scholarly journals Human Adenovirus 11 in 2 Renal Transplant Recipients: Suspected Donor-Derived Infection

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Amy C Sherman ◽  
Xiaoyan Lu ◽  
Eileen Schneider ◽  
Amelia Langston ◽  
Carla L Ellis ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Clinical Course ◽  
Treatment Options ◽  
Organ Transplant ◽  
Human Adenovirus ◽  
Solid Organ ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Sequence Identity ◽  
Clinical Syndromes

Abstract Background Human adenovirus (HAdV) infections can lead to high mortality in solid organ transplant (SOT) recipients, with rare reports of donor-derived infection. Methods Two renal transplant recipients with HAdV-11 infection who received kidneys from the same donor are described. Whole-genome sequencing (WGS) was performed. Results WGS showed 100% nucleotide sequence identity for the 2 HAdV-11 isolates. The patients presented with distinct clinical syndromes, and both were treated with brincidofovir. Conclusions Donor-derived HAdV infection is presumed to be low; however, disseminated HAdV in SOT recipients can be severe, and clinicians should be aware of the clinical course and treatment options.

scholarly journals Lower Respiratory Tract Infection in a Renal Transplant Recipient: Do not Forget Metapneumovirus

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
N. Noel ◽  
B. Rammaert ◽  
J. Zuber ◽  
N. Sayre ◽  
M. F. Mamzer-Bruneel ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Organ Transplant ◽  
Detection Methods ◽  
Solid Organ ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Solid Organ Transplant Recipients

Human metapneumovirus (hMPV) is emerging as a cause of a severe respiratory tract infection in immunocompromised patients. hMPVpneumonia has only been seldom reported in nonpulmonary solid organ transplanted patients, such as renal transplant recipients. We report here a case of a 39-year-old patient presenting with fever, cough, and interstitial opacities on CT scan diagnosed as a nonsevere hMPVpneumonia 11 years after a renal transplantation. Infection resolved spontaneously. Differential diagnosis withPneumocystispneumonia was discussed. We review the medical literature and discuss clinical presentation and detection methods that can be proposed in solid organ transplant recipients.

scholarly journals Different clinical presentations of two renal transplant recipients with Coronavirus Disease 2019: a case report

2020 ◽  
Author(s):  
Jing Li ◽  
Gang Chen ◽  
chao chen
Keyword(s):  
Renal Transplant ◽  
Antiviral Treatment ◽  
Organ Transplant ◽  
Severe Pneumonia ◽  
Disease Spread ◽  
Solid Organ ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Clinical Presentations ◽  
The Impact

Abstract Background: The Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome Coronavirus-2 has spread rapidly worldwide and disease spread is currently increasing. The clinical picture of transplant recipients and the effect of the anti-rejection immunosuppressive regimens on the clinical course of COVID-19 are lacking.Case presentation: We report two cases of COVID-19infection in renal transplant recipients with variable clinical presentations. The first patient presented with mild respiratory symptoms and a stableclinical course. The second patient had more severe clinical characteristics and presented with severe pneumonia and multi-organ failure. Both patients received a combination therapy including antiviral treatment and reducedimmunosuppressiontherapy and finally recovered.Conclusions: We report COVID-19 infectionin two renal transplant recipients with a favorable outcome but different clinical courses, which may provide a reference valuefor treating such patients. Additional data are needed to gain a better understanding of the impact of immunosuppressive therapy on the clinical presentation, severity, and outcome of COVID-19in solid organ transplant recipients.

scholarly journals Deceptively asymptomatic cryptococcaemia in a renal transplant recipient: the lull before a storm

2019 ◽  
Vol 12 (4) ◽  
pp. e228115 ◽  
Author(s):  
Vivek Sood ◽  
Navin Pattanashetti ◽  
Raja Ramachandran ◽  
Krishan Lal Gupta
Keyword(s):  
Renal Transplant ◽  
Ischaemic Stroke ◽  
Opportunistic Infections ◽  
Organ Transplant ◽  
Induction Phase ◽  
Solid Organ ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Intracranial Vessel ◽  
Solid Organ Transplant Recipients

