Long term respiratory outcomes following solid organ transplantation in children: a retrospective cohort study.

Mapping Intimacies ◽

10.22541/au.163255287.73643413/v1 ◽

2021 ◽

Author(s):

Marie Wright ◽

Mark Chilvers ◽

Tom Blydt-Hansen

Keyword(s):

Respiratory Tract ◽

Organ Transplantation ◽

Respiratory Tract Infections ◽

Solid Organ Transplantation ◽

Solid Organ ◽

Respiratory Complications ◽

History Of ◽

Tract Infections ◽

Respiratory Outcomes

Background Solid organ transplantation (SOT) has become commonly used in children and is associated with excellent survival rates into adulthood. Data regarding long-term respiratory outcomes following pediatric transplantation are lacking. We aimed to describe the prevalence and nature of respiratory pathology following pediatric heart, kidney, and liver transplant, and identify potential risk factors for respiratory complications. Methods Retrospective review involving all children under active follow-up at the provincial transplant service in British Columbia, Canada, following SOT. Results Of 118 children, 33% experienced respiratory complications, increasing to 54% in heart transplant recipients. Chronic or recurrent cough with persistent chest x-ray changes was the most common clinical picture, and most infections were with non-opportunistic organisms typically found in otherwise healthy children. A history of respiratory illness prior to transplant was significantly associated with risk of post-transplant respiratory complications. 8% were diagnosed with bronchiectasis, which was more common in recipients of heart and kidney transplant. Bronchiectasis was associated with recurrent hospital admissions with lower respiratory tract infections, treatment of acute rejection episodes, and treatment with sirolimus. Interpretation Respiratory morbidity is common after pediatric SOT, and bronchiectasis rates were disproportionately high in this patient group. We hypothesise that this relates to recurrent infections resulting from iatrogenic immunosuppression. Direct pulmonary toxicity from immunosuppression drugs may also be contributory. A high index of suspicion for respiratory complications is needed following childhood SOT, particularly in those with a history of respiratory disease prior to transplant, experiencing recurrent or severe respiratory tract infections, or exposed to intensified immunosuppression.

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Solid Organ Transplantation in Patients With a History of Lymphoma

Journal of Oncology Practice ◽

10.1200/jop.2017.028480 ◽

2018 ◽

Vol 14 (1) ◽

pp. 11-17 ◽

Cited By ~ 3

Author(s):

Philip J. Bierman

Keyword(s):

Organ Transplantation ◽

Solid Organ Transplantation ◽

Supporting Evidence ◽

Solid Organ ◽

Post Transplantation ◽

Term Survival ◽

Hematopoietic Stem ◽

Lymphoma Treatment ◽

History Of

There is an increasing number of long-term survivors of Hodgkin and non-Hodgkin lymphoma. These people may have a need for subsequent solid organ transplantation, often as a result of late effects of their lymphoma treatment. There is abundant literature demonstrating that patients with a history of lymphoma are appropriate candidates for solid organ transplantation. Long-term survival without relapse and with a functioning graft is possible. Patients with a history of post-transplantation lymphoproliferative disorders and patients who have received a prior hematopoietic stem-cell transplantation may also be candidates. Although high-level supporting evidence is not available, most guidelines recommend a waiting period of 2 to 5 years after lymphoma treatment before patients undergo solid organ transplantation. Each patient with a history of lymphoma requires a multidisciplinary approach and should be evaluated on a case-by-case basis before consideration of solid organ transplantation.

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Respiratory tract infections in children with allergic asthma on allergen immunotherapy during influenza season

Scientific Reports ◽

10.1038/s41598-021-81558-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yuyun Li ◽

Dongming Wang ◽

Lili Zhi ◽

Yunmei Zhu ◽

Lan Qiao ◽

...

Keyword(s):

Respiratory Tract ◽

Allergic Asthma ◽

Respiratory Tract Infections ◽

Allergen Immunotherapy ◽

Clinical Symptoms ◽

Influenza Season ◽

The Body ◽

History Of ◽

Tract Infections ◽

Stage 1

AbstractTo describle how respiratory tract infections (RTIs) that occurred in children with allergic asthma (AA) on allergen immunotherapy (AIT) during an influenza season. Data including clinical symptoms and treatment history of children (those with AA on AIT and their siblings under 14 years old), who suffered from RTIs during an influenza season (Dec 1st, 2019–Dec 31st, 2019), were collected (by face to face interview and medical records) and analyzed. Children on AIT were divided into 2 groups: stage 1 (dose increasing stage) and stage 2 (dose maintenance stage). Their siblings were enrolled as control. During the study period, 49 children with AA on AIT (33 patients in stage 1 and 16 patients in stage 2) as well as 49 children without AA ( their siblings ) were included. There were no significant differences in occurrences of RTIs among the three groups (p > 0.05). Compared with children in the other two groups, patients with RTIs in stage 2 had less duration of coughing and needed less medicine. Children on AIT with maintenance doses had fewer symptoms and recovered quickly when they were attacked by RTIs, which suggested that AIT with dose maintenance may enhance disease resistance of the body.

