Infections in the Transplant Patient

2016 ◽  
Author(s):  
Alexander Billioux
Keyword(s):  
Transplant Patient ◽  
Drug Resistant ◽  
Unique Combination ◽  
Risk Of Infection ◽  
Urinary Catheters ◽  
Endotracheal Tubes ◽  
Transplant Patients ◽  
Resistant Species ◽  
Surgical Wounds ◽  
Clinical Presentations

Recipients of donor-derived tissues and organs are at particularly high risk of infection because of their unique combination of risk factors. Chronic illness results in more exposure to health care contexts in which pathogens—especially drug-resistant species—might be acquired. The transplant surgery itself compromises anatomical barriers to infection via indwelling venous and urinary catheters, endotracheal tubes, and surgical wounds. Donor-derived tissues and organs may harbor infectious pathogens undetected during rapid pre-transplant evaluations. The immunosuppression necessary to prevent rejection of donor tissues increases the risk of infection. In addition, each type of transplanted organ bears unique infectious risks. Many pathogens seen in post-transplant patients have unique clinical presentations. Infections in the transplant patient can vary depending on time from transplantation, the type of organ transplanted, and the primary manifestation of the infection.

scholarly journals Clinical Differences between COVID-19 and a COVID-Like Syndrome

2021 ◽  
Vol 10 (11) ◽  
pp. 2519
Author(s):  
Pierpaolo Di Micco ◽  
Giuseppe Camporese ◽  
Vincenzo Russo ◽  
Giuseppe Cardillo ◽  
Egidio Imbalzano ◽  
...  
Keyword(s):  
False Negative ◽  
Nasopharyngeal Swab ◽  
Similar Group ◽  
Risk Of Infection ◽  
Hospital Workers ◽  
Serological Tests ◽  
Clinical Presentations ◽  
The World ◽  
Lung Failure ◽  
The Difference

COVID-19 is an infection due to SARS-CoV-2; this virus has been identified as the cause of the present pandemic. Several typical characteristics are present in this infection, in particular pneumonia with possible lung failure, but atypical clinical presentations are being described daily by physicians around the world. Ground-glass opacities with pneumonia are the most common and dangerous presentations of the COVID-19 disease, and they are usually associated with positive nasopharyngeal swab (NPS) tests with detectable SARS-CoV-2 viral RNA. Compared to the general population, hospital workers have been at a greater risk of infection ever since the first patients were hospitalized. However, hospital workers have also been reported as having COVID-like symptoms despite repeated negative swab tests but having tested positive for SARS-CoV-2 antibodies with serological tests. We can postulate that a COVID-like syndrome is possible, in particular in hospital workers, that is characterized by symptoms similar to those of COVID-19, but with repeated negative nasopharyngeal swabs. These repeated negative NSPs make the difference in daily clinical management with people that experienced a single false negative nasopharyngeal swab; furthermore, a clear clinical differentiation of these situations is still lacking in the literature. For this reason, here, we report our main findings from a cohort of patients with a COVID-like syndrome compared to a similar group affected by typical COVID-19.

scholarly journals Aggressive Behaviour of Merkel Cell Carcinoma in a Kidney Transplant Patient Receiving Tacrolimus Treatment – Is There an Alternative in Immune Checkpoint Inhibitor Treatment?

2020 ◽  
pp. 1-4
Author(s):  
Giuseppina Gallucci ◽  
Anna Maria Bochicchio ◽  
Giuseppina Gallucci ◽  
Luigi Cagiano ◽  
Michele Grieco ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Immune Checkpoint ◽  
Aggressive Behaviour ◽  
Transplant Patient ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor ◽  
Kidney Transplant Patient ◽  
Merkel Cell ◽  
Transplant Patients