Cryptococcal infection constitutes around 3% of opportunistic infections in solid organ transplant recipients. Most common organ affected in renal transplant recipients (RTRs) is central nervous system and usually presents with chronic meningoencephalitis (CME). Ischaemic stroke as a consequence of cryptococcal meningoencephalitisis rare and possibly due to the involvement of intracranial vessel by exudates causing vasculitis-related thrombosis. In this context, we describe an unusual case of asymptomatic cryptococcaemia in an RTR, progressing on to acute ischaemic stroke secondary to acute CME with near complete neurological recovery following timely diagnosis, early and appropriate antifungal treatment. The index case attempts to re-emphasise the significance of mandatory screening required to exclude the possibility of dissemination of cryptococcaemia in RTRs besides highlighting the requirement of prolonged induction phase with combination therapy, particularly in presence of stroke.

scholarly journals Gastric Mucormycosis in a Renal Transplant Patient Treated with Isavuconazole Monotherapy

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Imran Gani ◽  
Atbin Doroodchi ◽  
Kristina Falkenstrom ◽  
Holly Berry ◽  
Won Lee ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Amphotericin B ◽  
Organ Transplant ◽  
Solid Organ ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Mortality And Morbidity ◽  
Presenting Symptoms ◽  
Solid Organ Transplant Recipients ◽  
Upper Gastrointestinal

Gastrointestinal mucormycosis is a rare infection in solid organ transplant recipients. Our patient, a 79-year-old male, presented with severe dysphagia and odynophagia about 2 weeks after receiving a renal transplant. An upper gastrointestinal (UGI) endoscopy revealed esophagitis and gastric ulceration, the cultures from which grew Rhizopus species. A usual treatment strategy should include Amphotericin B as monotherapy or in combination with Posaconazole or Isavuconazole for such infections. Our patient was treated with Isavuconazole monotherapy, in an effort to minimize renal toxicity from Amphotericin B to the new allograft. Unique to our case was a successful clinical response and resolution of UGI lesions with Isavuconazole monotherapy. Due to the vagueness of presenting symptoms, such infections can be easily missed in an immunocompromised patient which can have tragic outcomes. Prompt diagnosis and modulation of immunosuppression are essential to decrease mortality and morbidity. Isavuconazole is a novel agent and can be used as a monotherapy for such infections, especially in renal transplant recipients.

scholarly journals Impaired Humoral Response in Renal Transplant Recipients to SARS-CoV-2 Vaccination with BNT162b2 (Pfizer-BioNTech)

Viruses ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 756
Author(s):  
Johannes Korth ◽  
Michael Jahn ◽  
Oliver Dorsch ◽  
Olympia Evdoxia Anastasiou ◽  
Burkhard Sorge-Hädicke ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Messenger Rna ◽  
Organ Transplant ◽  
Humoral Response ◽  
Solid Organ ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Transplant Patients ◽  
Vulnerable Patients ◽  
Individual Vaccination

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has a major impact on transplant recipients, with mortality rates up to 20%. Therefore, the effect of established messenger RNA (mRNA)-based SARS-CoV-2 vaccines have to be evaluated for solid organ transplant patients (SOT) since they are known to have poor responses after vaccination. We investigated the SARS-CoV-2 immune response via SARS-CoV-2 IgG detection in 23 renal transplant recipients after two doses of the mRNA-based SARS-CoV-2 vaccine BNT162b2 following the standard protocol. The antibody response was evaluated once with an anti-SARS-CoV-2 IgG CLIA 15.8 +/− 3.0 days after the second dose. As a control, SARS-CoV-2 IgG was determined in 23 healthcare workers (HCW) and compared to the patient cohort. Only 5 of 23 (22%) renal transplant recipients were tested positive for SARS-CoV-2 IgG antibodies after the second dose of vaccine. In contrast, all 23 (100%) HCWs were tested positive for antibodies after the second dose. Thus, the humoral response of renal transplant recipients after two doses of the mRNA-based vaccine BNT162b2 (Pfizer-BioNTech, Kronach, Germany) is impaired and significantly lower compared to healthy controls (22% vs. 100%; p = 0.0001). Individual vaccination strategies might be beneficial in these vulnerable patients.

