scholarly journals Malignant and Noninvasive Skin Tumours in Renal Transplant Recipients

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Christopher D. Roche ◽  
Joelle S. Dobson ◽  
Sion K. Williams ◽  
Mara Quante ◽  
Joyce Popoola ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Skin Tumours ◽  
Skin Malignancy ◽  
Increased Risk ◽  
Malignant Skin ◽  
Risk Of Malignancy

Background.Transplant recipients require immunosuppression to prevent graft rejection. This conveys an increased risk of malignancy, particularly skin tumours. There is a need for up-to-date data for the South of England.Method.Pathology records were reviewed for 709 kidney transplant recipients on immunosuppression at our hospital from 1995 to 2008. Skin tumours were recorded/analysed.Results.Mean age at transplant was 46 years. Mean length of follow-up was 7.2 years and total follow-up was 4926 person-years. 53 (7.5%) patients (39/458 (8.5%) males and 14/251 (5.6%) females) developed ≥1 skin malignancy. Cumulative incidences of 4.0%, 7.5%, and 12.2% were observed for those with <5, <10, and ≥10 years follow-up, respectively. The rate was 45 tumours per 1000 person-years at risk. Additionally, 21 patients (3.0%) only had noninvasive tumours. 221 malignant skin tumours were found: 50.2% were SCCs, 47.1% BCCs, and 2.7% malignant melanomas. Mean years to first tumour were 5.8. Mean number of tumours per patient was 4, with mean interval of 12 months.Conclusions.Despite changes in transplantation practice during the time since the last data were published in this region, these findings are similar to previous studies. This adds to the evidence allowing clinicians to inform patients in this region of their risk.

scholarly journals Urinary Carnosinase-1 Excretion is Associated with Urinary Carnosine Depletion and Risk of Graft Failure in Kidney Transplant Recipients: Results of the TransplantLines Cohort Study

Antioxidants ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 1102
Author(s):  
Angelica Rodriguez-Niño ◽  
Diego O. Pastene ◽  
Adrian Post ◽  
M. Yusof Said ◽  
Antonio W. Gomes-Neto ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Graft Failure ◽  
Cox Regression ◽  
Carbonyl Stress ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Increased Risk ◽  
High Concentrations ◽  
Kidney Function Decline

Carnosine affords protection against oxidative and carbonyl stress, yet high concentrations of the carnosinase-1 enzyme may limit this. We recently reported that high urinary carnosinase-1 is associated with kidney function decline and albuminuria in patients with chronic kidney disease. We prospectively investigated whether urinary carnosinase-1 is associated with a high risk for development of late graft failure in kidney transplant recipients (KTRs). Carnosine and carnosinase-1 were measured in 24 h urine in a longitudinal cohort of 703 stable KTRs and 257 healthy controls. Cox regression was used to analyze the prospective data. Urinary carnosine excretions were significantly decreased in KTRs (26.5 [IQR 21.4–33.3] µmol/24 h versus 34.8 [IQR 25.6–46.8] µmol/24 h; p < 0.001). In KTRs, high urinary carnosinase-1 concentrations were associated with increased risk of undetectable urinary carnosine (OR 1.24, 95%CI [1.06–1.45]; p = 0.007). During median follow-up for 5.3 [4.5–6.0] years, 84 (12%) KTRs developed graft failure. In Cox regression analyses, high urinary carnosinase-1 excretions were associated with increased risk of graft failure (HR 1.73, 95%CI [1.44–2.08]; p < 0.001) independent of potential confounders. Since urinary carnosine is depleted and urinary carnosinase-1 imparts a higher risk for graft failure in KTRs, future studies determining the potential of carnosine supplementation in these patients are warranted.

scholarly journals Effects of Rituximab on the Development of Viral and Fungal Infections in Renal Transplant Recipients

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Samir J. Patel ◽  
Jennifer M. Devos ◽  
Richard J. Knight ◽  
Kyle L. Dawson ◽  
Wadi N. Suki ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Odds Ratio ◽  
Viral Infections ◽  
Fungal Infections ◽  
Graft Function ◽  
Deceased Donor ◽  
Infectious Complications ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

