scholarly journals Infectious Complications in Kidney Transplantation

Author(s):  
Amr El-Husseini ◽  
Rashad Hass

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250829
Author(s):  
Nancy Perrottet ◽  
Mario Fernández-Ruiz ◽  
Isabelle Binet ◽  
Michael Dickenmann ◽  
Suzan Dahdal ◽  
...  

Acute antibody-mediated rejection (AMR) remains a challenge after kidney transplantation (KT). As there is no clear-cut treatment recommendation, accurate information on current therapeutic strategies in real-life practice is needed. KT recipients from the multicenter Swiss Transplant Cohort Study treated for acute AMR during the first post-transplant year were included retrospectively. We aimed at describing the anti-rejection protocols used routinely, as well as patient and graft outcomes, with focus on infectious complications. Overall, 65/1669 (3.9%) KT recipients were treated for 75 episodes of acute AMR. In addition to corticosteroid boluses, most common therapies included plasmapheresis (56.0%), intravenous immunoglobulins (IVIg) (38.7%), rituximab (25.3%), and antithymocyte globulin (22.7%). At least one infectious complication occurred within 6 months from AMR treatment in 63.6% of patients. Plasmapheresis increased the risk of overall (hazard ratio [HR]: 2.89; P-value = 0.002) and opportunistic infection (HR: 5.32; P-value = 0.033). IVIg exerted a protective effect for bacterial infection (HR: 0.29; P-value = 0.053). The recovery of renal function was complete at 3 months after AMR treatment in 67% of episodes. One-year death-censored graft survival was 90.9%. Four patients (6.2%) died during the first year (two due to severe infection). In this nationwide cohort we found significant heterogeneity in therapeutic approaches for acute AMR. Infectious complications were common, particularly among KT recipients receiving plasmapheresis.



1999 ◽  
Vol 31 (8) ◽  
pp. 3204 ◽  
Author(s):  
R Al-Aasfari ◽  
S Hadidy ◽  
S Yagan


2017 ◽  
Vol 30 (4) ◽  
pp. 601-606 ◽  
Author(s):  
Flávio de Castro Rodrigues Ferreira ◽  
Marina Pontello Cristelli ◽  
Mayara Ivani Paula ◽  
Henrique Proença ◽  
Claudia Rosso Felipe ◽  
...  


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Natalia Silva ◽  
Catarina Isabel Ribeiro ◽  
Jorge Malheiro ◽  
Manuela Almeida ◽  
Sofia Pedroso ◽  
...  

Abstract Background and Aims ABO incompatiblitity was considered a barrier to kidney transplant. However, the shortage of available organs for transplantation and the excellent long term results further establish ABO-incompatible (ABOi) as a safe and effective therapeutic strategy. The aim of the present study was to evaluate the outcomes of ABOi transplantation in terms of graft survival and function, rejection episodes and infections complications. Method The authors present a single center retrospective observational study, that include the analyse of 12 patients who underwent ABOi kidney transplantation between November 2014 and July 2019. All patients received Rituximab (375mg/m2) pre-operation and started Tacrolimus, Mycophenolate Mofetil and Prednisolone one week before surgery. Plasmapheresis was done to remove anti-A or B antibodies until their titles were <1:8 during the first post-operative week and <1:16 at the second. Results : A total of 12 patients were included in the study, 75,0% male with 43 years (IQR 31-50) The most common blood group mismatch was A to O (n=4; 33%). In the first year, 2 of patients (17%) developed acute rejection. The follow-up time was 17 months (IQR 7-36). Five patients (42%) developed infectious complications. None patients developed cytomegalovirus or BK polyomavirus infections. At the end graft and patient survival were 100%. Conclusion ABOi kidney transplantation has become a routine procedure. By this approach, about 30% of living donors who were refused in the past can now donate their kidneys and thereby significantly expand the living donor pool. Immunosuppressive protocol of this Center can be considered safe.



2007 ◽  
Vol 9 (4) ◽  
pp. 302-309 ◽  
Author(s):  
G. Pourmand ◽  
S. Salem ◽  
A. Mehrsai ◽  
M. Taherimahmoudi ◽  
R. Ebrahimi ◽  
...  


2019 ◽  
Vol 18 (5) ◽  
pp. 309-315
Author(s):  
John P. Vella ◽  
Alexander C. Wiseman




2015 ◽  
Vol 47 (5) ◽  
pp. 1429-1432 ◽  
Author(s):  
A. Yalci ◽  
Z.K. Celebi ◽  
B. Ozbas ◽  
O.L. Sengezer ◽  
H. Unal ◽  
...  


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Maria Lanau Martinez ◽  
Marta Artamendi Larrañaga ◽  
Celia Garijo Pacheco ◽  
Iñigo Gaston Najarro ◽  
Guillermo Pereda Bengoa ◽  
...  

Abstract Background and Aims Kidney transplantation (KT) is considered to be the best option for renal replacement therapy (RRT) in patients with advanced chronic kidney disease, surpassing any dialysis technique in quality and life expectancy. However, results in terms of how pre-KT dialysis technique influences graft and recipient survival are mixed. Some studies show a higher incidence of vascular complications in the immediate post-transplant period and higher rates of acute rejection in patients coming from peritoneal dialysis (PD) versus those coming from hemodialysis (HD) while others observe a lower incidence of delayed graft function in the PD group of patients versus those on HD. Our objective is to analyze if there are differences in immediate post-kidney transplantation and at 6 months of follow-up depending on the pre-KT dialysis technique, PD versus HD. Method Observational study of all patients with KT of cadaveric donor from the beginning of the KT program in our Center, from August 2011 to August 2019. We analyzed the characteristics of donors and recipients according to the technique (PD/HD), the evolution and complications in the immediate post-KT, as well as results at 6 months of follow-up in terms of complications, renal function and survival of the recipient and the graft. For statistical analysis we used SPSS 25. We compared qualitative variables by means of Xi2 test, and quantitative variables by t of Student, or U of Mann-Whitney if the variables did not follow a normal distribution. A value of p <0.05 was considered significant. Results 121 patients were included, 71 of whom were in the HD group, versus 50 who were in the PD group. The recipients in the HD group were significantly older (57.2 vs 51.6 years, p 0,02) and stayed on dialysis longer (33.8 vs 26.8 months). We observed no difference in the recipient's cardiovascular history, except for increased smoking in the HD group (52.1% vs. 24%). The donor-recipient immune profile was similar in both groups. As for the incidence of delayed graft function, it was significantly lower in the PD group (14.9% vs 34.3%), finding no difference in renal function at hospital discharge or in days of admission. In the first 6 months of follow-up, we found no differences in terms of vascular, urological or infectious complications. There were also no differences in the incidence of acute rejection, renal function measured by creatinine (HD 1.47 vs DP 1.50 mg/dl) and proteinuria (HD 200 vs DP 216 mg/24 hours). Graft and recipient survival at 6 months of TR follow-up were similar in both groups. Conclusion In our experience, we have not found differences in the evolution at 6 months of the KT according to the modality of dialysis , nor greater incidence of vascular, immunological or other complications, with a survival of graft and receptor superimposable between both groups, PD or HD.



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