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Bacillary angiomatosis (BA) is an uncommon systemic disease caused by Bartonella henselae (BH) or Bartonella quintana (BQ) that occurs primarily in immunocompromised hosts. Few cases of BA recipients have been reported in adult solid transplant recipients over the years, with most cases presenting years after transplant. We describe a case of a kidney transplant recipient who developed cutaneous BA very early in the post-transplant period despite not having any exposures. Retrospective testing of donor and recipient's serum was performed and raised the concern for possible How to cite this article: Morillas JA, Hassanein M, Syed B, et al. Early post-transplant cutaneous bacillary angiomatosis in a kidney recipient: Case report and review of the literature.

Purpose: New estimated glomerular filtration rate (eGFR) equations using serum creatinine (Cr) and/or cystatin C (CysC) have been derived to eliminate adjustment by perceived Black ancestry. We sought to analyze the performance of newer eGFR equations in Black living kidney donor (LD) candidates. Methods: Black LD candidates (n=64) who had measured iothalamate (i) GFR between 1/2015 and 10/2021 were included, and eGFR was calculated using race adjusted (Cr2009, Cr-CysC2012) and race unadjusted (Cr2021, Cr-CysC2021) CKD-EPI equations. Bias (eGFR-iGFR) and accuracy (percent within 30% of iGFR) were calculated. Results: Mean age at LD evaluation was 41±12 yrs, and 45% were male. Mean iGFR was 105±23 ml/min/1.73m 2 . Results are shown in Table 1. CKD-EPICr2021 eGFR showed a greater negative bias, and underestimated iGFR to a level < 80 ml/min/1.73m 2 in 11% with iGFR ≥ 80. Alternatively, the CKD-EPICr-CysC2021 equation showed less bias and high accuracy in the absence of correction for Black ancestry. In donor candidates with iGFR ≥ 80 ml/min/1.73m 2 , none were estimated below 80 by the CKD-EPICr-CysC2021 equation. Eighteen Black candidates went on to donate and had eGFR measured at 6-18 months post-donation. By the Cr2021 equation, substantially more donors had an eGFR < 60 ml/min/1.73m 2 (44%), Table 2. Conclusions: The CKD-EPICr2021 equation appears to underestimate true GFR in Black LD candidates, with the potential to exclude some for falsely low eGFR, and the potential to underestimate GFR post-donation. Alternatively, the recently recalibrated CKD-EPICr-CysC2021 equation appears to perform well in Black LD candidates, without negative bias or underestimation.

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