Bariatric surgery in solid organ transplant patients: Long-term follow-up results of outcome, safety, and effect on immunosuppression

Introduction: Depression and anxiety are common affective experiences during the first year following a solid organ transplant. This study examined the degree to which an evidenced-based clinical intervention implemented by social workers—Symptom Targeted Intervention—can alter self-reported depression and anxiety in heart, kidney, liver, and lung transplant recipients. Research Questions: This investigation explored 2 questions: (1) Can symptom-targeted interventions significantly reduce posttransplant recipients’ self-reported depression and anxiety at the conclusion of treatment and at 1-month follow-up? and (2) Does the response differ by gender? Design: A 1-group pretest–posttest design with a 1-month follow-up was used to test for changes in anxiety and depression after transplantation. Forty-eight patients at 2 US transplant centers were enrolled between January 2016 and May 2017. Data were collected using an online platform and analyzed to assess for differences over time and by gender. Results: Anxiety decreased significantly between pretest and posttest using the General Anxiety Disorder-2 ( P < .05). Comparisons by gender indicated that women had a significant decrease in anxiety between pretest and posttest ( P < .001); however, there was no significant decrease in anxiety for men. Analyses by gender and time yielded no significant differences for depression. Discussion: Symptom-targeted interventions have the potential to reduce anxiety in solid organ transplant patients and enhance their psychosocial adjustment after surgery.

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Long-Term Persistence of Immunoglobulin A (IgA) and IgM Antibodies against Human Cytomegalovirus in Solid-Organ Transplant Recipients

Clinical and Diagnostic Laboratory Immunology ◽

10.1128/cdli.6.4.621-623.1999 ◽

1999 ◽

Vol 6 (4) ◽

pp. 621-623 ◽

Cited By ~ 4

Author(s):

Bodo R. Eing ◽

Horst G. Baumeister ◽

Joachim E. Kuehn ◽

Guenter May

Keyword(s):

Human Cytomegalovirus ◽

Immunoglobulin A ◽

Organ Transplant ◽

Solid Organ Transplant ◽

Solid Organ ◽

Transplant Recipients ◽

Organ Transplant Recipients ◽

Solid Organ Transplant Recipients

ABSTRACT The retrospective analysis of 494 solid-organ transplant recipients revealed that during the follow-up period (mean duration, 3.2 years) 184 (88%) of 209 anti-human cytomegalovirus (HCMV) immunoglobulin A (IgA)-positive patients remained IgA positive, as did 128 (74.85%) of 171 anti-HCMV IgM-positive patients. We conclude that anti-HCMV IgA and IgM testing for management of clinically relevant HCMV infections in solid-organ transplant recipients is dispensable.

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Long-term outcomes of acute diverticulitis in solid organ transplant patients

10.26226/morressier.596648e4d462b80290b520c3 ◽

2017 ◽

Author(s):

Petro Youssef

Keyword(s):

Acute Diverticulitis ◽

Organ Transplant ◽

Solid Organ Transplant ◽

Solid Organ ◽

Long Term Outcomes ◽

Transplant Patients

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2646. Incidence of Myelosuppression Related to Valganciclovir Prophylaxis in Solid-Organ Transplant Recipients at High Risk of CMV Disease

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.2324 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S925-S926

Author(s):

Sara Belga ◽

Cristina Hernandez ◽

Dima Kabbani ◽

Carlos Cervera

Keyword(s):

Complete Blood Count ◽

Organ Transplant ◽

Solid Organ Transplant ◽

First Year ◽

Solid Organ ◽

Transplant Patients ◽

Increased Risk ◽

Cmv Disease ◽

The Impact

Abstract Background Valganciclovir (VGCV) prophylaxis in solid-organ transplant patients (SOT) is limited by myelotoxicity. We aimed to analyze the impact of VGCV prophylaxis on myelotoxicity and risk factors for its occurrence. Methods Retrospective single-center cohort study of adult CMV-seronegative recipients transplanted between July 2005 and November 2017. CMV D+/R− recipients received 3 to 6 months of VGCV prophylaxis whereas CMV D-/R- received no VGCV. Definitions: leukopenia < 3.5 × 109/L, significant neutropenia < 1.0 × 109/L and significant thrombocytopenia < 50 × 109/L. Results A total of 363 SOT recipients were included, 169 (47%) CMV D+/R− and 194 (53%) CMV D−/R−, with a mean age of 49.5 years and 275 (76%) males; types of organ transplant: 133 (37%) liver, 181 (50%) kidney, 37 (10%) simultaneous kidney-pancreas and 12 (3%) other. Although there was no difference in the incidence of significant neutropenia or thrombocytopenia per transplant type, leukopenia in the first year was more common in liver transplant patients (P < 0.001). New onset leukopenia post-SOT, significant neutropenia (Figure 1) and significant thrombocytopenia in the first year were more common in patients receiving VGCV: 116 D+/R− (69%) vs. 52 D−/R− (31%), P < 0.001; 86 (91%) vs. 9 (9%), P < 0.001; 8 (80%) vs. 2 (20%), P = 0.050; respectively. G-CSF was used more frequently in patients receiving prophylaxis (60% CMV D+/R− vs. 10% CMV D−/R−, P < 0.001). Significant neutropenia had no impact on long-term mortality adjusted by age and transplant type (HR 1.1, 95% CI 0.6–2.1, P = 0.709). Significant neutropenia led to decrease immunosuppression in 90% of patients (vs. 46%, P < 0.001) and was associated with increased risk of rejection (HR 8.5, P < 0.001). In multivariate analysis for significant neutropenia in the first year, VGCV prophylaxis was the only predictor of this outcome after adjusting for confounders (HR 15.1, 95% CI 7.5–30.1, P < 0.001). Conclusion VGCV prophylaxis increased the risk of significant neutropenia by 15-fold post-SOT. No other clinical variables were useful to predict this complication. Therefore, complete blood count monitoring is still needed for all SOT recipients receiving VGCV prophylaxis. Disclosures All authors: No reported disclosures.

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