scholarly journals Stage-Specific Oligonucleotide Primers for the Diagnosis of Toxoplasmosis Among Iranian Pediatric Heart Transplant Recipients; Evaluation of Cotrimoxazole as a Preventive Therapy

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Mohammad Mahdavi ◽  
Abdoulreza Esteghamati ◽  
Khadijeh Khanaliha ◽  
Shirin Sayyahfar ◽  
Elahe Orang ◽  
...  
Keyword(s):  
Heart Transplant ◽  
Nested Pcr ◽  
Organ Transplant ◽  
Preventive Therapy ◽  
Solid Organ ◽  
Toxoplasma Infection ◽  
Peripheral Blood Mononuclear ◽  
Blood Samples ◽  
Serologic Tests ◽  
Pediatric Heart Transplant

Background: Toxoplasmosis is an opportunistic infection that affects solid organ transplant (SOT) recipients. The parasite transmission may be occurred from a Toxoplasma-seropositive donor to a Toxoplasma-seronegative recipient by organ transplantation. Objectives: In this study, a nested PCR was carried out using different primers targeting the B1, SAG4, and MAG1 genes to assess Toxoplasma infection in pediatric heart transplantation at Shahid Rajaei Heart Center in Tehran. Methods: Blood samples were collected from 46 pediatric heart transplant patients aged 1 - 17 years referring to Rajaei Cardiovascular and Medical Research Center from 2018 - 2019. All patients were on oral administration of Trimethoprim-sulfamethoxazole (cotrimoxazole). Blood samples were collected, and peripheral blood mononuclear cell (PBMC) isolation using the Ficoll gradient method was performed. DNA was extracted from PBMC, and nested PCR was carried out. Serologic tests were performed using ELISA to determine IgG and IgM anti - Toxoplasma gondii antibodies. Results: The results of serologic tests showed that all 46 patients had negative anti-T. gondii IgM antibody. Furthermore, 6 (13.05%) and 3 (6.5 %) out of the 46 patients were positive for IgG T. gondii antibody before and after transplantation, respectively. All 46 patients were evaluated using PCR using B1, MAG-1, and SAG-4 genes, and PCR results were negative. Conclusions: In general, due to the negative results of Toxoplasma with PCR using B1 and bradyzoite-specific genes (SAG-4 and MAG-1), it is possible that the results obtained in this study are because of prophylaxis with cotrimoxazole.

scholarly journals Neutropenic Enterocolitis in a Pediatric Heart Transplant Recipient on Multiple Immunosuppressants

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Emily E. Miller ◽  
Leigh Christopher Reardon
Keyword(s):  
Heart Transplant ◽  
Case Reports ◽  
Organ Transplant ◽  
Pneumatosis Intestinalis ◽  
Heart Transplant Recipient ◽  
Cytotoxic Agents ◽  
Severe Neutropenia ◽  
Solid Organ ◽  
Neutropenic Enterocolitis ◽  
Pediatric Heart Transplant

Neutropenic enterocolitis (NE) historically primarily affects pediatric patients with leukemia who are undergoing chemotherapy or who have recently received bone marrow transplants. Although a few case reports have shown NE occurring outside of this typical population, to our knowledge, this is the first published case of NE occurring in the setting of pediatric heart transplant. This patient was diagnosed several months after pediatric heart transplant, with radiographs showing evidence of pneumatosis intestinalis. Although NE does not typically affect solid organ transplant patients, this patient had a variety of risk factors that may have predisposed her to development of NE such as severe neutropenia, supratherapeutic tacrolimus level, immunosuppression with cytotoxic agents, and elevated Epstein-Barr viral load. Fortunately, this patient improved with bowel rest, fluids, antibiotics, and alteration of her immunosuppressive regimen. However, NE can be fatal, and thus it is an important condition to consider, even in patients without leukemia or on chemotherapeutic regimens.

scholarly journals An Analysis of Adherence to Vaccination Recommendations in a Thoracic Organ Transplant Cohort