Background. Rituximab is becoming increasingly utilized in renal transplant recipients; however, its association with infections remains unclear. Methods. We reviewed the incidence of viral and fungal infections in kidney transplant recipients treated with () or without () rituximab (RTX) in addition to standard immunosuppression. Results. Infections occurred in 134 (30%) patients, with a greater proportion in RTX versus no RTX patients (47% versus 28%; ). Viral infections occurred in 44% and 27% of RTX and no RTX patients, respectively (). This was largely driven by the frequency of BK viremia and noncytomegalovirus/non-BK viruses in RTX patients (27% versus 13% () and 15% versus 2% (), resp.). Fungal infections also occurred more often in RTX patients (11% versus 3 %; ). Multivariate analysis revealed deceased donor recipient (odds ratio = 2.5; ) and rituximab exposure (odds ratio = 2.2; ) as independent risk factors for infection. Older patients, deceased donor recipients, those on dialysis longer, and those with delayed graft function tended to be at a greater risk for infections following rituximab. Conclusions. Rituximab is associated with an increased incidence of viral and fungal infections in kidney transplantation. Additional preventative measures and/or monitoring infectious complications may be warranted in those receiving rituximab.

Venous Thromboembolism and the Risk of Death and Graft Loss in Kidney Transplant Recipients

2017 ◽  
Vol 46 (4) ◽  
pp. 343-354 ◽  
Author(s):  
Ngan N. Lam ◽  
Amit X. Garg ◽  
Greg A. Knoll ◽  
S. Joseph Kim ◽  
Krista L. Lentine ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Venous Thromboembolism ◽  
General Population ◽  
Kidney Transplant ◽  
Graft Loss ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Risk Of Death ◽  
Increased Risk

Background: The implications of venous thromboembolism (VTE) for morbidity and mortality in kidney transplant recipients are not well described. Methods: We conducted a retrospective study using linked healthcare databases in Ontario, Canada to determine the risk and complications of VTE in kidney transplant recipients from 2003 to 2013. We compared the incidence rate of VTE in recipients (n = 4,343) and a matched (1:4) sample of the general population (n = 17,372). For recipients with evidence of a VTE posttransplant, we compared adverse clinical outcomes (death, graft loss) to matched (1:2) recipients without evidence of a VTE posttransplant. Results: During a median follow-up of 5.2 years, 388 (8.9%) recipients developed a VTE compared to 254 (1.5%) in the matched general population (16.3 vs. 2.4 events per 1,000 person-years; hazard ratio [HR] 7.1, 95% CI 6.0-8.4; p < 0.0001). Recipients who experienced a posttransplant VTE had a higher risk of death (28.5 vs. 11.2%; HR 4.1, 95% CI 2.9-5.8; p < 0.0001) and death-censored graft loss (13.1 vs. 7.5%; HR 2.3, 95% CI 1.4-3.6; p = 0.0006) compared to matched recipients who did not experience a posttransplant VTE. Conclusions: Kidney transplant recipients have a sevenfold higher risk of VTE compared to the general population with VTE conferring an increased risk of death and graft loss.

scholarly journals Exponentially increased risk of infectious death in older renal transplant recipients

2001 ◽  
Vol 59 (4) ◽  
pp. 1539-1543 ◽  
Author(s):  
Herwig-Ulf Meier-Kriesche ◽  
Akinlolu O. Ojo ◽  
Julie A. Hanson ◽  
Bruce Kaplan
Keyword(s):  
Renal Transplant ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Increased Risk

scholarly journals Early Description of Coronavirus 2019 Disease in Kidney Transplant Recipients in New York

2020 ◽  
Vol 31 (6) ◽  
pp. 1150-1156 ◽  
Author(s):  
Keyword(s):  
New York ◽  
Kidney Transplant ◽  
Severe Disease ◽  
Treatment Protocol ◽  
Current Treatment ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Radiographic Findings ◽  
Increased Risk

BackgroundThe novel SARS-CoV-2 virus has caused a global pandemic of coronavirus disease 2019 (COVID-19). Although immunosuppressed individuals are thought to be at an increased risk of severe disease, little is known about their clinical presentation, disease course, or outcomes.MethodsWe report 15 kidney transplant recipients from the Columbia University kidney transplant program who required hospitalization for confirmed COVID-19, and describe their management, clinical course, and outcomes.ResultsPatients presented most often with a fever (87%) and/or cough (67%). Initial chest x-ray most commonly showed bilateral infiltrates, but 33% had no acute radiographic findings. Patients were managed with immunosuppression reduction and the addition of hydroxychloroquine and azithromycin. Although 27% of our patients needed mechanical ventilation, over half were discharged home by the end of follow-up.ConclusionsKidney transplant recipients with COVID-19 have presentations that are similar to that of the general population. Our current treatment protocol appears to be associated with favorable outcomes, but longer follow-up of a larger cohort of patients is needed.