Detection of Toxoplasma Gondii Antibodies and DNA Among Renal Transplant Recipient and blood donor in Khartoum State, Sudan

2021 ◽  
pp. 135-141
Author(s):  
Elghazali Mohammed ◽  
Mustafa Yassin ◽  
Khalid Anan ◽  
Dina N Abdelrahman ◽  
Abdelrahim M. ElHussein ◽  
...  
Keyword(s):  
Toxoplasma Gondii ◽  
Renal Transplant ◽  
Transplant Recipient ◽  
Renal Transplant Recipient ◽  
Blood Donor ◽  
Blood Donors ◽  
Solid Organ ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Toxoplasma Gondii Infection

Background and Aim: Toxoplasma gondii infection arises in transplant recipient groups, but at varying frequencies. Reactivation of latent T. gondii infection in transplant patients is uncommon, but does occur. The incidence of reactivation is greater in patient groups receiving more aggressive immunosuppressive therapy. Early diagnosis and treatment should be considered in T. gondii-antibody-positive patients subjected to solid organ transplantation. The aim of this study was to estimate the seroprevalence of Toxoplasma gondii infection in renal transplant recipients in Khartoum, Sudan, using serological and molecular methods. Methods: This was a descriptive cross sectional, hospital based study, blood sample were collected from 108 participants; out of them 58 renal transplant recipient individuals and 50 healthy Blood donor attending Sudanese Kidney Association Hospital and Sudan Heart Center Blood Bank. Demographic data were collected by structured questionnaire. All samples were tested for anti-Toxoplasma IgG and IgM antibodies using ELISA, and PCR for detection of Toxoplasma DNA was performed. Results: The seropositivity of IgG anti-T. gondii antibodies was higher in renal transplant recipients than in blood donors (36.2% vs 32.0%). Anti-toxoplasma IgM was positive in one renal transplant recipient individual (1.70%), and no samples exhibit reactive IgM antibody for blood donors. None of the samples exhibited positivity to T.gondii DNA. Conclusion: the study showed a relatively high seroprevalence of T.gondii antibodies in renal transplant recipients and blood donor volunteers, on the other hand, the prevalence was much higher in the study conducted in pregnant woman in Sudan. Our study highlighted that asymptomatic blood donors, may constitute a significant risk of transmitting toxoplasmosis to susceptible recipients.

P0863TYPE OF PROTON PUMP INHIBITOR AND RISK OF IRON DEFICIENCY IN RENAL TRANSPLANT RECIPIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Rianne M. Douwes ◽  
Joanna Sophia Jacoline Vinke ◽  
António W Gomes-Neto ◽  
Hans Blokzijl ◽  
Stefan P Berger ◽  
...  
Keyword(s):  
Cohort Study ◽  
Renal Transplant ◽  
Iron Deficiency ◽  
Proton Pump ◽  
Ferritin Level ◽  
Solid Organ ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Increased Risk ◽  
Different Types

