scholarly journals 1383. Everolimus is Associated with an Increased Risk of Tuberculosis in Solid-Organ Transplant Recipients

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S502-S502
Author(s):  
Hsin-Yun Sun ◽  
Aristine Cheng ◽  
So-Meng Wang ◽  
Meng-Kun Tsai ◽  
Yih-Sharng Chen ◽  
...  
Keyword(s):  
Conditional Logistic Regression ◽  
Multivariable Analysis ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
University Hospital ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Increased Risk ◽  
Matched Case ◽  
Control Study

Abstract Background Tuberculosis (TB) is an important post-transplant infection. Everolimus has been documented to reduce the risk of cytomegalovirus infection in transplant recipients, but its impact on other infections is less known. The present study aimed to assess immunosuppressive regimens on TB risk in solid-organ transplant (SOT) recipients via a matched case–control study. Methods From May 2005 to December 2018, SOT recipients with TB were retrospectively identified, and those without TB undergoing transplantation at the same university hospital were selected as controls. Controls and cases were matched by age (±5 years), transplant type and year (±5 years) at a ratio of 4:1. Conditional logistic regression was used to analyze the risk factors of TB. Results TB developed in 30 SOT recipients (13 kidney, 7 heart, 6 liver, and 4 lung) after a mean duration of 1,601 days after transplantation, with predominant lung involvement (87%). The diagnosis was made by culture in 70% and pathology in 17%. Rifamycins-based regimens were used in 27 cases, and 4 developed rejection without graft failure. A total of 106 controls were selected. At the time of TB diagnosis, cases were more likely to use everolimus than controls (27% vs. 11%, P < 0.05), but no significant differences were observed in the use of tacrolimus, cyclosporin, sirolimus, prednisolone, or mycophenolate mofetil. The median duration of everolimus use was 585 and 698 days in 8 cases and 12 controls, respectively. Multivariable analysis showed that everolimus use (adjust odds ratio [aOR] 22.3, 95% conference interval [CI] 2.5–203.0) and hemodialysis (aOR 19.6, 95% CI 1.3–287.1) were independently associated with TB. Conclusion TB is more likely to develop in SOT recipients on everolimus and hemodialysis. Further studies to confirm our findings are warranted, and TB risk assessment should be performed for those receiving everolimus and hemodialysis. Disclosures All authors: No reported disclosures.

scholarly journals Risk Factors, Clinical Features, and Outcomes of Listeriosis in Solid‐Organ Transplant Recipients: A Matched Case‐Control Study

2009 ◽  
Vol 49 (8) ◽  
pp. 1153-1159 ◽  
Author(s):  
Núria Fernàndez‐Sabé ◽  
Carlos Cervera ◽  
Francisco López‐Medrano ◽  
Miguel Llano ◽  
Elena Sáez ◽  
...  
Keyword(s):  
Case Control Study ◽  
Organ Transplant ◽  
Case Control ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Matched Case ◽  
Solid Organ Transplant Recipients ◽  
Matched Case Control Study ◽  
Control Study

scholarly journals Viral Enteritis in Solid-Organ Transplantation

Viruses ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2019
Author(s):  
Anum Abbas ◽  
Andrea J. Zimmer ◽  
Diana Florescu
Keyword(s):  
Solid Organ Transplantation ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Post Transplantation ◽  
Organ Transplant Recipients ◽  
Increased Risk ◽  
Viral Enteritis ◽  
Solid Organ Transplant Recipients

Solid organ transplant recipients are at increased risk for infections due to chronic immunosuppression. Diarrhea is a commonly encountered problem post transplantation, with infectious causes of diarrhea being a frequent complication. Viral infections/enteritides in solid organ transplant recipients often result from frequently encountered pathogens in this population such as cytomegalovirus, adenovirus, and norovirus. However, several emerging viral pathogens are increasingly being recognized as more sensitive diagnostic techniques become available. Treatment is often limited to supportive care and reduction in immunosuppression, though antiviral therapies mayplay a role in the treatment in certain diseases. Viral enteritis is an important entity that contributes to morbidity and mortality in transplant recipients.

scholarly journals NocardiaInfection in Solid Organ Transplant Recipients: A Multicenter European Case-control Study

2016 ◽  
Vol 63 (3) ◽  
pp. 338-345 ◽  
Author(s):  
Julien Coussement ◽  
David Lebeaux ◽  
Christian van Delden ◽  
Hélène Guillot ◽  
Romain Freund ◽  
...  
Keyword(s):  
Case Control Study ◽  
Organ Transplant ◽  
Case Control ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Organ Transplant Recipients ◽  
Solid Organ Transplant Recipients ◽  
Control Study

scholarly journals The Role of Systems Vaccinology in Understanding the Immune Defects to Vaccination in Solid Organ Transplant Recipients