Background: Merkel cell carcinoma (MCC) is a rare skin neoplasm first described by Toker in 1972. The tumor usually presents in the sixth to seventh decade of life as a solitary reddish-brown to violaceous subcutaneous nodule on the head, neck, or the extremities. It is seen at an earlier age only in immunocompromised patients like transplant patients in immunosuppressive therapy. Thus, cancer has now become the second cause of death among transplant patients. The tumor growth is rapid in MCC patients, and for metastatic disease, no substantial benefit is obtained by chemotherapy. A new drug has recently become available, an immune checkpoint inhibitor (CPI), avelumab, that is able to delay disease progression significantly. However, there are no current guidelines for the use of immune checkpoint inhibitors in transplant patients. Case Presentation: We describe the case of a 55-year-old kidney transplant patient on immunosuppressive therapy with tacrolimus with an early occurrence of a Merkel cell carcinoma whose aggressive behaviour could not be hampered by Avelumab, due to fear of allograft rejection. Conclusion: CPI therapy is potentially lifesaving in advanced MCC. Further studies are urgently needed to test its benefit in this rapidly expanding field of post-transplant malignancies where there are only a few and less effective therapeutic options.

scholarly journals Successful treatment of a kidney transplant patient with COVID-19 and late-onset Pneumocystis jirovecii pneumonia

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Jing Peng ◽  
Ming Ni ◽  
Dunfeng Du ◽  
Yanjun Lu ◽  
Juan Song ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Successful Treatment ◽  
Transplant Patient ◽  
Late Onset ◽  
Combined Treatment ◽  
Pneumocystis Jirovecii ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Kidney Transplant Patient ◽  
Transplant Patients ◽  
Kidney Transplant Patients

Abstract Background Solid transplant patients are susceptible to Pneumocystis jirovecii pneumonia (PJP). While the vast majority of PJP cases occur within the first 6 months after transplantation, very few PJP cases are seen beyond 1 year post-transplantation (late-onset PJP). PJP and coronavirus disease 2019 (COVID-19, caused by infection with SARS-CoV-2) share quite a few common clinical manifestations and imaging findings, making the diagnosis of PJP often underappreciated during the current COVID-19 pandemic. To date, only 1 case of kidney transplantation who developed COVID-19 and late-onset PJP has been reported, but this patient also suffered from many other infections and died from respiratory failure and multiple organ dysfunction syndrome. A successful treatment of kidney patients with COVID-19 and late-onset PJP has not been reported. Case presentation We present a case of a 55-year-old male kidney transplant patient with COVID-19 who also developed late-onset PJP. He received a combined treatment strategy, including specific anti-pneumocystis therapy, symptomatic supportive therapy, adjusted immunosuppressive therapy, and use of antiviral drugs/antibiotics, ending with a favorable outcome. Conclusions This case highlights the importance of prompt and differential diagnosis of PJP in kidney transplant patients with SARS-CoV-2 infection. Further studies are required to clarify if kidney transplant patients with COVID-19 could be prone to develop late-onset PJP and how these patients should be treated.

Postoperative Management of Liver Transplant Patients

2018 ◽  
Author(s):  
Aleah L. Brubaker ◽  
Marianne Chen ◽  
Amy Gallo
Keyword(s):  
Critical Care ◽  
Liver Transplant ◽  
Transplant Patient ◽  
Graft Function ◽  
Postoperative Management ◽  
Transplant Patients ◽  
Key Words Critical Care ◽  
Poor Graft Function ◽  
Primary Graft Nonfunction ◽  
Care Course

Management of the postoperative liver transplant patient can be extremely challenging. The combination of preoperative comorbidities and intraoperative complexity can make for a tenuous postoperative critical care course. Consideration and monitoring of graft function are paramount as poor graft function or primary graft nonfunction will affect every aspect of care. Our goal in this review is to use a systems-based approach to highlight the key tenets for postoperative management of liver transplant patients to help orchestrate integrated care across subspecialties.  This review contains 2 figures, 2 tables, and 94 references. Key words: critical care, liver transplant, systems-based management

Immunosuppressive Drug Resistant Armored TCR T cells for immune‐therapy of HCC in liver transplant patients