Vaccines ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 622
Author(s):  
Deeksha Jandhyala ◽  
Jessica D. Lewis
Keyword(s):  
Hepatitis B ◽  
Heart Transplant ◽  
Lung Transplant ◽  
Organ Transplant ◽  
Hepatitis B Vaccine ◽  
Hepatitis B Vaccination ◽  
Solid Organ ◽  
Vaccination Rates ◽  
Post Transplant ◽  
Vaccination Recommendations

(1) Background: Vaccination of solid organ transplant (SOT) candidates and recipients is vital to decrease infection-related morbidity and mortality. Here we describe our heart and lung transplant programs’ rates of completion of hepatitis B and pneumococcal vaccinations and identify potential opportunities for improvement. (2) Methods: This is a single-center retrospective study that included all heart and lung transplant recipients between 1 July 2013 and 31 July 2018. We assessed demographics, causes of organ failure, pretransplant hepatitis B immune status, and completion rates for hepatitis B vaccine series, pneumococcal conjugate vaccine (PCV13), and pneumococcal polysaccharide vaccine (PPSV23). (3) Results: A total of 41 patients were included in the heart transplant cohort. Twelve (29.3%) had baseline hepatitis B immunity. Only 8/29 (27.6%) completed the entire 3-dose hepatitis B vaccination series pretransplant. Pretransplant PCV13 and PPSV23 vaccination rates were 58.5% (24/41) and 48.8% (20/41), respectively; no additional patients received PCV13 or PPSV23 post-transplant. In the heart transplant cohort, a majority (82.9%) of patients were evaluated by the Transplant Infectious Diseases consultative service (TxID) pretransplant, and this had a statistically significant association with increased pneumococcal vaccination rates (p = 0.0017, PCV13 and p = 0.0103, PPSV23). In total, 55 patients were included in the lung transplant cohort. Five (9.1%) had baseline hepatitis B immunity; 33/50 (66.0%) completed the hepatitis B vaccine series in the pretransplant setting. Pretransplant PCV13 and PPSV23 vaccination rate was 40.0% (22/55) and 69.1% (38/55), respectively. There was only a 47.3% and 72.3% completion rate overall in the post-transplant setting. (4) Conclusions: There continues to be a need for a comprehensive and coordinated effort to increase vaccine adherence for all SOT candidates in the pretransplant setting.

Aspergillus Infections among Solid Organ Transplant Recipients: A Case Study

1997 ◽  
Vol 7 (4) ◽  
pp. 187-189
Author(s):  
Joann Pfundstein
Keyword(s):  
Mortality Rate ◽  
Transplant Recipient ◽  
Heart Transplant ◽  
Organ Transplant ◽  
Heart Transplant Recipient ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Solid Organ Transplant Recipients

Infection remains a major cause of morbidity and mortality among transplant recipients. Aspergillus infections in particular are associated with a high mortality rate. The diagnosis of Aspergillus among transplant recipients may be difficult, because many patients have multiple complications. This article presents a case of Aspergillus in a heart transplant recipient. The discussion provides an overview of the presentation, diagnosis, and treatment of Aspergillus infections.

scholarly journals Clinical course and challenging management of early COVID-19 infection after heart transplantation: case report of two patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Vincent Tchana-Sato ◽  
Arnaud Ancion ◽  
Julien Tridetti ◽  
Natzi Sakalihasan ◽  
Marie Pierre Hayette ◽  
...  
Keyword(s):  
Heart Transplant ◽  
Clinical Course ◽  
Case Reports ◽  
Organ Transplant ◽  
Case Series ◽  
Perioperative Period ◽  
Severe Form ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Heart Transplant Recipients

