MP322PREVALENCE AND RISK FACTORS OF HEMORRHAGIC COMPLICATIONS AFTER KIDNEY ALLOGRAFT BIOPSY: RESULTS FROM THE JAPANESE NATIONWIDE CLAIM DATABASE

Epidemiology of opportunistic infections (OI) after kidney allograft transplantation in the modern era of immunosuppression and the use of OI prevention strategies are poorly described. We retrospectively analyzed a single-center cohort on kidney allograft adult recipients transplanted between January 2008 and December 2013. The control group included all kidney recipients transplanted in the same period, but with no OI. We analyzed 538 kidney transplantations (538 patients). The proportion of OI was 15% (80 and 72 patients). OI occurred 12.8 (6.0–31.2) months after transplantation. Viruses were the leading cause (n = 54, (10%)), followed by fungal (n = 15 (3%)), parasitic (n = 6 (1%)), and bacterial (n = 5 (0.9%)) infections. Independent risk factors for OI were extended criteria donor (2.53 (1.48–4.31), p = 0.0007) and BK viremia (6.38 (3.62–11.23), p < 0.0001). High blood lymphocyte count at the time of transplantation was an independent protective factor (0.60 (0.38–0.94), p = 0.026). OI was an independent risk factor for allograft loss (2.53 (1.29–4.95), p = 0.007) but not for patient survival. Post-kidney transplantation OIs were mostly viral and occurred beyond one year after transplantation. Pre-transplantation lymphopenia and extended criteria donor are independent risk factors for OI, unlike induction therapy, hence the need to adjust immunosuppressive regimens to such transplant candidates.

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HLA Mismatches Remain Risk Factors for Acute Kidney Allograft Rejection in Patients Receiving Quadruple Immunosuppression With Anti-Interleukin-2 Receptor Antibodies

Transplantation Journal ◽

10.1097/tp.0b013e31816349b5 ◽

2008 ◽

Vol 85 (3) ◽

pp. 411-416 ◽

Cited By ~ 31

Author(s):

Karl M. Wissing ◽

Guy Fomegné ◽

Nilufer Broeders ◽

Lidia Ghisdal ◽

Anh Dung Hoang ◽

...

Keyword(s):

Risk Factors ◽

Allograft Rejection ◽

Interleukin 2 ◽

Kidney Allograft ◽

Interleukin 2 Receptor ◽

Receptor Antibodies ◽

Hla Mismatches ◽

Kidney Allograft Rejection

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DONOR KIDNEY HISTOLOGICAL CHANGES AS RISK FACTORS FOR DELAYED AND SLOW KIDNEY ALLOGRAFT (KAG) FUNCTION

Transplantation Journal ◽

10.1097/01.tp.0000331095.43889.a9 ◽

2008 ◽

Vol 86 (Supplement) ◽

pp. 580

Author(s):

A Trailin ◽

T Nikonenko ◽

A Nikonenko ◽

T I. Ostapenko ◽

N N. Polyakov

Keyword(s):

Risk Factors ◽

Donor Kidney ◽

Histological Changes ◽

Kidney Allograft

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Abstract WMP117: Patterns of All Bleeding Complications Associated with r-tPA Use-experience of an Acadamic Center in China

Stroke ◽

10.1161/str.48.suppl_1.wmp117 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Hong Chang ◽