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Respiratory tract infections in solid organ transplant recipients

Respiratory Infections ◽

10.1201/b13421-32 ◽

2006 ◽

pp. 759-774

Keyword(s):

Respiratory Tract ◽

Respiratory Tract Infections ◽

Organ Transplant ◽

Solid Organ Transplant ◽

Solid Organ ◽

Transplant Recipients ◽

Organ Transplant Recipients ◽

Solid Organ Transplant Recipients ◽

Tract Infections

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A case of rhabdomyolysis after atorvastatin therapy of a liver transplant recipient receiving immunosuppressive therapy with cyclosporine

Transplantologiya The Russian Journal of Transplantation ◽

10.23873/2074-0506-2021-13-2-158-164 ◽

2021 ◽

Vol 13 (2) ◽

pp. 158-164

Author(s):

A. V. Shabunin ◽

S. P. Loginov ◽

P. A. Drozdov ◽

I. V. Nesterenko ◽

D. A. Makeev ◽

...

Keyword(s):

Liver Transplantation ◽

Drug Interactions ◽

Liver Transplant ◽

Immunosuppressive Therapy ◽

Organ Transplantation ◽

Muscle Pain ◽

Solid Organ Transplantation ◽

Solid Organ ◽

Term Survival

Rationale. To date, liver transplantation is the most effective method of treating end-stage liver failure, and therefore this treatment has become widespread throughout the world. However, due to the improvement in the quality of transplant care and an increase in the long-term survival of patients, the development of concomitant pathology, which often requires medical treatment, is inevitably associated with a higher life expectancy of liver transplant recipients. Thus, in patients who underwent liver transplantation, there is. a significant increase in the incidence of dyslipidemia. However, a long-term immunosuppressive therapy in organ transplant patients can adversely modify the effect of the prescribed drugs, which requires careful monitoring and consideration of drug interactions.Purpose. Using a clinical example to demonstrate the importance of taking drug interactions into account in the treatment of patients after organ transplantation receiving immunosuppressive drugs.Material and methods. In the presented clinical case, a patient after orthotopic liver transplantation performed in 2005 underwent a staged treatment of cicatricial stricture of choledochal anastomosis in the S.P. Botkin City Clinical Hospital. During the following hospitalization, the patient complained of minor muscle pain when walking. At doctor's visit 3 weeks before hospitalization, a local physician prescribed therapy with atorvastatin 10 mg per day due to an increase in blood plasma cholesterol levels. The patient underwent removal of the self-expanding nitinol stent. During the follow-up examination, the patient had no evidence of an impaired bile outflow, however, muscle pain and weakness progressively increased, the rate of diuresis decreased, and in the biochemical analysis of blood there was an abrupt increase in the concentration of creatinine, aspartate aminotransferase, alanine aminotransferase. Atorvastatin was canceled, a diagnosis of acute non-traumatic rhabdomyolysis was established, treatment with hemodialysis and plasma exchange was started on 03/05/2020. The last session of renal replacement therapy was 03/30/20.Results. With the restoration of the diuresis rate, there was a spontaneous decrease in the level of creatinine to 170 μmol/L. The patient was discharged with satisfactory renal and hepatic function. The pain syndrome completely resolved. Conclusion. Drug interactions between atorvastatin and cyclosporine have resulted in acute rhabdomyolysis with life-threatening consequences. This once again confirms the importance of taking drug interactions into account when managing patients after solid organ transplantation.

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Mesenchymal Stromal Cell Therapy in Solid Organ Transplantation

Frontiers in Immunology ◽

10.3389/fimmu.2020.618243 ◽

2021 ◽

Vol 11 ◽

Author(s):

Manuel Alfredo Podestà ◽

Giuseppe Remuzzi ◽

Federica Casiraghi

Keyword(s):

Organ Transplantation ◽

Patient Survival ◽

Immunosuppressive Agents ◽

Graft Function ◽

Solid Organ Transplantation ◽

Solid Organ ◽

Clinical Models ◽

Transplant Failure

Transplantation is the gold-standard treatment for the failure of several solid organs, including the kidneys, liver, heart, lung and small bowel. The use of tailored immunosuppressive agents has improved graft and patient survival remarkably in early post-transplant stages, but long-term outcomes are frequently unsatisfactory due to the development of chronic graft rejection, which ultimately leads to transplant failure. Moreover, prolonged immunosuppression entails severe side effects that severely impact patient survival and quality of life. The achievement of tolerance, i.e., stable graft function without the need for immunosuppression, is considered the Holy Grail of the field of solid organ transplantation. However, spontaneous tolerance in solid allograft recipients is a rare and unpredictable event. Several strategies that include peri-transplant administration of non-hematopoietic immunomodulatory cells can safely and effectively induce tolerance in pre-clinical models of solid organ transplantation. Mesenchymal stromal cells (MSC), non-hematopoietic cells that can be obtained from several adult and fetal tissues, are among the most promising candidates. In this review, we will focus on current pre-clinical evidence of the immunomodulatory effect of MSC in solid organ transplantation, and discuss the available evidence of their safety and efficacy in clinical trials.

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