scholarly journals Cytomegalovirus Viremia and Risk Factors in Renal Transplant Recipients in Iran: a Prospective Case-control Study

2021 ◽  
Author(s):  
Najmeh Parhizgari ◽  
Farhad Rezaei ◽  
Mohamad-Reza Khatami ◽  
Sayed Mahdi Marashi ◽  
Mohammad Farahmand ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Kidney Transplant ◽  
Case Control Study ◽  
Case Control ◽  
Control Group ◽  
Transplant Recipients ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
Control Study ◽  
Prospective Case Control Study

Abstract Background: In spite of effective anti-viral drugs and risk-balanced prophylaxis regimen, cytomegalovirus (CMV) remains a major reason of morbidity in kidney transplant patients. The aim of present study was to evaluate CMV viral load and laboratory findings correlation with CMV viremia graft origin and investigation on late or early onset CMV infection in kidney transplant recipients with CMV viremia. Methods: This research designed as a prospective case-control study based on CMV PCR test and exclusion of other viral infection among renal transplant patients in Iran.Results: From 192 examined patients, 153 participants were qualified to enter the study: 43 in case (with CMV viremia) and 110 in control group (CMV negative test). Statistical analysis performed to identify the risk factors raising this viral viremia among kidney transplant patients. Conclusion: Receiving a renal graft from a deceased donor significantly raise the chance of viremia in renal transplant patients. The median month of CMV viremia occurrence was month 4 after transplantation in both groups. Serum laboratory testing showed creatinine and platelets significantly raised and reduced, retrospectively in the case compare to control group. Our results indicating the viremia has not affected the survival of the allograft or patient.

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 >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 >1,000 (normal: < 5) pg/mL in 3 KTR. Tacrolimus or sirolimus levels were >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 Comparison of humoral and cellular responses in kidney transplant recipients receiving BNT162b2 and ChAdOx1 SARS-CoV-2 vaccines

2021 ◽  
Author(s):  
Maria Prendecki ◽  
Tina Thomson ◽  
Candice L Clarke ◽  
Paul Martin ◽  
Sarah Gleeson ◽  
...  
Keyword(s):  
T Cell ◽  
Kidney Transplant ◽  
T Cell Responses ◽  
Cellular Responses ◽  
Control Group ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Cell Responses ◽  
Transplant Patients ◽  
Kidney Transplant Patients

Background Attenuated immune responses to mRNA SARS-CoV-2 vaccines have been reported in solid organ transplant recipients. Most studies have assessed serological responses alone, and there is limited immunological data on vector-based vaccines in this population. This study compares the immunogenicity of BNT162b2 with ChAdOx1 in kidney transplant patients, assessing both serological and cellular responses. Methods 920 patients were screened for spike protein antibodies (anti-S) following 2 doses of either BNT162b2 (n=490) or ChAdOx1 (n=430). 106 patients underwent assessment with T-cell ELISpot assays. 65 health care workers were used as a control group. Results Anti-S was detected in 569 (61.8%) patients. Seroconversion rates in infection-naïve patients who received BNT162b2 were higher compared with ChAdOx1, at 269/410 (65.6%) and 156/358 (43.6%) respectively, p<0.0001. Anti-S concentrations were higher following BNT162b, 58(7.1-722) BAU/ml, compared with ChAdOx1, 7.1(7.1-39) BAU/ml, p<0.0001. Calcineurin inhibitor monotherapy, vaccination occurring >1st year post-transplant and receiving BNT162b2 was associated with seroconversion. Only 28/106 (26.4%) of patients had detectable T-cell responses. There was no difference in detection between infection-naïve patients who received BNT162b2, 7/40 (17.5%), versus ChAdOx1, 2/39 (5.1%), p=0.15. There was also no difference in patients with prior infection who received BNT162b2, 8/11 (72.7%), compared with ChAdOx1, 11/16 (68.8%), p=0.83. Conclusions. Enhanced humoral responses were seen with BNT162b2 compared with ChAdOx1 in kidney transplant patients. T-cell responses to both vaccines were markedly attenuated. Clinical efficacy data is still required but immunogenicity data suggests weakened responses to both vaccines in transplant patients, with ChAdOx1 less immunogenic compared with BNT162b2.

scholarly journals Is delayed graft function associated with ureteral stenosis in the kidney transplant recipient? A case-control study

2019 ◽  
Vol 13 (11) ◽  
Author(s):  
Axel Cayetano-Alcaraz ◽  
Juan Sebastian Rodriguez-Alvarez ◽  
Mario Vilatobá-Chapa ◽  
Josefina Alberú-Gómez ◽  
Bernardo Gabilondo-Pliego ◽  
...  
Keyword(s):  
Risk Factor ◽  
Kidney Transplant ◽  
Kidney Transplant Recipient ◽  
Graft Function ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Transplant Patients ◽  
Increased Risk ◽  
Kidney Transplant Patients ◽  
Control Study

Introduction: Ureteral stricture (US) in the kidney transplant recipient is a rare complication that can lead to morbidity and graft loss. Risk factor recognition is crucial in the prevention and management of this entity. Delayed graft function (DGF), as defined by the need for dialysis in the first week after transplantation, has been proposed as a risk factor in previous studies. Our objective is to determine the impact of DGF in US development in kidney transplant patients. Methods: We designed a matched case-control study. US cases in kidney transplant recipients were identified in the 2008–2017 period. We defined US as the rise in serum creatinine associated with findings suggesting obstruction in ultrasound, scintigraphy, or retrograde pyelogram; any other cause of graft dysfunction was excluded. Controls were defined as kidney transplant recipients from the same population and period without US, matched in a 1:2 fashion by age, sex, and donor type. Results: From 532 kidney transplant patients, 31 cases and 62 controls were included. Cumulative US incidence was 58 per 1000 cases. When calculating for odds ratio (OR), post-operative urinoma (OR 3.2; 95% confidence interval [CI] 2.36–4.37) and ureteral duplication (OR 3.29; 95% CI 2.40–4.51) were associated with an increased risk for US, while DGF was not found to be statistically significant as a risk factor (OR 3.3; 95% CI 0.96–11.52). No statistically significant differences were found between groups in other pre- and post-transplant-related factors. Conclusions: DGF was not associated with US in our cohort; however, ureteral duplication and postoperative urinoma were associated with an increased risk of graft ureteral stenosis development.

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

scholarly journals A matched case-control study on the prognosis of native kidney neoplasia in renal transplant recipients

2002 ◽  
Vol 15 (9-10) ◽  
pp. 455-458 ◽  
Author(s):  
Tadeusz Grochowiecki ◽  
Jacek Szmidt ◽  
Slawomir Nazarewski ◽  
Zbigniew Galazka ◽  
Magdalena Durlik ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Case Control Study ◽  
Case Control ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Native Kidney ◽  
Matched Case ◽  
Matched Case Control Study ◽  
Control Study
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