ ◽  
Cross Sectional ◽  
Post Transplant ◽  
Pediatric Transplantation ◽  
Prevention And Treatment ◽  
Current Practices

(1) Background: Post-transplant lymphoproliferative disease (PTLD) is a significant complication of solid organ transplantation (SOT). However, there is lack of consensus in PTLD management. Our aim was to establish a present benchmark for comparison between international centers and between various organ transplant systems and modalities; (2) Methods: A cross-sectional questionnaire of relevant PTLD practices in pediatric transplantation was sent to multidisciplinary teams from 17 European center members of ERN TransplantChild to evaluate the centers’ approach strategies for diagnosis and treatment and how current practices impact a cross-sectional series of PTLD cases; (3) Results: A total of 34 SOT programs from 13 European centers participated. The decision to start preemptive treatment and its guidance was based on both EBV viremia monitoring plus additional laboratory methods and clinical assessment (61%). Among treatment modalities the most common initial practice at diagnosis was to reduce the immunosuppression (61%). A total of 126 PTLD cases were reported during the period 2012–2016. According to their histopathological classification, monomorphic lesions were the most frequent (46%). Graft rejection after PTLD remission was 33%. Of the total cases diagnosed with PTLD, 88% survived; (4) Conclusions: There is still no consensus on prevention and treatment of PTLD, which implies the need to generate evidence. This might successively allow the development of clinical guidelines.

Increased CD64 expression on polymorphonuclear neutrophils indicates infectious complications following solid organ transplantation

2011 ◽  
Vol 79A (6) ◽  
pp. 446-460 ◽  
Author(s):  
Daniel Grey ◽  
Ulrich Sack ◽  
Markus Scholz ◽  
Heike Knaack ◽  
Stephan Fricke ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Infectious Complications ◽  
Polymorphonuclear Neutrophils ◽  
Solid Organ ◽  
Cd64 Expression

Characteristics of infectious complications associated with mortality after solid organ transplantation

2000 ◽  
Vol 14 (4) ◽  
pp. 401-408 ◽  
Author(s):  
Shawn J Pelletier ◽  
Traves D Crabtree ◽  
Thomas G Gleason ◽  
Daniel P Raymond ◽  
Chang-Kwon Oh ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Infectious Complications ◽  
Solid Organ
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