scholarly journals Dengue virus infection among renal transplant recipients in Singapore: a 15-year single-centre retrospective review

2021 ◽  
Author(s):  
SXS Tan ◽  
QY Ho ◽  
S Thangaraju ◽  
TT Tan ◽  
T Kee ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Retrospective Review ◽  
Dengue Infection ◽  
Graft Function ◽  
Warning Signs ◽  
Severe Dengue ◽  
Published Data ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Graft Dysfunction

Introduction: Dengue is a mosquito-borne viral infection endemic in Singapore. Its impact in renal transplantation is limited to small case series. We aimed to characterise the clinical presentation and outcomes of dengue infection among renal transplant recipients in Singapore. Methods: We conducted a 15-year retrospective review of dengue in renal transplant patients treated at Singapore General Hospital between January 2005 and October 2019. The diagnosis of dengue was made if there were a compatible clinical syndrome and a positive dengue diagnostic assay (Dengue NS1 antigen, IgM or RT-PCR). Results: 31 patients were diagnosed with dengue, 18 (58.1%) were deceased donor recipients. The median age was 52 (IQR 40–61) years; 16 (51.6%) were females. The median time to diagnosis was 99 (IQR 18–169) months from transplant. The most common clinical symptoms were fever (87.1%), myalgia (41.9%), gastrointestinal symptoms (38.7%) and headache (25.8%). 19 (61.3%) patients had dengue without warning signs, 9 (29.0%) had dengue with warning signs, 3 (9.7%) had severe dengue and 30 (96.8%) were hospitalized. 17 (54.8%) patients had graft dysfunction, 16 (94.1%) of whom had recovery of graft function. 1 (3.2%) patient required dialysis and subsequently died. There were two cases of donor-derived infections (DDIs) with favourable outcomes. Conclusion: Our experience with dengue in renal transplant recipients is concordant with published data. Although graft dysfunction is common, it is often transient with favourable outcomes. Outpatient management may be considered for mild infections. Although dengue DDIs are uncommon, more stringent donor screening may be considered in endemic regions.

scholarly journals 197. Dengue Virus Infection Among Renal Transplant Recipients in Singapore: A 15-year Single Center Retrospective Review

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S227-S228
Author(s):  
Sophie Tan Seine Xuan ◽  
Quan Yao Ho ◽  
Sobhana Thangaraju ◽  
Thuan Tong Tan ◽  
Terence Kee ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Clinical Presentation ◽  
Deceased Donor ◽  
Warning Signs ◽  
Severe Dengue ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Graft Dysfunction ◽  
Dengue Virus Infection ◽  
Transplant Patients

Abstract Background Dengue is a mosquito-borne viral infection endemic in Singapore. Its clinical course in the immunocompetent host is well characterised but its impact in renal transplantation is not well described. We aim to characterise the clinical presentation and outcomes of dengue virus infection in renal transplant recipients treated at a tertiary center in Singapore. Methods We conducted a 15 year retrospective review of dengue in renal transplant patients treated at Singapore General Hospital between January 2005 to October 2019. The diagnosis of dengue was made if there were a compatible clinical syndrome and a positive dengue diagnostic assay, either Dengue NS1 antigen, IgM or PCR. Results Thirty-two renal transplant patients were diagnosed with dengue, 18 (56.3%) were deceased donor recipients. The median age at time of diagnosis was 53 [IQR 42,61] years; 16 (50%) were males. The median time to diagnosis of dengue was 95.5 [IQR 15.0,95.5] months from transplant; and the median duration of clinical illness was 7 [IQR 5,7] days. The most common clinical symptoms were fever (84.4%), myalgia (40.6%), gastrointestinal symptoms (37.5%) and headache (25.0%). Based on the WHO 2009 dengue classification, 20 (62.5%) had dengue without warning signs, 9 (28.1%) had dengue with warning signs, and 3 (9.4%) had severe dengue; 19 (59.3%) had graft dysfunction and 1 (3.1%) required dialysis. Of the patients who had graft dysfunction, 18 (94.7%) had recovery of graft function at time of dengue resolution. Dengue mortality rate was 3.1%. There were 2 possible cases of donor derived dengue infections, occurring within 2 weeks of deceased donor transplantation. Conclusion Dengue in renal transplant is usually community acquired; donor derived infections are uncommon. The clinical presentation of dengue is similar to the immunocompetent host, however graft dysfunction is common and fluid management in this population is important. Severe dengue is less common. Disclosures All Authors: No reported disclosures

scholarly journals Higher CD19+CD25+ Bregs are independently associated with better graft function in renal transplant recipients

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Eman H. Ibrahim ◽  
Mostafa G. Aly ◽  
Gerhard Opelz ◽  
Christian Morath ◽  
Martin Zeier ◽  
...  
Keyword(s):  
Renal Transplant ◽  
B Cell ◽  
Graft Function ◽  
Cell Subset ◽  
Immunosuppressive Drugs ◽  
Renal Transplant Recipients ◽  
Healthy Controls ◽  
Transplant Recipients ◽  
Significant Positive Association ◽  
Ifn Γ