scholarly journals COVID-19 in Renal Transplant Recipients: Case Series and a Brief Review of Current Evidence

Nephron ◽  
2020 ◽  
pp. 1-7
Author(s):  
Muhammed Ahmed Elhadedy ◽  
Yazin Marie ◽  
Ahmed Halawa
Keyword(s):  
Renal Transplant ◽  
Kidney Transplant ◽  
Therapy Monitoring ◽  
Intensive Therapy ◽  
Current Evidence ◽  
Intensive Care Treatment ◽  
Renal Transplant Recipients ◽  
Supportive Treatment ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

By April 26, 2020, infections related to coronavirus disease 2019 (COVID-19) affected people from 210 countries and caused 203,818 reported deaths worldwide. A few studies discussed the outcome of COVID-19 in kidney transplant recipients. This short series demonstrates our experience in managing COVID-19 disease in renal transplant patients in the absence of strong evidence. We report 8 cases of kidney transplant recipients infected with COVID-19 (median age = 48.5 years; range = 21–71 years), including 4 males and 4 females. The most frequently associated comorbidity was hypertension. The most common presenting features were fever and cough. The main radiological investigation was a portable chest X-ray. Other common features included lymphopenia, high C-reactive protein, and a very high ferritin level. Overall, 1 patient was managed as an outpatient, the remaining 7 required hospital admission, 1 of them referred to the intensive therapy unit. Management included supportive treatment (intravenous fluid therapy, monitoring renal function, and symptomatic treatment with or without ward-based oxygen therapy depending on oxygen saturation) and discontinuation of the antiproliferative immunosuppressive drugs. Seven patients recovered and discharged home to self-isolate. One patient required intensive care treatment and mechanical ventilation. Supportive treatment could be sufficient for the management or to be tried first. We also found that short hospital stay with self-isolation on discharge reduces the burden on the health service and protect the staff and the public.

scholarly journals High Plasma Branched-Chain Amino Acids Are Associated with Higher Risk of Post-Transplant Diabetes Mellitus in Renal Transplant Recipients

2020 ◽  
Vol 9 (2) ◽  
pp. 511 ◽  
Author(s):  
Maryse C. J. Osté ◽  
Jose L. Flores-Guerrero ◽  
Eke G. Gruppen ◽  
Lyanne M. Kieneker ◽  
Margery A. Connelly ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Amino Acids ◽  
Renal Transplant ◽  
Branched Chain Amino Acids ◽  
Resonance Spectroscopy ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Post Transplant ◽  
Branched Chain

Post-transplant diabetes mellitus (PTDM) is a serious complication in renal transplant recipients. Branched-chain amino acids (BCAAs) are involved in the pathogenesis of insulin resistance. We determined the association of plasma BCAAs with PTDM and included adult renal transplant recipients (≥18 y) with a functioning graft for ≥1 year in this cross-sectional cohort study with prospective follow-up. Plasma BCAAs were measured in 518 subjects using nuclear magnetic resonance spectroscopy. We excluded subjects with a history of diabetes, leaving 368 non-diabetic renal transplant recipients eligible for analyses. Cox proportional hazards analyses were used to assess the association of BCAAs with the development of PTDM. Mean age was 51.1 ± 13.6 y (53.6% men) and plasma BCAA was 377.6 ± 82.5 µM. During median follow-up of 5.3 (IQR, 4.2–6.0) y, 38 (9.8%) patients developed PTDM. BCAAs were associated with a higher risk of developing PTDM (HR: 1.43, 95% CI 1.08–1.89) per SD change (p = 0.01), independent of age and sex. Adjustment for other potential confounders did not significantly change this association, although adjustment for HbA1c eliminated it. The association was mediated to a considerable extent (53%) by HbA1c. The association was also modified by HbA1c; BCAAs were only associated with renal transplant recipients without prediabetes (HbA1c < 5.7%). In conclusion, high concentrations of plasma BCAAs are associated with developing PTDM in renal transplant recipients. Alterations in BCAAs may represent an early predictive biomarker for PTDM.

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