Increase of infectious complications in ABO-incompatible kidney transplant recipients--a single centre experience

Habicht, Antje; Bröker, Verena; Blume, Cornelia; Lorenzen, Johan M.; Schiffer, Mario; Richter, N.; Klempnauer, J.; Haller, Hermann; Lehner, Frank; Schwarz, Anke

doi:10.1093/ndt/gfr215

Cited by 129 publications

(116 citation statements)

References 47 publications

Supporting

Mentioning

105

Contrasting

Unclassified

Order By: Relevance

“…Previously, Kamar et al noted that BK virus was the most common virus detected in RTX-treated patients [8], and Habicht et al found a nonsignificantly higher rate of BK in ABO-incompatible recipients administered RTX [11]. The rates of BK viremia and nephropathy in our cohort are congruent with rates previously reported in the renal transplant population [18][19][20][21].…”

Section: Discussionsupporting

confidence: 89%

“…Varicella zoster infection occurred in 4 of 55 RTX patients compared to 1 in 386 no RTX patients. Zoster infections have been reported in other series of RTX-treated patients [11] and were even fatal in some cases [22,23]. While none of our zoster cases suffered such fate, 3 deaths occurred among RTX patients owing to EBV-associated PTLD, RSV, and JCV-associated PML.…”

Section: Discussionmentioning

confidence: 49%

“…The safety profile of RTX in this population remains unclear, however, with conflicting data on its association with infectious complications [3,[7][8][9][10][11][12][13][14]. This study of 55 kidney transplant patients treated with RTX for its common peri-and posttransplant indications favors an association an increased risk of infections with RTX.…”

Section: Discussionmentioning

confidence: 89%

“…T-lymphocyte depleting preparations in particular have been associated with an increased risk, as opposed to nonlymphocyte depleting agents which demonstrated similar infectious risks when compared to placebo [5,6]. RTX has generally been considered to have an acceptable safety profile in hematological and autoimmune disorders; however, whether it can be used without an increased risk of infectious complications remains controversial in the immunosuppressed population [3,[7][8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Effects of Rituximab on the Development of Viral and Fungal Infections in Renal Transplant Recipients

Patel

DeVos

Knight

et al. 2013

ISRN Transplantation

View full text Add to dashboard Cite

Background. Rituximab is becoming increasingly utilized in renal transplant recipients; however, its association with infections remains unclear. Methods. We reviewed the incidence of viral and fungal infections in kidney transplant recipients treated with ( = 55) or without ( = 386) rituximab (RTX) in addition to standard immunosuppression. Results. Infections occurred in 134 (30%) patients, with a greater proportion in RTX versus no RTX patients (47% versus 28%; = 0.005). Viral infections occurred in 44% and 27% of RTX and no RTX patients, respectively ( = 0.012). This was largely driven by the frequency of BK viremia and noncytomegalovirus/non-BK viruses in RTX patients (27% versus 13% ( = 0.011) and 15% versus 2% ( < 0.001), resp.). Fungal infections also occurred more often in RTX patients (11% versus 3 %; = 0.009). Multivariate analysis revealed deceased donor recipient (odds ratio = 2.5; < 0.001) and rituximab exposure (odds ratio = 2.2; = 0.016) as independent risk factors for infection. Older patients, deceased donor recipients, those on dialysis longer, and those with delayed graft function tended to be at a greater risk for infections following rituximab. Conclusions. Rituximab is associated with an increased incidence of viral and fungal infections in kidney transplantation. Additional preventative measures and/or monitoring infectious complications may be warranted in those receiving rituximab.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 49%

Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effects of Rituximab on the Development of Viral and Fungal Infections in Renal Transplant Recipients

Patel

DeVos

Knight

et al. 2013

ISRN Transplantation

View full text Add to dashboard Cite

show abstract

“…Risks and benefits of performing transplantation across the blood-group barrier are well documented (6-9), but a link between ABO-incompatible kidney transplantation and risk for BKVAN is contentious. Some groups have observed a higher risk for BK viremia or nephropathy (10)(11)(12), whereas others have not (8,13). The implication is that ABO-incompatible kidney recipients may be at greater risk for development of BK viremia or nephropathy because of increased intensity of induction protocols and subsequent immunosuppressant burden (both maintenance and treatment of cellularand antibody-mediated rejections).…”

Section: Introductionmentioning

confidence: 99%

Incidence and Outcomes of BK Virus Allograft Nephropathy among ABO- and HLA-Incompatible Kidney Transplant Recipients

Sharif

Alachkar²,

Bagnasco³

et al. 2012

Clinical Journal of the American Society of Nephrology

106

View full text Add to dashboard Cite

SummaryBackground and objectives ABO-incompatible kidney transplant recipients may have a higher incidence of BK virus allograft nephropathy (BKVAN) compared with ABO-compatible recipients. It is unclear whether HLAincompatible recipients share this risk or whether this phenomenon is unique to ABO-incompatible recipients.Design, setting, participation, & measurements This study analyzed adult incompatible kidney transplant recipients from 1998 to 2010 (62 ABO-incompatible and 221 HLA-incompatible) and identified patients in whom BKVAN was diagnosed by biopsy (per protocol or for cause). This was a retrospective analysis of a prospectively maintained database that compared BKVAN incidence and outcomes between ABO-and HLA-incompatible recipients, respectively. BKVAN link to rejection and graft accommodation phenotype were also explored. The Johns Hopkins Institutional Review Board approved this study.Results Risk for BKVAN was greater among ABO-incompatible than HLA-incompatible patients (17.7% versus 5.9%; P=0.008). Of BKVAN cases, 42% were subclinical, diagnosed by protocol biopsy. ABO-incompatibility and age were independent predictors for BKVAN on logistic regression. C4d deposition without histologic features of glomerulitis and capillaritis (graft accommodation-like phenotype) on 1-year biopsies of ABO-incompatible patients with and without BKVAN was 40% and 75.8%, respectively (P=0.04). Death-censored graft survival (91%) and serum creatinine level among surviving kidneys (1.8 mg/dl) were identical in ABO-and HLAincompatible patients with BKVAN (median, 1399 and 1017 days after transplantation, respectively).Conclusions ABO-incompatible kidney recipients are at greater risk for BKVAN than HLA-incompatible kidney recipients. ABO-incompatible recipients not showing the typical graft accommodation-like phenotype may be at heightened risk for BKVAN, but this observation requires replication among other groups.

show abstract

Case-matched comparison of ABO-incompatible and ABO-compatible living donor liver transplantation

Kim

Kwon

Han

et al. 2016

Journal of British Surgery

View full text Add to dashboard Cite

show abstract

Increase of infectious complications in ABO-incompatible kidney transplant recipients--a single centre experience

Cited by 129 publications

References 47 publications

Effects of Rituximab on the Development of Viral and Fungal Infections in Renal Transplant Recipients

Effects of Rituximab on the Development of Viral and Fungal Infections in Renal Transplant Recipients

Incidence and Outcomes of BK Virus Allograft Nephropathy among ABO- and HLA-Incompatible Kidney Transplant Recipients

Case-matched comparison of ABO-incompatible and ABO-compatible living donor liver transplantation

Contact Info

Product

Resources

About