scholarly journals 18 Fungal infections of blood in patients undergoing immunosuppressive therapy after solid organ transplantation: Epidemiology and susceptibility of the fungal strains

2006 ◽  
Vol 10 ◽  
pp. S11
Author(s):  
E. Swoboda-Kopec ◽  
I. Netsvyetayeva ◽  
D. Kawecki ◽  
W. Rowinski ◽  
M. Durlik ◽  
...  
Keyword(s):  
Immunosuppressive Therapy ◽  
Organ Transplantation ◽  
Fungal Infections ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Fungal Strains

scholarly journals A case of rhabdomyolysis after atorvastatin therapy of a liver transplant recipient receiving immunosuppressive therapy with cyclosporine

2021 ◽  
Vol 13 (2) ◽  
pp. 158-164
Author(s):  
A. V. Shabunin ◽  
S. P. Loginov ◽  
P. A. Drozdov ◽  
I. V. Nesterenko ◽  
D. A. Makeev ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Drug Interactions ◽  
Liver Transplant ◽  
Immunosuppressive Therapy ◽  
Organ Transplantation ◽  
Muscle Pain ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Term Survival

Rationale. To date, liver transplantation is the most effective method of treating end-stage liver failure, and therefore this treatment has become widespread throughout the world. However, due to the improvement in the quality of transplant care and an increase in the long-term survival of patients, the development of concomitant pathology, which often requires medical treatment, is inevitably associated with a higher life expectancy of liver transplant recipients. Thus, in patients who underwent liver transplantation, there is. a significant increase in the incidence of dyslipidemia. However, a long-term immunosuppressive therapy in organ transplant patients can adversely modify the effect of the prescribed drugs, which requires careful monitoring and consideration of drug interactions.Purpose. Using a clinical example to demonstrate the importance of taking drug interactions into account in the treatment of patients after organ transplantation receiving immunosuppressive drugs.Material and methods. In the presented clinical case, a patient after orthotopic liver transplantation performed in 2005 underwent a staged treatment of cicatricial stricture of choledochal anastomosis in the S.P. Botkin City Clinical Hospital. During the following hospitalization, the patient complained of minor muscle pain when walking. At doctor's visit 3 weeks before hospitalization, a local physician prescribed therapy with atorvastatin 10 mg per day due to an increase in blood plasma cholesterol levels. The patient underwent removal of the self-expanding nitinol stent. During the follow-up examination, the patient had no evidence of an impaired bile outflow, however, muscle pain and weakness progressively increased, the rate of diuresis decreased, and in the biochemical analysis of blood there was an abrupt increase in the concentration of creatinine, aspartate aminotransferase, alanine aminotransferase. Atorvastatin was canceled, a diagnosis of acute non-traumatic rhabdomyolysis was established, treatment with hemodialysis and plasma exchange was started on 03/05/2020. The last session of renal replacement therapy was 03/30/20.Results. With the restoration of the diuresis rate, there was a spontaneous decrease in the level of creatinine to 170 μmol/L. The patient was discharged with satisfactory renal and hepatic function. The pain syndrome completely resolved. Conclusion. Drug interactions between atorvastatin and cyclosporine have resulted in acute rhabdomyolysis with life-threatening consequences. This once again confirms the importance of taking drug interactions into account when managing patients after solid organ transplantation.

Fungal infections in solid organ transplantation

2017 ◽  
Author(s):  
Darius Armstrong James ◽  
Anand Shah ◽  
Anna Reed
Keyword(s):  
Organ Transplantation ◽  
Fungal Infections ◽  
Wide Spectrum ◽  
Treatment Options ◽  
Solid Organ Transplantation ◽  
Invasive Disease ◽  
Global Scale ◽  
Molecular Diagnostic ◽  
Individual Risk ◽  
Solid Organ

Fungal infections are a significant and life-threatening complication of organ transplantation, on a global scale. Risk varies according to transplant type, with liver, lung, and small bowel transplant recipients being at particular risk. Whilst invasive candidiasis is the most common fungal infection in organ transplantation overall, aspergillosis is a particular problem in lung transplantation. In addition, a wide spectrum of fungi may cause invasive disease in organ transplantation, consequently diagnosis and treatment can be challenging. Key challenges are to understand individual risk for infection, appropriate prophylactic strategies, and molecular diagnostic approaches. Treatment options are complicated by drug–drug interactions with transplant therapy, as well as intrinsic allograft dysfunction seen in many patients. In this chapter, we review the epidemiology, risk factors, diagnosis, and management of fungal infections in solid organ transplantation.

