INTRAOPERATIVE HYPOTHERMIA IS AN INDEPENDENT RISK FACTOR FOR CYTOMEGALOVIRUS (CMV) INFECTION IN LIVER TRANSPLANT RECIPIENTS

1998 ◽  
Vol 65 (12) ◽  
pp. S114
Author(s):  
David L Paterson ◽  
Nina Singh ◽  
Wolf Stapelfeldt ◽  
Marilyn Wagener ◽  
Timothy Gayowski ◽  
...  
Keyword(s):  
Risk Factor ◽  
Liver Transplant ◽  
Independent Risk Factor ◽  
Transplant Recipients ◽  
Cmv Infection ◽  
Intraoperative Hypothermia ◽  
Liver Transplant Recipients

INTRAOPERATIVE HYPOTHERMIA IS AN INDEPENDENT RISK FACTOR FOR CYTOMEGALOVIRUS (CMV) INFECTION IN LIVER TRANSPLANT RECIPIENTS.

1998 ◽  
Vol 65 (Supplement) ◽  
pp. 190
Author(s):  
David L Paterson ◽  
Nina Singh ◽  
Wolf Stapelfeldt ◽  
Marilyn Wagener ◽  
Timothy Gayowski ◽  
...  
Keyword(s):  
Risk Factor ◽  
Liver Transplant ◽  
Independent Risk Factor ◽  
Transplant Recipients ◽  
Cmv Infection ◽  
Intraoperative Hypothermia ◽  
Liver Transplant Recipients

INTRAOPERATIVE HYPOTHERMIA IS AN INDEPENDENT RISK FACTOR FOR EARLY CYTOMEGALOVIRUS INFECTION IN LIVER TRANSPLANT RECIPIENTS

1999 ◽  
Vol 67 (8) ◽  
pp. 1151-1155 ◽  
Author(s):  
David L. Paterson ◽  
Wolf H. Stapelfeldt ◽  
Marilyn M. Wagener ◽  
Timothy Gayowski ◽  
Ignazio R. Marino ◽  
...  
Keyword(s):  
Risk Factor ◽  
Liver Transplant ◽  
Cytomegalovirus Infection ◽  
Independent Risk Factor ◽  
Transplant Recipients ◽  
Intraoperative Hypothermia ◽  
Liver Transplant Recipients

scholarly journals Pre-transplant portal vein thrombosis is an independent risk factor for graft loss due to hepatic artery thrombosis in liver transplant recipients

HPB ◽  
2016 ◽  
Vol 18 (3) ◽  
pp. 279-286 ◽  
Author(s):  
Jonathan G. Stine ◽  
Shawn J. Pelletier ◽  
Timothy M. Schmitt ◽  
Robert J. Porte ◽  
Patrick G. Northup
Keyword(s):  
Risk Factor ◽  
Portal Vein ◽  
Liver Transplant ◽  
Hepatic Artery ◽  
Independent Risk Factor ◽  
Graft Loss ◽  
Transplant Recipients ◽  
Vein Thrombosis ◽  
Artery Thrombosis ◽  
Liver Transplant Recipients

scholarly journals Liver Transplant Recipients Incur More Costly Care When Undergoing Treatment for Breast Cancer

2021 ◽  
Author(s):  
Gregory Veillette ◽  
Maria Castaldi ◽  
Sacha A Roberts ◽  
Afshin Parsikia ◽  
Ankur Choubey ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Risk Factor ◽  
Liver Transplant ◽  
Independent Risk Factor ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Transplant Recipients ◽  
Operative Complications ◽  
Liver Transplant Recipients

Abstract Purpose The incidence of breast cancer (BC) in solid organ transplant recipients is comparable to the age-matched general population. It is among the three top-most commonly occurring cancers in women after liver transplantation (LT). There is limited information on the management and outcomes of breast cancer in liver transplant recipients (LTR). We aim to evaluate the impact of LT on breast cancer surgery outcomes. Further we compare the outcomes after breast cancer surgery in LTR in transplant versus non-transplant centers. Methods National Inpatient Sample (NIS) database was accessed to identify LTR with BC. Mortality, complications, hospital charges and total length of stay (LOS) were evaluated with multivariate logistic regression testing. Weighted multivariate regression models were employed to compare outcomes at transplant and non-transplant centers. Results Ninety-nine women met inclusion criteria for LT + BC and were compared against a cohort of women with BC without LT (n = 736,527). LT + BC had lower performance status as confirmed via higher Elixhauser Comorbidity Index (20.5% vs.10.2%, p < 0001). There were significantly more complications in the LT cohort when compared to the non-LTR (15.0% vs. 8.2%, p = 0.012). However, on multivariate analysis, LT was not an independent risk factor for post-operative complications following breast cancer surgery (OR 1.223, p = 0.480). Cost associated with breast cancer care was significantly higher in those with LT (2.621, p < 0.001). Breast conservation surgery in LT had shorter LOS as compared to BC alone (OR 0.568, p 0.027) in all hospitals. Conclusion LT does not increase short-term mortality when undergoing breast cancer surgery. Although there were significantly more complications in the LT cohort when compared to the non-LTR (15.0% vs. 8.2%, p = 0.012), on multivariate analysis, LT was not an independent risk factor for post-operative complications following breast cancer surgery. Additionally, breast cancer treatment is more costly in LTR.

scholarly journals Comparison of Three Cellular Assays to Predict the Course of CMV Infection in Liver Transplant Recipients

