scholarly journals Temporal Change in Blood Group after Bone Marrow Transplant: A Case of Successful ABO-Incompatible Deceased Donor Transplant

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Susanna Lam ◽  
Sebastian Hultin ◽  
John Preston ◽  
Scott Campbell
Keyword(s):  
Stem Cell ◽  
Kidney Transplantation ◽  
Blood Group ◽  
Stem Cell Transplant ◽  
Graft Function ◽  
Deceased Donor ◽  
Haematopoietic Stem Cell ◽  
Cell Transplant ◽  
Blood Group A ◽  
Group A

ABO-incompatible kidney transplantation has been successfully utilised in a deceased donor and living donor kidney transplantation to improve organ utilisation and decrease waiting times. We describe a case of a successful, unanticipated ABO-incompatible donation after cardiac death (DCD) kidney transplant in a patient who had a previous ABOi haematopoietic stem cell transplant (HSCT) and had reverted to his original blood group B, after matching as a blood group A recipient with a blood group A donor. The recipient was unsensitized with a cPRA which was 0% and no donor-specific antibodies and zero HLA mismatch. An urgent anti-A titre was 1 : 2. Given the low antibody titres, we proceeded to transplantation. The patient developed delayed graft function and required dialysis on postoperative day 1 and day 2. The creatinine fell spontaneously on day 5, with progressively increased urine output and stable graft function on discharge at day 6. Anti-A titres were 1 : 1 on serial postoperative measurements. There were no rejection episodes, and the patient has a functioning graft at 16 months posttransplant. We describe a rare case in which the blood group can change after stem cell transplant and should be checked. We also demonstrate that a DCD ABOi transplant in the context of low anti-A titres for a patient with previous ABOi stem cell transplant can be performed successfully with standard immunosuppression.

Carbapenem-resistant Klebsiella pneumoniae colonization and infection is associated with lower overall survival in a cohort of haematopoietic stem-cell transplantation patients: mechanism of resistance and virulence by whole-genome sequencing

2021 ◽  
Vol 70 (10) ◽  
Author(s):  
Hermes Ryoiti Higashino ◽  
Ana Paula Marchi ◽  
Roberta Cristina Ruedas Martins ◽  
Laina Bubach Carvalho ◽  
Lauro Vieira Perdigão Neto ◽  
...  
Keyword(s):  
Overall Survival ◽  
Stem Cell ◽  
Klebsiella Pneumoniae ◽  
Genome Sequencing ◽  
Stem Cell Transplant ◽  
Haematopoietic Stem Cell ◽  
Cell Transplant ◽  
Whole Genome ◽  
Carbapenem Resistant ◽  
Overall Mortality

Carbapenem-resistant Klebsiella pneumoniae (CRK) infections are a growing concern in immunocompromised patients. The aim of the present study was to evaluate the impact of CRK colonization and infection in overall mortality for haematopoietic stem-cell transplant (HSCT) patients. We also aimed to investigate resistance and virulence profiles of CRK isolates and assess their epidemiological and genetic relatedness. Patients in the HSCT unit were screened for colonization with CRK with weekly rectal swab or stool cultures and placed under contact precautions. We defined CRK colonization as positive culture from a swab or stool sample grown in MacConkey agar with meropenem at 1 µg ml−1. Demographic and clinical data were retrieved from the patients’ charts and electronic records. According to resistance mechanisms and pulsed field gel electrophoresis profile, isolates were selected based on whole-genome sequencing (WGS) using MiSeq Illumina. Outcomes were defined as overall mortality (death up to D+100), and infection-related death (within 14 days of infection). We report a retrospective cohort of 569 haematopoietic stem-cell transplant patients with 105 (18.4 %) CRK colonizations and 30 (5.3 %) infections. blaKPC was the most frequent carbapenemase in our cohort with three isolates co-harbouring blaKPC and blaNDM. We found no difference in virulence profiles from the CRK isolates. There were also no significant differences in virulence profiles among colonization and infection isolates regarding genes encoding for type 1 and 3 fimbriae, siderophores, lipopolysaccharide and colibactin. In clonality analysis by PFGE and WGS, isolates were polyclonal and ST340 was the most prevalent. Overall survival at D+100 was 75.4 % in in CRK-colonized (P=0.02) and 35.7 % in infected patients and significantly lower than non-colonized patients (85.8 %; P<0.001). We found a higher overall mortality associated with colonization and infection; KPC was the main resistance mechanism for carbapenems. The polyclonal distribution of isolates and findings of CRK infection in patients not previously colonized suggest the need to reinforce antibiotic stewardship.

Dynamics of cytomegalovirus populations harbouring mutations in genes UL54 and UL97 in a haematopoietic stem cell transplant recipient

2013 ◽  
Vol 58 (4) ◽  
pp. 733-736 ◽  
Author(s):  
Nathalie Schnepf ◽  
Nathalie Dhédin ◽  
Séverine Mercier-Delarue ◽  
Annalisa Andreoli ◽  
Anne-Claire Mamez ◽  
...  
Keyword(s):  
Stem Cell ◽  
Transplant Recipient ◽  
Stem Cell Transplant ◽  
Haematopoietic Stem Cell Transplant ◽  
Haematopoietic Stem Cell ◽  
Cell Transplant
Sign in / Sign up

Export Citation Format

Share Document