Abstract Background There are limited data on Coronavirus disease 2019 (COVID-19) in solid organ transplant patients, especially in heart transplant recipients, with only a few case reports and case series described so far. Heart transplant recipients may be at particular high risk due to their comorbidities and immunosuppressed state. Case presentation This report describes the clinical course and the challenging management of early COVID-19 infection in two heart transplant recipients who tested positive for the SARS-CoV-2 virus in the perioperative period of the transplant procedure. The two patients developed a severe form of the disease and ultimately died despite the initiation of an antiviral monotherapy with hydroxychloroquine coupled with the interruption of mycophenolate mofetil. Conclusions These two cases illustrate the severity and poor prognosis of COVID-19 in the perioperative period of a heart transplant. Thorough screening of donors and recipients is mandatory, and the issue of asymptomatic carriers needs to be addressed.

scholarly journals Clinical course and challenging management of early COVID-19 infection after heart transplantation: Case report of two patients

2020 ◽  
Author(s):  
Vincent Tchana-Sato ◽  
Arnaud Ancion ◽  
Julien Tridetti ◽  
Natzi Sakalihasan ◽  
Marie pierre Hayette ◽  
...  
Keyword(s):  
Heart Transplant ◽  
Clinical Course ◽  
Asymptomatic Carrier ◽  
Case Reports ◽  
Organ Transplant ◽  
Case Series ◽  
Perioperative Period ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Heart Transplant Recipients

Abstract Background: There are limited data on Coronavirus disease 2019 (COVID-19) in solid organ transplant patients and especially in heart transplant recipients with only few case reports and case series described so far. Heart transplant recipients may be at particular high risk due to their comorbidities and immunosuppressed state. Case presentation: This report describes the clinical course and the challenging management of early COVID-19 infection in two heart transplants recipients who were tested positive for the SARS-CoV-2 virus in the perioperative period of the transplant procedure. The two patients developed a severe form of the disease, and ultimately died despite the initiation of an antiviral monotherapy with hydroxychloroquine coupled with the interruption of mycophenolate mofetil. Conclusions: These two cases illustrate the severity and the poor prognosis of COVID-19 in the perioperative period of a heart transplant. Thorough screening of donors and recipients is mandatory and the issue of asymptomatic carrier need to be addressed.

scholarly journals Heart transplant recipient survivor from COVID-19: The first case of Turkey

2020 ◽  
Vol 28 (4) ◽  
pp. 674-679
Author(s):  
Güle Çınar
Keyword(s):  
Transplant Recipient ◽  
Heart Transplant ◽  
Organ Transplant ◽  
Heart Transplant Recipient ◽  
Solid Organ Transplant ◽  
Primary Concern ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Organ Transplant Recipients ◽  
Solid Organ Transplant Recipients

Any highly infectious and rapidly spreading disease is a primary concern for immunocompromised solid organ transplant recipients. The number of data about the spectrum of clinical illness, the treatment modalities, and the outcomes of COVID-19 in this vulnerable population is scant and still remains empirical. Herein, we report the first COVID-19 case of a heart transplant recipient in Turkey who presented with fever, postnasal discharge, and myalgias for two days. The possibility of lung involvement was ruled out by thoracic computed tomography. Despite stable vital signs, we reduced the intensity of immunosuppressive therapy and maintained home self-isolation promptly. We also commenced a five-day course of hydroxychloroquine 200 mg q12h initially. After confirmation of real-time reverse-transcriptase-polymerase-chain-reaction testing of the nasopharyngeal swab positive for COVID-19, the patient was hospitalized. After a loading dose of favipiravir 1,600 mg b.i.d., the patient received a five-day course of favipiravir 600 mg q12h. He was discharged with cure after 23 days of hospital isolation and treatment. In conclusion, treatment process can be affected by the daily electrocardiography, hand-held portable echocardiography, myocardial injury markers, and pulse oximeter for self-monitoring in the follow-up of previous heart transplant recipients suffering from COVID-19. The lack of treatment protocols in the solid organ transplant recipients with COVID-19 infection and the controversies about the protective effect of immunosuppression invite a global and update discussion.

scholarly journals Donor-Derived Coccidioides immitis Endocarditis and Disseminated Infection in the Setting of Solid Organ Transplantation

