scholarly journals Serologic Screening and Infectious Diseases Consultation in Renal Transplant Candidates for Measles, Mumps, Rubella and Varicella

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Zeynep Idil Seckin ◽  
Claudia R. Libertin ◽  
Lisa M. Brumble
Keyword(s):  
Renal Transplant ◽  
Infectious Diseases ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Vaccine Preventable Diseases ◽  
Vaccination Rates ◽  
Increased Risk ◽  
Serologic Screening ◽  
Transplant Candidates ◽  
Infectious Diseases Consultation

AbstractBackground: Renal transplant recipients are at increased risk for developing complications of vaccine-preventable diseases. They benefit from a comprehensive pre-transplant evaluation when they might safely receive live vaccines. The primary aim of our study was to investigate the number of renal transplant recipients who were evaluated for serologic status against measles, mumps, rubella (MMR), and varicella. Secondarily, we investigated if pre-transplant Infectious Diseases consultation (IDC) improved vaccination rates.Methods: We retrospectively analyzed 282 kidney-alone and kidney-plus adult transplant recipients who were born in or after 1957. Patients were evaluated at Mayo Clinic, Florida Transplant Center between January 2015 and December 2017. Serologic status evaluation and vaccination rates were compared in two groups created based on IDC and no ID consultation (NIDC).Results: 235 (83%) of a total 282 patients received an IDC pre-transplantation. Varicella IgG levels were screened in all 235 IDC candidates. Among the IDC patients, mumps, measles and rubella IgG serologies were performed in 7 (3%), 143 (61%) and 144 (61%), respectively. Among 44 patients seronegative for any of MMR, 24 (55%) were vaccinated. Ten (66%) of 15 varicella seronegative patients were vaccinated. Zostavax was not given to 18% of IDC patients. Zostavax and MMR were administered more frequently in the IDC group compared to NIDC (p<.001 and p=0.0016, respectively).Conclusion: Although the majority of patients had IDC, the screening rate for MMR serologies was lower than varicella. A protocol-driven serologic screening similar to the one for VZV is required for MMR. Pre-transplant IDC increases vaccination rates.

scholarly journals Exponentially increased risk of infectious death in older renal transplant recipients

2001 ◽  
Vol 59 (4) ◽  
pp. 1539-1543 ◽  
Author(s):  
Herwig-Ulf Meier-Kriesche ◽  
Akinlolu O. Ojo ◽  
Julie A. Hanson ◽  
Bruce Kaplan
Keyword(s):  
Renal Transplant ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Increased Risk

P0863TYPE OF PROTON PUMP INHIBITOR AND RISK OF IRON DEFICIENCY IN RENAL TRANSPLANT RECIPIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Rianne M. Douwes ◽  
Joanna Sophia Jacoline Vinke ◽  
António W Gomes-Neto ◽  
Hans Blokzijl ◽  
Stefan P Berger ◽  
...  
Keyword(s):  
Cohort Study ◽  
Renal Transplant ◽  
Iron Deficiency ◽  
Proton Pump ◽  
Ferritin Level ◽  
Solid Organ ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Increased Risk ◽  
Different Types

Abstract Background and Aims Use of proton-pump inhibitors (PPIs) is common practice in renal transplant recipients (RTRs). Emerging data suggest several adverse effects of use of PPIs, including development of iron deficiency (ID). Although the latter has been shown with respect to PPIs, specific analyses for different types of PPIs and the associated risk of ID have not been performed. Method We used data from the TransplantLines Biobank and Cohort study, an ongoing prospective cohort study among all types of solid organ transplant recipients. For the current study, we used data from stable RTRs with a functional graft for more than 1 year post transplantation (n=795). We excluded RTRs who used any form of iron supplementation (n=54) and EPO-stimulating agents (n=24), resulting in 728 RTRs eligible for analyses. Use of PPIs was subdivided in different types of PPIs, i.e. omeprazole, esomeprazole, pantoprazole, and rabeprazole. ID was defined as TSAT&lt;20% and ferritin &lt;300 µg/L. Logistic regression analysis was used to assess the associations between PPIs and ID. Results We included 728 RTRs (age 56±13 years, 61% males), with a mean eGFR of 53±18 ml/min/1.73m2, a median [interquartile range] ferritin level of 96 (44 – 191) µg/L and mean TSAT of 24±10%. PPIs were used by 504 (69%) of the included RTRs, of which 398 (79%), 55 (11%), 49 (10%), and 2 (0.4%) respectively used omeprazole, pantoprazole, esomeprazole, and rabeprazole. Use of PPIs was strongly associated with ID (OR, 2.20; 95%CI 1.48 – 3.28; P&lt;0.001), independent of adjustment for age, sex, BMI, eGFR, hs-CRP, smoking, alcohol use, use of calcineurine inhibitors, prednisolone, antiplatelet drugs, and antihypertensives. When subdividing the PPIs into the different types, both omeprazole (OR, 1.98; 95%CI 1.39 – 2.83; P&lt;0.001) and esomeprazole (OR, 2.11; 95%CI 1.09 – 4.07; P=0.03) were independently associated with iron deficiency, whereas pantoprazole was not associated (OR, 0.89; 95%CI 0.47 – 1.70; P=0.73). Conclusion Omeprazole and esomeprazole, but not pantoprazole, are associated with an increased risk of ID. Our results are in line with previous reports that pantoprazole has the lowest potency with least increase in intragastric pH, thereby possibly interfering less with reduction of ferric to ferrous iron, and subsequently iron absorption. Future studies are warranted to confirm our present findings.