Bronchoalveolar Lavage Fluid (1,3)β-D-Glucan for the Diagnosis of Invasive Fungal Infections in Solid Organ Transplantation

2015 ◽  
Vol 99 (9) ◽  
pp. e140-e144 ◽  
Author(s):  
Wolfgang Mutschlechner ◽  
Brigitte Risslegger ◽  
Birgit Willinger ◽  
Martin Hoenigl ◽  
Brigitte Bucher ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Organ Transplantation ◽  
Bronchoalveolar Lavage Fluid ◽  
Fungal Infections ◽  
Solid Organ Transplantation ◽  
Lavage Fluid ◽  
Invasive Fungal Infections ◽  
Solid Organ

Treatment of hypertension due to immunosuppressive therapy after solid organ transplantation - pharmacological approach.

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Wojciech Gilewski ◽  
Joanna Banach ◽  
Daniel Rogowicz ◽  
Łukasz Wołowiec ◽  
Sławomir Sielski ◽  
...  
Keyword(s):  
Immunosuppressive Therapy ◽  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Pharmacological Approach ◽  
Treatment Of Hypertension

Posttransplant Lymphoproliferative Disorders in Pediatric Solid Organ Recipients: A Multicenter Retrospective Analysis of Patients from 1990 to 2003.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 1929-1929
Author(s):  
B. Maecker ◽  
T. Jack ◽  
H. Abdul-Khaliq ◽  
M. Burdelski ◽  
J. Ehrich ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Immunosuppressive Therapy ◽  
Retrospective Analysis ◽  
Organ Transplantation ◽  
Median Time ◽  
Solid Organ Transplantation ◽  
Lymphoproliferative Disorders ◽  
Solid Organ ◽  
Hodgkin's Lymphomas ◽  
Posttransplant Lymphoproliferative Disorders

Abstract Posttransplant lymphoproliferative disorders (PTLD) have been recognized as severe side effects of immunosuppressive therapy after organ transplantation. However, no standard diagnostic and therapeutic approaches have been defined. Furthermore, few interdisciplinary perspectives comparing patients with heart/liver/kidney transplants are available. Here, we present results of a multicenter, retrospective analysis of pediatric patients treated for PTLD in Germany and Switzerland from 1990 to 2003. Patients were recruited by surveys through the working groups of pediatric renal, liver, and heart/lung transplantation as well as from the registry of pediatric Non-Hodgkin’s lymphomas (NHL-BFM). Inclusion criteria consisted of a history of solid organ transplantation, biopsy-proven diagnosis of PTLD, and age at onset of PTLD 18 years of less. Patient charts were analyzed for clinical course from transplant to onset of PTLD, virus serology, treatment regimen, and outcome. A total of 53 patients from 19 centers could be included, among them 25 renal graft recipients, 14 heart-, 11 liver-, and 1 lung transplant recipients as well as 2 patients after combined heart/lung transplantation. PTLD was diagnosed at a median time of 34 months [range 2 – 119 months] post organ transplantation. Histological evaluation based on the WHO classification showed 2 early lesion PTLD, 8 polymorphic PTLD, 26 high-grade B-cell lymphomas, 12 Burkitt-like lymphomas, 3 cases of Hodgkin’s disease and 2 T-cell lymphomas. Cytogenetic analysis revealed translocations involving chromosome 8 in five patients with Burkitt-like lymphomas. EBV gene products were detected in 31 tumors by in situ hybridization or immunohistochemistry, while 13 tumors were EBV negative (no data available on 9 tumors). EBV serology was negative in 55% of patients at the time of organ transplantation. However, in 29 patients EBV primary infection/reactivation was documented after organ transplantation (median time to infection/reactivation 5.9 months). In all patients immunosuppressive therapy was reduced. Treatment and follow up data were available in 51 patients: six patients remained in complete remission without additional treatment, in one patient autologous EBV-specific T-cells were infused. 41 patients received monoclonal antibodies (anti-CD20; n=7), chemotherapy (n=28), or a combination thereof (n=5). Fifteen of 51 patients died of progressing PTLD (n=7; among them 3 patients in which treatment was refused), treatment-related mortality (n=7), or fatal graft failure (n=2). Mortality was higher in patients with Burkitt-like lymphomas (7 of 12 patients) compared to all other entities (8 of 39 patients; p=0.026). Patients with stage IV disease had an inferior outcome compared to patients with stage I-III disease (mortality 6 of 7 vs. 9 of 44 patients, p=0.002). Thus, pediatric PTLD is a heterogeneous disease often associated with fatal outcome. The PED-PTLD study group has initiated a prospective multicenter trial of standardized diagnosis and treatment of PTLD after solid organ transplantation in children.

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