Abstract Background and Aims Use of proton-pump inhibitors (PPIs) is common practice in renal transplant recipients (RTRs). Emerging data suggest several adverse effects of use of PPIs, including development of iron deficiency (ID). Although the latter has been shown with respect to PPIs, specific analyses for different types of PPIs and the associated risk of ID have not been performed. Method We used data from the TransplantLines Biobank and Cohort study, an ongoing prospective cohort study among all types of solid organ transplant recipients. For the current study, we used data from stable RTRs with a functional graft for more than 1 year post transplantation (n=795). We excluded RTRs who used any form of iron supplementation (n=54) and EPO-stimulating agents (n=24), resulting in 728 RTRs eligible for analyses. Use of PPIs was subdivided in different types of PPIs, i.e. omeprazole, esomeprazole, pantoprazole, and rabeprazole. ID was defined as TSAT<20% and ferritin <300 µg/L. Logistic regression analysis was used to assess the associations between PPIs and ID. Results We included 728 RTRs (age 56±13 years, 61% males), with a mean eGFR of 53±18 ml/min/1.73m2, a median [interquartile range] ferritin level of 96 (44 – 191) µg/L and mean TSAT of 24±10%. PPIs were used by 504 (69%) of the included RTRs, of which 398 (79%), 55 (11%), 49 (10%), and 2 (0.4%) respectively used omeprazole, pantoprazole, esomeprazole, and rabeprazole. Use of PPIs was strongly associated with ID (OR, 2.20; 95%CI 1.48 – 3.28; P<0.001), independent of adjustment for age, sex, BMI, eGFR, hs-CRP, smoking, alcohol use, use of calcineurine inhibitors, prednisolone, antiplatelet drugs, and antihypertensives. When subdividing the PPIs into the different types, both omeprazole (OR, 1.98; 95%CI 1.39 – 2.83; P<0.001) and esomeprazole (OR, 2.11; 95%CI 1.09 – 4.07; P=0.03) were independently associated with iron deficiency, whereas pantoprazole was not associated (OR, 0.89; 95%CI 0.47 – 1.70; P=0.73). Conclusion Omeprazole and esomeprazole, but not pantoprazole, are associated with an increased risk of ID. Our results are in line with previous reports that pantoprazole has the lowest potency with least increase in intragastric pH, thereby possibly interfering less with reduction of ferric to ferrous iron, and subsequently iron absorption. Future studies are warranted to confirm our present findings.

scholarly journals Gastrointestinal Mucormycosis in a Renal Transplant Patient

2001 ◽  
Vol 15 (4) ◽  
pp. 269-271 ◽  
Author(s):  
Jill Tinmouth ◽  
Jeffrey Baker ◽  
Geoffrey Gardiner
Keyword(s):  
Renal Transplant ◽  
Renal Transplant Patient ◽  
Transplant Patient ◽  
Clinical Course ◽  
Organ Transplant ◽  
Pathological Examination ◽  
Solid Organ ◽  
Resected Tissue ◽  
Solid Organ Transplant Patient ◽  
Organ Transplant Patient

The clinical course and management of a rare case of gastrointestinal mucormycosis occurring in a renal transplant patient are presented. The diagnosis was made on pathological examination of surgically resected tissue from the colon, spleen and stomach. The patient did not survive the infection. To the best of our knowledge, this is the 11th reported case of gastrointestinal mucormycosis in a solid organ transplant patient. The pathophysiology, incidence and prognosis of this disease are discussed.

scholarly journals Use of Letermovir as Salvage Therapy for Drug-Resistant Cytomegalovirus Retinitis

2019 ◽  
Vol 63 (3) ◽  
Author(s):  
Nicholas Turner ◽  
Andrew Strand ◽  
Dilraj S. Grewal ◽  
Gary Cox ◽  
Sana Arif ◽  
...  
Keyword(s):  
Hematopoietic Cell Transplantation ◽  
Adverse Drug Events ◽  
Treatment Options ◽  
Organ Transplant ◽  
Virologic Suppression ◽  
Solid Organ ◽  
Drug Resistant ◽  
Transplant Recipients ◽  
Solid Organ Transplant Recipients ◽  
Cmv Prophylaxis

ABSTRACT Treatment options for drug-resistant cytomegalovirus (CMV) are limited. Letermovir is a novel antiviral recently approved for CMV prophylaxis following hematopoietic cell transplantation, but its efficacy in other settings is unknown. We recently used letermovir for salvage treatment in four solid organ transplant recipients with ganciclovir-resistant CMV retinitis. All patients improved clinically without known adverse drug events. However, three patients failed to maintain virologic suppression, including two patients who developed genotypically confirmed resistance to letermovir while on therapy.

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