scholarly journals Malignant and Noninvasive Skin Tumours in Renal Transplant Recipients

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Christopher D. Roche ◽  
Joelle S. Dobson ◽  
Sion K. Williams ◽  
Mara Quante ◽  
Joyce Popoola ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Skin Tumours ◽  
Skin Malignancy ◽  
Increased Risk ◽  
Malignant Skin ◽  
Risk Of Malignancy

Background.Transplant recipients require immunosuppression to prevent graft rejection. This conveys an increased risk of malignancy, particularly skin tumours. There is a need for up-to-date data for the South of England.Method.Pathology records were reviewed for 709 kidney transplant recipients on immunosuppression at our hospital from 1995 to 2008. Skin tumours were recorded/analysed.Results.Mean age at transplant was 46 years. Mean length of follow-up was 7.2 years and total follow-up was 4926 person-years. 53 (7.5%) patients (39/458 (8.5%) males and 14/251 (5.6%) females) developed ≥1 skin malignancy. Cumulative incidences of 4.0%, 7.5%, and 12.2% were observed for those with <5, <10, and ≥10 years follow-up, respectively. The rate was 45 tumours per 1000 person-years at risk. Additionally, 21 patients (3.0%) only had noninvasive tumours. 221 malignant skin tumours were found: 50.2% were SCCs, 47.1% BCCs, and 2.7% malignant melanomas. Mean years to first tumour were 5.8. Mean number of tumours per patient was 4, with mean interval of 12 months.Conclusions.Despite changes in transplantation practice during the time since the last data were published in this region, these findings are similar to previous studies. This adds to the evidence allowing clinicians to inform patients in this region of their risk.

scholarly journals A need-adapted transition program after pediatric kidney transplantation

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Susanne Rieger ◽  
Dirk Bethe ◽  
Angela Bagorda ◽  
Dorothea Treiber ◽  
Jörg Beimler ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Transition Process ◽  
Transition Program ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Adult Care ◽  
Increased Risk ◽  
Pediatric Renal Transplant ◽  
The Individual ◽  
The Impact

AbstractA successful transition of renal transplant recipients from pediatric to adult care requires a structured, need-adapted and multidisciplinary approach to preserve renal graft function during this critical period of life. In this article we present our clinical protocol for transition from pediatric to adult care, which we developed on the basis of the International Society of Nephrology (ISN)/International Pediatric Nephrology Association (IPNA) consensus guidelines influenced by our own experience. This transition program was established in our center in July 2017. The entire transition process is structured and accompanied by a transition key worker (social worker). From 12 years of age we train pediatric renal transplant recipients in medical knowledge, self-management skills and networking with self-help groups. The training is adapted to the individual patient‘s intellectual ability, lasts about 10 years and takes place with increasing intensity. Repeatedly we perform standardized informational interviews and check patient’s knowledge of transplant-related topics. Psychosocial and educational issues are evaluated concomitantly. The actual transfer takes place in a pediatric-adult-transition clinic. Relevant medical and psychosocial aspects are discussed and the future treatment regimen is established. The date of transfer is adapted to the individual patient’s need; it varies between 18 and 24 years of age. In periods of increased risk for non-adherence the transfer is postponed to intensify the efforts for training and assistance. After transfer a standardized evaluation of each individual patient takes place focusing on medical and psychosocial issues and on satisfaction with the transition process. Collection of these data is still in progress and will be analyzed systematically at a later stage in order to evaluate the impact of this new transition program on the stability of transplant function. That analysis might serve as a basis for negotiations about refunding with health insurance companies.

