scholarly journals Bacterial and fungal bloodstream infections in pediatric liver and kidney transplant recipients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dina Leth Møller ◽  
Søren Schwartz Sørensen ◽  
Neval Ete Wareham ◽  
Omid Rezahosseini ◽  
Andreas Dehlbæk Knudsen ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Bloodstream Infections ◽  
Incidence Rates ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Post Transplantation ◽  
Pediatric Liver ◽  
Resistance Patterns ◽  
Liver And Kidney ◽  
Liver Transplant Recipients

Abstract Background Bacterial and fungal bloodstream infections (BSI) are common after pediatric liver and kidney transplantations and associated with morbidity and mortality. However, knowledge about incidence rates, pathogen composition, and resistance patterns is limited. We aimed to describe the pattern of bacterial and fungal BSI in a cohort of pediatric liver and kidney transplant recipients. Methods A prospective study of 85 pediatric liver and kidney transplant recipients transplanted from 2010 to 2017 with a total of 390 person-years of follow-up. Clinical characteristics and BSI were retrieved from national registries assuring nationwide follow-up for at least 1 year. BSI incidence rates and pathogen composition were investigated and stratified by the time post-transplantation and type of transplanted organ. Results A total of 29 BSI were observed within the first 5 years post-transplantation with 16 different pathogens. The overall incidence rate of first BSI was 1.91 per 100 recipients per month (95% CI, 1.1–3.1) in the first year post-transplantation. The most common pathogens were Enterococcus faecium, Candida albicans, Escherichia coli, and Klebsiella pneumoniae. The pathogen composition depended on the transplanted organ with a higher proportion of BSI with Enterobacterales in kidney transplant recipients than in liver transplant recipients (67% vs. 20%, p = 0.03), while multiple pathogens were detected in the liver transplant recipients. Conclusions BSI were common in pediatric liver and kidney transplant recipients and the pathogen composition differed between liver and kidney transplant recipients. Guidelines for empiric antibiotic therapy should consider the type of transplanted organ as well as the local resistance patterns.

Bacterial and Fungal Bloodstream Infections in Pediatric Liver and Kidney Transplant Recipients

2020 ◽  
Author(s):  
Dina Møller ◽  
Søren Sørensen ◽  
Neval Wareham ◽  
Omid Rezahosseini ◽  
Andreas Knudsen ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Bloodstream Infections ◽  
Incidence Rates ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Post Transplantation ◽  
Pediatric Liver ◽  
Resistance Patterns ◽  
Liver And Kidney ◽  
Liver Transplant Recipients

Abstract Background Bacterial and fungal bloodstream infections (BSI) are common after pediatric liver and kidney transplantations and associated with morbidity and mortality. However, knowledge about incidence rates, pathogen composition, and resistance patterns is limited. We aimed to describe the pattern of bacterial and fungal BSI in a cohort of pediatric liver and kidney transplant recipients.Methods A prospective study of 85 pediatric liver and kidney transplant recipients transplanted from 2010 to 2017 with a total of 390 person-years of follow-up. Clinical characteristics and BSI were retrieved from national registries assuring nationwide follow-up for at least one year. BSI incidence rates and pathogen composition were investigated and stratified by the time post-transplantation and type of transplanted organ. Results A total of 29 BSI were observed within the first 5 years post-transplantation with 16 different pathogens. The overall incidence rate of first BSI was 1.91 per 100 recipients per month (95% CI, 1.1-3.1) in the first-year post-transplantation. The most common pathogens were Enterococcus faecium, Candida albicans, Escherichia coli, and Klebsiella pneumoniae. The pathogen composition depended on the transplanted organ with a higher proportion of BSI with Enterobacterales in kidney transplant recipients than in liver transplant recipients (67% vs. 20%, P = 0.03), while multiple pathogens were detected in the liver transplant recipients.Conclusions BSI were common in pediatric liver and kidney transplant recipients and the pathogen composition differed between liver and kidney transplant recipients. Guidelines for empiric antibiotic therapy should consider the type of transplanted organ as well as the local resistance patterns.

scholarly journals Dose-adjusted and dose/kg-adjusted concentrations of mycophenolic acid precursors reflect metabolic ratios of their metabolites in contrast with tacrolimus and cyclosporine

2019 ◽  
Vol 39 (9) ◽  
Author(s):  
Ewa Hryniewiecka ◽  
Jolanta Żegarska ◽  
Dorota Żochowska ◽  
Emilia Samborowska ◽  
Radosław Jaźwiec ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Kidney Transplant ◽  
Mycophenolic Acid ◽  
Parent Drug ◽  
Immunosuppressive Drug ◽  
Therapeutic Drug ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Liver And Kidney ◽  
Liver Transplant Recipients