Hepatology ◽  
2020 ◽  
Author(s):  
Morteza Hafezi ◽  
Meiyin Lin ◽  
Adeline Chia ◽  
Alicia Chua ◽  
Zi Zong Ho ◽  
...  
Keyword(s):  
T Cells ◽  
Liver Transplant ◽  
Immune Therapy ◽  
Immunosuppressive Drug ◽  
Drug Resistant ◽  
Transplant Patients

scholarly journals Refractory extensive vulvar high-grade squamous intraepithelial lesion in an immunosuppressed transplant patient treated with topical cidofovir: A case report

2020 ◽  
Vol 8 ◽  
pp. 2050313X2090454
Author(s):  
Darosa Lim ◽  
Annie Belisle ◽  
Deana Funaro
Keyword(s):  
Case Report ◽  
Transplant Patient ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Transplant Patients ◽  
Immunosuppressed Patients ◽  
Premalignant Condition ◽  
Intraepithelial Lesion ◽  
Mucosal Lesions ◽  
Refractory Case

High-grade squamous intraepithelial lesion of the vulva is a premalignant condition which may be especially resistant to treatments among immunosuppressed patients. We present our experience with the use of topical cidofovir in a refractory case of extensive vulvar high-grade squamous intraepithelial lesion in a 37-year-old transplant patient. Eighteen cycles of cidofovir over a 2-year period led to a sustained significant improvement, mainly of the mucosal lesions and was well tolerated. To our knowledge, we have not seen this therapy described in transplant patients with extensive high-grade squamous intraepithelial lesion.

scholarly journals Care of the Liver Transplant Patient

2014 ◽  
Vol 28 (4) ◽  
pp. 213-219 ◽  
Author(s):  
Mamatha Bhat ◽  
Said A Al-Busafi ◽  
Marc Deschênes ◽  
Peter Ghali
Keyword(s):  
Liver Transplant ◽  
Transplant Patient ◽  
Keywords Liver Transplantation ◽  
Metabolic Complications ◽  
Transplant Patients ◽  
Medical Issues ◽  
Metabolic Bone ◽  
Increased Risk

OBJECTIVE: To provide an approach to the care of liver transplant (LT) patients, a growing patient population with unique needs.METHODS: A literature search of PubMed for guidelines and review articles using the keywords “liver transplantation”, “long term complications” and “medical management” was conducted, resulting in 77 articles.RESULTS: As a result of being on immunosuppression, LT recipients are at increased risk of infections and must be screened regularly for metabolic complications and malignancies.DISCUSSION: Although immunosuppression is key to maintaining allograft health after transplantation, it comes with its own set of medical issues to follow. Physicians following LT recipients must be aware of the greater risk for hypertension, diabetes, dyslipidemia, renal failure, metabolic bone disease and malignancies in these patients, all of whom require regular monitoring and screening. Vaccination, quality of life, sexual function and pregnancy must be specifically addressed in transplant patients.

scholarly journals COMPARATIVE CHARACTERISTICS OF VARIOUS TYPES OF MEMBRANES USED FOR BONE GRAFTING AND GUIDED TISSUE REGENERATION IN DENTISTRY AND MAXILLOFACIAL SURGERY

2017 ◽  
Vol 21 (5) ◽  
pp. 291-296
Author(s):  
I. Mecuku ◽  
A. A Muraev ◽  
Julia V. Gazhva ◽  
S. G Ivashkevich
Keyword(s):  
Bone Defect ◽  
Tissue Regeneration ◽  
Bone Grafting ◽  
Maxillofacial Surgery ◽  
Guided Tissue Regeneration ◽  
Dental Practice ◽  
Risk Of Infection ◽  
Professional Literature ◽  
Surgical Wounds ◽  
High Degree

This review aims to analyze the domestic and foreign professional literature, and it shows the main positive and negative properties of the materials for the manufacture of membranes used in modern dental practice in bone-grafting interventions and guided tissue regeneration. Emphasis is placed on the importance of developing a new individual membrane made of polytetrafluorethylene, due to high relevance of such researches owing toreduce the risk of infection of surgical wounds and high degree of adaptation to the geometry of the bone defect.

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