MRP2 24 CT is Associated with an Increased Risk of Cytomegalovirus Infection Among Renal Transplant Recipients

2018 ◽  
Vol 102 ◽  
pp. S405-S406
Author(s):  
Beatriz Rodriguez-Cubillo ◽  
Virginia V de la Orden ◽  
Beatriz B Mediero ◽  
Isabel I Pérez-Flores ◽  
Natividad N Calvo-Romero ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Cytomegalovirus Infection ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Increased Risk

scholarly journals High Serum PCSK9 Is Associated With Increased Risk of New-Onset Diabetes After Transplantation in Renal Transplant Recipients

Diabetes Care ◽  
2017 ◽  
Vol 40 (7) ◽  
pp. 894-901 ◽  
Author(s):  
Michele F. Eisenga ◽  
Dorien M. Zelle ◽  
John H. Sloan ◽  
Carlo A.J.M. Gaillard ◽  
Stephan J.L. Bakker ◽  
...  
Keyword(s):  
Renal Transplant ◽  
High Serum ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Onset Diabetes ◽  
Increased Risk ◽  
New Onset

Infectious Diseases in Hospitalized Renal Transplant Recipients

Medicine ◽  
1982 ◽  
Vol 61 (6) ◽  
pp. 360-372 ◽  
Author(s):  
PHILLIP K. PETERSON ◽  
RONALD FERGUSON ◽  
DAVID S. FRYD ◽  
HENRY H. BALFOUR ◽  
JOHN RYNASIEWICZ ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Infectious Diseases ◽  
Renal Transplant Recipients ◽  
Transplant Recipients

scholarly journals 1379. Vaccination Rates among Liver Transplant Recipients at a Tertiary Care Hospital in Newark, NJ

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S775-S776
Author(s):  
Tilly Varughese ◽  
Michael Song ◽  
Joachim Sackey
Keyword(s):  
Hepatitis B ◽  
Liver Transplant ◽  
Hepatitis A ◽  
Hepatitis B Vaccination ◽  
Care Hospital ◽  
Transplant Recipients ◽  
Vaccination Rates ◽  
Increased Risk ◽  
Transplant Candidates ◽  
To Receive

Abstract Background Transplant candidates and recipients are at increased risk of infectious complications of vaccine-preventable diseases due to their longstanding immunosuppressive regimens. We assessed the rates of vaccination in our liver transplant patients at University Hospital (UH) in Newark, NJ. Methods Retrospective chart-review including patients &gt; 18 years old who underwent liver transplantation at UH for a 3-year period from 01/01/2017 to 07/20/2020. Data collected included demographics, clinical outcomes, eligibility and receipt of vaccinations before and after transplantation, protection titers after administration of hepatitis vaccinations and presence of an ID outpatient consultation. We looked at the following receipt of vaccinations: Prevnar-13, Pneumovax-23, Influenza, TDaP, Shingrix, Varivax, Havrix and Engerix/Heplisav. Characteristics of study participants was analyzed using descriptive statistics and Chi-Square/Fisher’s Exact tests were used to test associations. Results 119 unique medical charts were reviewed and no patients were excluded. Of those patients who were eligible to receive Hepatitis A vaccination, only 44.8% were documented to receive vaccination and of those eligible to receive Hepatitis B vaccination, only 47.8% received it. Influenza vaccination pre-transplantation was 46% and 66.1% in post-transplant recipients. For the other vaccinations, during the pre-transplant period, 17.6 % of patients received Prevnar-13, 36.1% Pneumovax-23 and 20.2% TDaP and 26.1% received Shingrix. Patients who had ID consultation were significantly more likely to receive appropriate Hepatitis A and Hepatitis B vaccinations (p values 0.026 and 0.005). Conclusion We are not meeting national vaccination standards set by the American Society of Transplantation (AST) for optimal vaccination in this population. Our study can inform of possible solutions to increase vaccination rates in this population such as the simple addition of a smartphrase within EMR notes to remind providers to order appropriate vaccinations and eventually, a more long term solution of creation of a dedicated vaccination clinic and/or routine ID pre-transplant evaluations for all transplant candidates. Disclosures All Authors: No reported disclosures

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