Vaccines ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 88
Author(s):  
Smaranda Gliga ◽  
Melanie Fiedler ◽  
Theresa Dornieden ◽  
Anne Achterfeld ◽  
Andreas Paul ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Cmv Infection ◽  
Cellular Assays ◽  
Risk Patients ◽  
Ifn Γ ◽  
Liver Transplant Recipients

To estimate protection from cytomegalovirus (CMV) replication after solid organ transplantation, CMV serology has been considered insufficient and thus CMV immunity is increasingly assessed by cellular in vitro methods. We compared two commercially available IFN-γ ELISpot assays (T-Track CMV and T-SPOT.CMV) and an IFN-γ ELISA (QuantiFERON-CMV). Currently, there is no study comparing these three assays. The assays were performed in 56 liver transplant recipients at the end of antiviral prophylaxis and one month thereafter. In CMV high- or intermediate-risk patients the two ELISpot assays showed significant correlation (p < 0.0001, r > 0.6) but the correlation of the ELISpot assays with QuantiFERON-CMV was weaker. Results of both ELISpot assays were similarly predictive of protection from CMV-DNAemia ≥500 copies/mL [CMV pp65 T-SPOT.CMV at the end of prophylaxis: area under curve (AUC) = 0.744, cut-off 142 spot forming units (SFU), sensitivity set to 100%, specificity 46%; CMV IE-1 T-Track CMV at month 1: AUC = 0.762, cut-off 3.5 SFU, sensitivity set to 100%, specificity 59%]. The QuantiFERON-CMV assay was inferior, reaching a specificity of 23% when setting the sensitivity to 100%. In conclusion, both CMV-specific ELISpot assays appear suitable to assess protection from CMV infection/reactivation in liver transplant recipients.

scholarly journals Risk factors predicting Cytomegalovirus infection in post liver transplant recipients

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M G Abdelrahman ◽  
H A Mahmoud ◽  
M K Mohsen ◽  
M O Ali ◽  
A M N Mohamed
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Liver Transplant ◽  
Organ Transplantation ◽  
Chronic Rejection ◽  
Cytomegalovirus Infection ◽  
Transplant Recipients ◽  
Cmv Infection ◽  
Donor Liver Transplantation ◽  
Liver Transplant Recipients

Abstract Background Liver transplantation is considered to be the only curative treatment for patients with end stage liver disease. Postoperative infection remains to be one of the most common causes of morbidity and mortality throughout the past years. Cytomegalovirus (CMV) infection although considered to be a weak viral infection that usually passes asymptomatic in immunocompetent patients, however, it is considered one of the most common pathogens causing morbidities and mortality in liver transplant recipients. Multiple studies have been done to assess the risk factors for developing CMV infection. Objective Identification of risk factors predicting Cytomegalovirus infection in liver transplant recipients following transplantation. Methods This retrospective study was conducted on 194 patients and their donors who underwent living donor liver transplantation operation at Ain Shams centre for organ transplantation (ASCOT) at Ain Shams specialized hospital in the period between January 2010 and December 2016 with at least one year follow up period after operation for the recipient group. Results In our study, 194 patients undergoing liver transplantation at Ain shams centre for organ transplantation over seven years from January 2010 to December 2016 have been followed to assess risk factors affecting CMV infection development. Chronic rejection was found to be the most common factor associated with CMV infection followed by Cyclosporin (Neoral) as main postoperative immunosuppressant following liver transplantation. Other factors that were found to carry risk for CMV infection included younger age, advanced MELD score, positive CMV IgM status of the donors and recipients. Conclusion Differentiation of Cytomegalovirus disease from Cytomegalovirus infection isn’t always available as it requires tissue invasive techniques. Multiple risk factors have been attributed to cause Cytomegalovirus infection (viremia) . In our study, rejection (chronic rejection) was the factor that carries highest risk for Cytomegalovirus infection development followed by Cyclosporin .

scholarly journals Prevention and Management of CMV Infections after Liver Transplantation: Current Practice in German Transplant Centers

2020 ◽  
Vol 9 (8) ◽  
pp. 2352
Author(s):  
Cornelius Engelmann ◽  
Martina Sterneck ◽  
Karl Heinz Weiss ◽  
Silke Templin ◽  
Steffen Zopf ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Antiviral Treatment ◽  
Standard Of Care ◽  
Threshold Value ◽  
Preemptive Therapy ◽  
Transplant Recipients ◽  
Cmv Infection ◽  
Mortality And Morbidity ◽  
Liver Transplant Recipients

Human cytomegalovirus (CMV) remains a major cause of mortality and morbidity in human liver transplant recipients. Anti-CMV therapeutics can be used to prevent or treat CMV in liver transplant recipients, but their toxicity needs to be balanced against the benefits. The choice of prevention strategy (prophylaxis or preemptive treatment) depends on the donor/recipient sero-status but may vary between institutions. We conducted a series of consultations and roundtable discussions with German liver transplant center representatives. Based on 20 out of 22 centers, we herein summarize the current approaches to CMV prevention and treatment in the context of liver transplantation in Germany. In 90% of centers, transient prophylaxis with ganciclovir or valganciclovir was standard of care in high-risk (donor CMV positive, recipient CMV naive) settings, while preemptive therapy (based on CMV viremia detected during (bi) weekly PCR testing for circulating CMV-DNA) was preferred in moderate- and low-risk settings. Duration of prophylaxis or intense surveillance was 3–6 months. In the case of CMV infection, immunosuppression was adapted. In most centers, antiviral treatment was initiated based on PCR results (median threshold value of 1000 copies/mL) with or without symptoms. Therefore, German transplant centers report similar approaches to the prevention and management of CMV infection in liver transplantation.

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