Epidemiology and risk factors associated with Pneumocystis jirovecii pneumonia in kidney transplant recipients after 6‐month trimethoprim‐sulfamethoxazole prophylaxis: A case‐control study

2020 ◽  
Vol 22 (2) ◽  
Author(s):  
Se Yoon Park ◽  
Joo Hee Jung ◽  
Hyunwook Kwon ◽  
Sung Shin ◽  
Young Hoon Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplant ◽  
Case Control Study ◽  
Case Control ◽  
Pneumocystis Jirovecii ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Factors Associated ◽  
Control Study

scholarly journals 1389. Risk Factors and Clinical Outcomes of Tuberculosis Among Kidney Transplant Recipients in High Endemic Country: A Case–Control Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S505-S505
Author(s):  
Saranya Thitisuriyarax ◽  
Kamonwan Jutivorakool ◽  
Suwasin Udomkarnjananun ◽  
Natavudh Townamchai ◽  
Gompol Suwanpimolkul ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplant ◽  
Allograft Rejection ◽  
Case Control Study ◽  
Latent Infection ◽  
Case Control ◽  
Transplant Recipients ◽  
Endemic Country ◽  
Kidney Transplant Recipients ◽  
Control Study

Abstract Background Tuberculosis (TB) is considered as a challenging issue in solid-organ transplant recipients because of high morbidity and mortality. Active TB after transplant can occur from reactivation of latent infection or newly acquired from community. Understanding risk factors and clinical information of TB may provide an appropriate prevention and treatment strategies in this specific patient population; however, most of data were from non-endemic countries. Methods A single-center, matched case–control study was conducted in our institute. Cases were defined as newly diagnosed proven or probable active TB in patients who underwent kidney transplant between April 1992 and October 2018. For each case, 5 controls were matched by age and sex. Risk factor associated with TB was determined using univariate and multivariate conditional logistic regression. Results Between study period, kidney transplant was performed in 787 patients. None of the recipients was screened or treated for latent tuberculosis. Twenty-seven patients (3.43%) were diagnosed with active TB including 20 proven and 7 probable cases. The overall incidence of TB in our population was 315 cases per 100,000 patients per year. Allograft rejection was significantly associated with active TB (P < 0.001). The median onset of infection was 17 months (IQR, 4–59 months) after transplantation and 3.4 months (IQR, 2.7–16.3 months) after episode of allograft rejection. Majority of patients (96.3%) were cured after complete treatment; however, those with TB remained having significant unfavorable outcomes including higher all-cause mortality and graft loss. Conclusion Incidence of TB in kidney transplant recipients is higher than normal population. Increasing risk of active TB after allograft rejection is probably due to mycobacterial reactivation following high-dose immunosuppression. Since TB is associated with poor post-transplant outcomes, screening, and treatment of latent infection may be beneficial even in endemic country. Disclosures All authors: No reported disclosures.

scholarly journals 530. COVID-19 in kidney transplant recipients: Single-center experience and case-control study

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S332-S332
Author(s):  
Anna Hardesty ◽  
Aakriti Pandita ◽  
Yiyun Shi ◽  
Kendra Vieira ◽  
Ralph Rogers ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Case Control Study ◽  
Clinical Course ◽  
Case Series ◽  
Case Fatality ◽  
Case Control ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Transplant Patients ◽  
Control Study

Abstract Background Organ transplant recipients (OTR) are considered high-risk for morbidity and mortality from COVID-19. Case-fatality rates (CFR) vary significantly in different case series, and some patients were still hospitalized at the time of analyses. To our knowledge, no case-control study of COVID-19 in OTR has been published to-date. Methods We captured kidney transplant recipients (KTR) diagnosed with COVID-19 between 3/1 and 5/18/2020. After exclusion of KTR on hemodialysis and off immunosuppression (IS), we compared the clinical course of COVID-19 between hospitalized KTR and non-transplant patients, matched by sex and age (controls). All patients were discharged from the hospital or died. Results 16 KTR had COVID-19. All 3 KTR off IS, who were excluded from further analyses, survived. Median age was 54 (range: 34–65) years; 5/13 KTR (38.4%) were men. Median time from transplant was 41 (range: 1–203) months. Two KTR, both transplanted &gt;10 years ago, were managed as outpatients. IS was reduced in 12/13 (92.3%), most often by discontinuation of the antimetabolite. IL6 levels were &gt;1,000 (normal: &lt; 5) pg/mL in 3 KTR. Tacrolimus or sirolimus levels were &gt;10 ng/mL in 6/9 KTR (67%) (Table 1). Eleven KTR were hospitalized (84.6%) and matched with 44 controls. One KTR, the only one treated with hydroxychloroquine, died (CFR 5.8%; 7.6% in KTR on IS; 9% in hospitalized KTR on IS). Four controls died (CFR: 9%; state CFR: 5.2%; inpatient CFR: 16.6%). There were no significant differences in length of stay or worst oxygenation status between hospitalized KTR and controls. Four KTR (30.7%), received remdesivir, 4 convalescent plasma, 3 (23%) tocilizumab. KTR received more often broad-spectrum antibiotics, convalescent plasma or tocilizumab, compared to controls (Table 2). Table 1 Table 2 Conclusion Unlike early reports from the pandemic epicenters, the clinical course and outcomes of KTR with COVID-19 in our small case series were comparable to those of non-transplant patients. Calcineurin or mTOR inhibitor levels were high, likely due to diarrhea and COVID-19-related hepatic dysfunction. Extremely high IL6 levels were common. The role of IS and potential benefits from investigational treatments remain to be elucidated. A larger multi-institutional study is underway. Disclosures All Authors: No reported disclosures

scholarly journals Severe Strongyloides stercoralis infection in kidney transplant recipients: A multicenter case-control study

2020 ◽  
Vol 14 (1) ◽  
pp. e0007998 ◽  
Author(s):  
Lísia Miglioli-Galvão ◽  
José Osmar Medina Pestana ◽  
Guilherme Lopes-Santoro ◽  
Renato Torres Gonçalves ◽  
Lúcio R. Requião Moura ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Case Control Study ◽  
Strongyloides Stercoralis ◽  
Case Control ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Control Study
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