Abstract Background and purpose: Therapeutic drug monitoring is a valuable tool supporting immunosuppressive therapy. Significant variation of immunosuppressive drug (ISD) concentrations during their use at similar doses is the basis of dose-normalization strategy. The strategy of dose-adjustment is proposed to identify variability in the rate of ISD metabolism. While the parent drug-to-metabolite ratio (metabolic ratio, MR) represents the rate of formation of individual metabolites. The present study was aimed at evaluation of associations between ISDs’ metabolism rate expressed as dose-adjusted concentrations (C/D) and dose/kg-adjusted concentrations (C/D/kg) and MRs of individual metabolites of tacrolimus, cyclosporine A and MPA precursors. Experimental approach: 506 patients have participated: 284 males (56.13%) and 222 females (43.87%); 318 after kidney (62.85%) and 188 after liver transplantation; median age was 51.34 (39.32-59.95) years and median time after transplantation 78.92 (33.87-138.4) months. Key results: Generally, we have not observed significant relationships between dose-adjusted and dose/kg-adjusted concentrations and MRs of cyclosporine and tacrolimus. Significant correlations were found for: AM9/CsA and dMC-CsA/CsA in kidney transplant recipients and MIII/Tac, AM1/CsA and AM4N/CsA in liver transplant recipients. In contrast, MRs of mycophenolic acid (MPA) metabolites correlated significantly with MPA C/D and C/D/kg both in kidney and liver transplant recipients. Conclusion and implications: In conclusion, easily available and easy to use in clinical practice C/D and C/D/kg ratios cannot be considered as parameters directly reflecting the rate of generation of major metabolites of cyclosporine and tacrolimus both in liver and kidney transplant recipients.

Tu1125 Eosinophilic Gastrointestinal Disease in Pediatric Liver and Kidney Transplant Recipients

2015 ◽  
Vol 148 (4) ◽  
pp. S-794
Author(s):  
Katie Amsden ◽  
Saeed Mohammad ◽  
Jonathan W. Bush ◽  
Hector Melin-Aldana ◽  
Nicoleta Arva ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Gastrointestinal Disease ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Pediatric Liver ◽  
Liver And Kidney

Evolution of Anxious-Depressive Symptomatology in Liver and Kidney Transplant Recipients: Hospitalization and 12-Month Post-Transplantation Phases

2013 ◽  
Vol 45 (10) ◽  
pp. 3656-3658 ◽  
Author(s):  
M.A. Pérez-San-Gregorio ◽  
E. Fernández-Jiménez ◽  
A. Martín-Rodríguez ◽  
J. Pérez-Bernal ◽  
M.A. Gómez Bravo
Keyword(s):  
Kidney Transplant ◽  
Depressive Symptomatology ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Post Transplantation ◽  
Liver And Kidney

scholarly journals BK Polyomavirus Micro-RNAs: Time Course and Clinical Relevance in Kidney Transplant Recipients

Viruses ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 351
Author(s):  
Baptiste Demey ◽  
Véronique Descamps ◽  
Claire Presne ◽  
Francois Helle ◽  
Catherine Francois ◽  
...  
Keyword(s):  
Viral Replication ◽  
Kidney Transplant ◽  
Clinical Relevance ◽  
Graft Loss ◽  
First Year ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Post Transplantation ◽  
Bk Polyomavirus ◽  
Micro Rnas

Background: Kidney transplant recipients (KTRs) are exposed to a high risk of BK polyomavirus (BKPyV) replication, which in turn may lead to graft loss. Although the microRNAs (miRNAs) bkv-miR-B1-3p and bkv-miR-B1-5p are produced during the viral cycle, their putative value as markers of viral replication has yet to be established. In KTRs, the clinical relevance of the changes over time in BKPyV miRNA levels has not been determined. Methods: In a retrospective study, we analyzed 186 urine samples and 120 plasma samples collected from 67 KTRs during the first year post-transplantation. Using a reproducible, standardized, quantitative RT-PCR assay, we measured the levels of bkv-miR-B1-3p and bkv-miR-B1-5p (relative to the BKPyV DNA load). Results: Detection of the two miRNAs had low diagnostic value for identifying patients with DNAemia or for predicting DNAuria during follow-up. Seven of the 14 KTRs with a sustained BKPyV infection within the first year post-transplantation showed a progressive reduction in the DNA load and then a rapid disappearance of the miRNAs. DNA and miRNA loads were stable in the other seven KTRs. Conclusions: After the DNA-based diagnosis of BKPyV infection in KTRs, bkv-miR-B1-3p and bkv-miR-B1-5p levels in the urine might be valuable markers for viral replication monitoring and thus might help physicians to avoid an excessive reduction in the immunosuppressive regimen.

ALLOREACTIVITY IN LIVER AND KIDNEY TRANSPLANT RECIPIENTS

2008 ◽  
Vol 86 (Supplement) ◽  
pp. 403-404
Author(s):  
M Lindemann ◽  
H Klinkenbusch ◽  
C Saure ◽  
O Witzke ◽  
C Valentin-Gamazo ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Liver And Kidney
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