Xiaojuan Wang ◽

Yuchen Qiao ◽

Jie Zhao ◽

Haiqing Song

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Intravenous Thrombolysis ◽

Tissue Type ◽

Bleeding Complications ◽

High Systolic Blood Pressure ◽

Gingival Bleeding ◽

Hemorrhagic Event ◽

Hemorrhagic Complications

Background and objective: Rapid administration of intravenous recombinant tissue-type plasminogen activator (rt-PA) is the standard treatment for patients with acute ischemic stroke (AIS). While hemorrhage represents as an important and unpredictable complication of thrombolytic treatment, few studies have specifically assessed the prevalence and predictors of bleeding complications among AIS patients in Asia. We assessed characteristics of hemorrhagic complications after intravenous thrombolysis in Chinese AIS patients. Methods: This single-academic-center study retrospectively evaluated 351 acute ischemic stroke patients who received rt-PA intravenously from April 2011 to April 2016. The occurrence and characteristics of any hemorrhagic complications, as well as their associated risk factors were recorded and summarized. Multivariate logistic regression was conducted to analyze significant predictors of bleeding. Results: 134 (38.1%) patients experienced one hemorrhagic event in one or more locations The top seven common sites were gingiva (49.3%), skin (18.3%), urinary system (10.4%), digestive tract (7.5%), intra-cranial cavity (7.5%), mouth (4.4%) and nasal cavity (2.2%). All the gingival bleeding occurred during 1 to 24 hours after thrombolysis and was the first sign of bleeding. Intracranial hemorrhage (both symptomatic and asymptomatic) occurred in 16 patients, of whom 4 presented first with gingival bleeding. Multivariate analysis showed that high systolic blood pressure (SBP) and National Institutes of Health Stroke Scale (NIHSS) score were independent risk factors for hemorrhage post thrombolysis (P<0.05). Conclusions: One out of three AIS patients in this study had a bleeding complication. The most common site of initial hemorrhage after intravenous thrombolysis was gingival, which frequently occurred as the initial bleeding site within 24 hours after thrombolysis. Consistent with literature, elevated SBP and higher NIHSS were the two key predictors of bleeding risk.

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Development of Encapsulating Peritoneal Sclerosis in Kidney Allograft Recipients: Risk Factors and Clinical Implications

Turkish Nephrology Dialysis Transplantation ◽

10.5262/tndt.2011.1002.04 ◽

2011 ◽

Vol 20 (02) ◽

pp. 142-145

Author(s):

Kenan Keven ◽

Ebru Uz ◽

Sule Sengul ◽

İlhan Kurultak ◽

Acar Tuzuner ◽

...

Keyword(s):

Risk Factors ◽

Clinical Implications ◽

Kidney Allograft

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POSTTRANSPLANT DIABETES MELLITUS IN KIDNEY ALLOGRAFT RECIPIENTS: INCIDENCE, RISK FACTORS, AND MANAGEMENT1

Transplantation Journal ◽

10.1097/00007890-200202150-00011 ◽

2002 ◽

Vol 73 (3) ◽

pp. 379-386 ◽

Cited By ~ 92

Author(s):

M. Roy First ◽

David A. Gerber ◽

Sundaram Hariharan ◽

Dixon B. Kaufman ◽

Ron Shapiro

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Kidney Allograft ◽

Incidence Risk

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Venous Thromboembolism in the Hematologic Malignancies

Journal of Clinical Oncology ◽

10.1200/jco.2009.22.8197 ◽

2009 ◽

Vol 27 (29) ◽

pp. 4848-4857 ◽

Cited By ~ 120

Author(s):

Anna Falanga ◽

Marina Marchetti

Keyword(s):

Risk Factors ◽

Multiple Myeloma ◽

Clinical Trials ◽

Venous Thromboembolism ◽

Best Practice ◽

Randomized Clinical Trials ◽

Neoplastic Transformation ◽

Hematologic Malignancies ◽

Central Venous ◽

Hemorrhagic Complications

Patients with hematologic malignancies are at high risk of thrombotic or hemorrhagic complications. The incidence of these events is greatly variable and is influenced by many factors, including the type of disease, the type of chemotherapy, and the use of a central venous device. As in solid tumors, a number of clinical risk factors have been identified and contribute to the increasing thrombotic rate in hematologic malignancies. Biologic properties of the tumor cells can influence the hypercoagulable state of patients with these malignancies by several mechanisms. Of interest, oncogenes responsible for neoplastic transformation in leukemia also may be involved in clotting activation. Epidemiologic data allow an estimate of the incidence of venous thromboembolism (VTE) in acute leukemia, lymphomas, and multiple myeloma (MM). In this review, we focus on the epidemiology, pathogenesis, and VTE management in these three hematologic malignancies. No recommendation for routine thromboprophylaxis in these conditions, with the exception of MM, is available. Large, prospective, randomized clinical trials are needed to establish the best practice for thromboprophylaxis and treatment of VTE in these types of cancers.

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