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Joanna K. Nelson ◽  
Genevieve Giraldeau ◽  
Jose G. Montoya ◽  
Stan Deresinski ◽  
Dora Y. Ho ◽  
...  
Keyword(s):  
Heart Transplant ◽  
Solid Organ Transplantation ◽  
Organ Transplant ◽  
Positive Culture ◽  
Solid Organ ◽  
Coccidioides Immitis ◽  
Disseminated Infection ◽  
Rare Manifestation ◽  
History Of ◽  
High Index Of Suspicion

Abstract Background.  Endocarditis is a rare manifestation of infection with Coccidioides. This is the first reported case of donor-derived Coccidioides endocarditis obtained from a heart transplant. Methods.  We present a unique case of donor-derived Coccidioides immitis endocarditis and disseminated infection in a heart transplant patient. We also conducted a review of the literature to identify other cases of donor-derived coccidioidomycosis in solid organ transplant recipients and reviewed their clinical characteristics. Results.  Fifteen prior cases of donor-derived coccidioidomycosis were identified. A majority of these cases were diagnosed by positive culture (83%). Mortality was high at 58%. Conclusions.  Clinicians should maintain a high index of suspicion for disseminated coccidioidomycosis in patients who received transplants with organs from donors with a history of residing in endemic regions.

scholarly journals Coronavirus disease 2019 outcomes in heart transplant recipients: a single-center case series

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Farah Naghashzadeh ◽  
Shadi Shafaghi ◽  
Babak Sharif-Kashani ◽  
Payam Tabarsi ◽  
Leila Saliminejad ◽  
...  
Keyword(s):  
Heart Transplant ◽  
Organ Transplant ◽  
Case Series ◽  
Outpatient Setting ◽  
Clinical Severity ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Transplant Patients ◽  
Treatment Data ◽  
Heart Transplant Recipients

Abstract Background With the rapidly expanding pandemic of severe acute respiratory syndrome coronavirus-2, a chronic immunosuppressed state in solid organ transplant recipients is a concern. We reported coronavirus disease 2019 in heart transplant recipients and described the patients’ course from diagnosis to either hospital admission or improvement in symptoms. Case presentation This study retrospectively identified 13 white (Iranian) heart transplant patients with coronavirus disease 2019 between December 2019 and October 2020. The mean age of patients was 43.7 years (19–65 years); seven (70%) were men. Laboratory and treatment data were collected for those admitted or managed as outpatients. Outcomes were also recorded for all patients. This report demonstrates a range of symptoms, clinical severity, and disease course in heart transplant recipients with coronavirus disease 2019, including ten hospitalized patients and three patients, managed entirely in the outpatient setting. One patient passed away, and none of them experienced an episode of clinically overt rejection. Conclusions We would like to emphasize the importance of being alert in these patients to consider testing in a broad range of clinical presentations and gathering more data for better management.

scholarly journals Adherence to Immunosuppression Medications among Heart Transplant Recipients: Challenges, Opportunities, and Potential Role of Digital Approaches in the COVID-19 Era

2021 ◽  
Vol 8 (6) ◽  
pp. 68
Author(s):  
Tasmeen Hussain ◽  
Keira Nassetta ◽  
Sherif M. Badawy
Keyword(s):  
Heart Transplant ◽  
Potential Role ◽  
Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Adherence Behavior ◽  
Unique Challenge ◽  
Heart Transplant Recipients

Society and medical practice have been restructured dramatically to avoid further spread of the COVID-19 virus; telehealth/telemedicine, mask wearing, and nationwide social distancing practices have become widespread. However, we still face unprecedented challenges in fields where patients require frequent and active follow-up visits for monitoring, including that of solid-organ transplant, and in particular, heart transplant. Adherence to immunosuppression remains a unique challenge in heart transplantation, especially during the COVID-19 pandemic. Failure to adhere to immunosuppression can have disastrous consequences, including graft rejection and death. In this article, we discuss challenges related to adherence to immunosuppression medications among heart transplant recipients, as well as opportunities to leverage digital approaches and interventions to monitor and optimize adherence behavior and health outcomes in this population.

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