2020 ◽  
Vol 11 ◽  
Author(s):  
Nicholas Scanlon ◽  
Youssef Saklawi ◽  
Nadine Rouphael
Keyword(s):  
Systems Biology ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Organ Transplant Recipients ◽  
Organ Rejection ◽  
Increased Risk ◽  
Solid Organ Transplant Recipients ◽  
Immune Defects

Solid organ transplant recipients (SOTRs) are at increased risk for many infections, whether viral, bacterial, or fungal, due to immunosuppressive therapy to prevent organ rejection. The same immune defects that render transplanted patients susceptible to infection dampen their immune response to vaccination. Therefore, it is vital to identify immune defects to vaccination in transplant recipients and methods to obviate them. These methods can include alternative vaccine composition, dosage, adjuvants, route of administration, timing, and re-vaccination strategies. Systems biology is a relatively new field of study, which utilizes high throughput means to better understand biological systems and predict outcomes. Systems biology approaches have been used to help obtain a global picture of immune responses to infections and vaccination (i.e. systems vaccinology), but little work has been done to use systems biology to improve vaccine efficacy in immunocompromised patients, particularly SOTRs, thus far. Systems vaccinology approaches may hold key insights to vaccination in this vulnerable population.

scholarly journals Increased Risk for Lymphoid and Myeloid Neoplasms in Elderly Solid-Organ Transplant Recipients

2010 ◽  
Vol 19 (5) ◽  
pp. 1229-1237 ◽  
Author(s):  
Scott C. Quinlan ◽  
Lindsay M. Morton ◽  
Ruth M. Pfeiffer ◽  
Lesley A. Anderson ◽  
Ola Landgren ◽  
...  
Keyword(s):  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Organ Transplant Recipients ◽  
Myeloid Neoplasms ◽  
Increased Risk ◽  
Solid Organ Transplant Recipients

scholarly journals A Multicenter Consortium to Define the Epidemiology and Outcomes of Pediatric Solid Organ Transplant Recipients With Inpatient Respiratory Virus Infection

2018 ◽  
Vol 8 (3) ◽  
pp. 197-204 ◽  
Author(s):  
Lara Danziger-Isakov ◽  
William J Steinbach ◽  
Grant Paulsen ◽  
Flor M Munoz ◽  
Leigh R Sweet ◽  
...  
Keyword(s):  
Virus Infection ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Respiratory Virus ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Increased Risk ◽  
Respiratory Virus Infection

Abstract Background Respiratory virus infection (RVI) in pediatric solid organ transplant (SOT) recipients poses a significant risk; however, the epidemiology and effects of an RVI after pediatric SOT in the era of current molecular diagnostic assays are unclear. Methods A retrospective observational cohort of pediatric SOT recipients (January 2010 to June 2013) was assembled from 9 US pediatric transplant centers. Charts were reviewed for RVI events associated with hospitalization within 1 year after the transplant. An RVI diagnosis required respiratory symptoms and detection of a virus (ie, human rhinovirus/enterovirus, human metapneumovirus, influenza virus, parainfluenza virus, coronavirus, and/or respiratory syncytial virus). The incidence of RVI was calculated, and the association of baseline SOT factors with subsequent pulmonary complications and death was assessed. Results Of 1096 pediatric SOT recipients (448 liver, 289 kidney, 251 heart, 66 lung, 42 intestine/multivisceral), 159 (14.5%) developed RVI associated with hospitalization within 12 months after their transplant. RVI occurred at the highest rates in intestine/abdominal multivisceral (38%), thoracic (heart/lung) (18.6%), and liver (15.6%) transplant recipients and a lower rate in kidney (5.5%) transplant recipients. RVI was associated with younger median age at transplant (1.72 vs 7.89 years; P < .001) and among liver or kidney transplant recipients with the receipt of a deceased-donor graft compared to a living donor (P = .01). The all-cause and attributable case-fatality rates within 3 months of RVI onset were 4% and 0%, respectively. Multivariable logistic regression models revealed that age was independently associated with increased risk for a pulmonary complication (odds ratio, 1.24 [95% confidence interval, 1.02–1.51]) and that receipt of an intestine/multivisceral transplant was associated with increased risk of all-cause death (odds ratio, 24.54 [95% confidence interval, 1.69–327.96]). Conclusions In this study, hospital-associated RVI was common in the first year after pediatric SOT and associated with younger age at transplant. All-cause death after RVI was rare, and no definitive attributable death occurred.

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