Abstract Background The Identification of B cell subsets with regulatory functions might open the way to new therapeutic strategies in the field of transplantation, which aim to reduce the dose of immunosuppressive drugs and prolong the graft survival. CD25 was proposed as a marker of a B-cell subset with an immunosuppressive action termed Bregs. The effect of CD19 + CD25 + Bregs on graft function in renal transplant recipients has not yet been elucidated. We investigated a potential impact of CD19 + CD25 + Bregs on renal graft function as well as a possible interaction of CD19 + CD25 + Bregs with peripheral Tregs in healthy controls, end-stage kidney disease patients (ESKD), and renal transplant recipients. Moreover, we aimed to investigate the association of CD19 + CD25 + Bregs with serum IL-10, TGF-ß1, and IFN-γ in the same study groups. Method Thirty-one healthy controls, ninety renal transplant recipients, and eighteen ESKD patients were enrolled. We evaluated the CD19 + CD25 + Bregs and Treg absolute counts. Next, we investigated CD19 + CD25 + Bregs as predictors of good graft function in multiple regression and ROC analyses. Finally, we evaluated the association between CD19 + CD25+ Bregs and serum IL-10, TGF-ß, and IFN-γ. Results ESKD patients and renal transplant recipients showed lower counts of CD19 + CD25+ Bregs compared to healthy controls (p < 0.001). Higher CD19 + CD25+ Breg counts were independently associated with a better GFR in renal transplant recipients (unstandardized B coefficient = 9, p = 0.02). In these patients, higher CD19 + CD25+ Bregs were independently associated with higher Treg counts (unstandardized B = 2.8, p = 0.004). In ROC analysis, cut-offs for CD19 + CD25 + Breg counts and serum TGF-ß1 of 0.12 cell/μl and 19,635.4 pg/ml, respectively, were shown to provide a good sensitivity and specificity in identifying GFR ≥ 30 ml/min (AUC = 0.67, sensitivity 77%, specificity 43%; AUC = 0.65, sensitivity 81%, specificity 50%, respectively). Finally, a significant positive association between CD19 + CD25+ Bregs and TGF-ß1 was shown in renal transplant recipients (r = 0.255, p = 0.015). Conclusions Our findings indicate that higher counts of CD19 + CD25+ Bregs are independently associated with better renal function and higher absolute Treg counts in renal transplant recipients.

scholarly journals Tacrolimus-Based Immunosuppressive Therapy Influences Sex Hormone Profile in Renal-Transplant Recipients—A Research Study

Biology ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 709
Author(s):  
Dagmara Szypulska-Koziarska ◽  
Aleksandra Wilk ◽  
Małgorzata Marchelek-Myśliwiec ◽  
Daria Śleboda-Taront ◽  
Barbara Wiszniewska
Keyword(s):  
Renal Transplant ◽  
Immunosuppressive Therapy ◽  
Follicle Stimulating Hormone ◽  
Plasma Concentrations ◽  
Graft Function ◽  
Hormonal Status ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Study Results ◽  
Stimulating Hormone

It is estimated that approximately 20% of couples suffer from infertility worldwide and within renal-transplant recipients, this problem is 10 times more common. An intake of immunosuppressants may lead to hormonal imbalance. The aim of the study was to investigate the influence of tacrolimus-based therapy on the hormonal status of grafted patients. Blood samples were obtained from patients from the Department of Nephrology, Transplantology, and Internal Medicine of Independent Public Clinical Hospital No. 2, Pomeranian Medical University. All 121 patients had stable graft function for over 6 months. The blood plasma concentrations of luteinizing hormone, follicle-stimulating hormone, prolactin, testosterone, estradiol, cortisol were assessed by the electrochemiluminescence method. We observed decreased levels of prolactin (11.9 ng/mL) and cortisol (87.4 μg/mL) in patients under tacrolimus-based therapy. Tacrolimus-based therapy was also associated with increased testosterone and follicle-stimulating hormone in males, 4.04 ng/mL and 6.9 mLU/mL, respectively, and decreased testosterone levels in females, 0.121 ng/mL. We also assessed that immunosuppressive therapy based on tacrolimus is less nephrotoxic in comparison to other regimens. Concluding, tacrolimus-based therapy may influence the hormonal status of transplant recipients in the current study. Results presented here are believed to be helpful for clinicians and patients, especially within the aspect of willingness for biological offspring.

NFATC1genotypes affect acute rejection and long-term graft function in cyclosporine-treated renal transplant recipients

2017 ◽  
Vol 18 (4) ◽  
pp. 381-392 ◽  
Author(s):  
Qinxia Xu ◽  
Xiaoyan Qiu ◽  
Zheng Jiao ◽  
Ming Zhang ◽  
Jianping Chen ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Acute Rejection ◽  
Graft Function ◽  
Renal Transplant Recipients ◽  
Transplant Recipients

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.

scholarly journals SAT-344 KIDNEY GRAFT FUNCTION AND ARTERIAL STIFFENSS IN RENAL TRANSPLANT RECIPIENTS

2020 ◽  
Vol 5 (3) ◽  
pp. S144
Author(s):  
Z. Heleniak PhD ◽  
S. Illersberger ◽  
S. Brakemeier ◽  
A. Dębska-Ślizień ◽  
K. Budde ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Graft Function ◽  
Renal Transplant Recipients ◽  
Kidney Graft ◽  
Transplant Recipients
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