Infection Frequency and Profile in Different Age Groups of Kidney Transplant Recipients

Dharnidharka, Vikas R.; Caillard, Sophie; Agodoa, Lawrence Y.; Abbott, Kevin C.

doi:10.1097/01.tp.0000226068.66819.37

Cited by 70 publications

(43 citation statements)

References 18 publications

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“…This is consistent with evidence that age has an appreciable effect on the rate of renal function recovery among recipients of grafts from donors aged more than 50 to 55 yr. 23,24 On the same line, a recent analysis from the USRDS registry involving more than 64,000 renal transplant recipients found that the risk of opportunistic infections increased only among recipients who were more than 50 yr old, whereas there was no relationship between outcome and age among recipients 18 to 50 yr old. 36 That the large majority of donors and recipients in the present study were younger than 50 yr at transplantation provides additional evidence that age did not affect the study findings to any appreciable extent. All considered outcomes were also independent of patient randomization to mycophenolate mofetil or azathioprine therapy (see Table 2).…”

Section: Discussionsupporting

confidence: 61%

ABCB1 Genotypes Predict Cyclosporine-Related Adverse Events and Kidney Allograft Outcome

Cattaneo

Ruggenenti

Baldelli

et al. 2009

Journal of the American Society of Nephrology

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Cyclosporine A (CsA) is a substrate of P-glycoprotein, an efflux transporter encoded by the ABCB1 gene. Compared with carriers of the wild-type gene, carriers of T allelic variants in exons 21 or 26 have reduced P-glycoprotein activity and, secondarily, increased intracellular concentration of CsA; therefore, carriers of T variants might be at increased risk for CsA-related adverse events. We evaluated the associations between ABCB1 genotypes (in exons 12, 21, and 26) and CsA-related outcomes in 147 renal transplant recipients who were receiving CsA-based immunosuppression and were included in the Mycophenolate Steroids Sparing study. During a median of 65.5 mo follow-up, carriers of T allelic variants in exons 21 or 26 had a three-fold risk for delayed graft function (DGF), a trend to slower recovery of renal function and lower GFR at study end, and significantly higher incidences of new-onset diabetes and cytomegalovirus reactivation compared with carriers of the wild-type genotype. T variants in both exons 21 and 26 were independently associated with 3.8-and 3.5-fold higher risk for DGF, respectively (P ϭ 0.022 and P ϭ 0.034). The incidence of acute rejection and the mean CsA dose and blood levels were comparable in genotype groups. In conclusion, renal transplant recipients with T allelic variants in ABCB1 exons 21 or 26 are at increased risk for CsA-related adverse events. Genetic evaluation may help to identify patients at risk and to modulate CsA therapy to optimize graft and patient outcomes. The introduction of cyclosporine A (CsA) therapy in the early 1980s opened a new era in organ transplantation. Compared with steroid-and azathioprine-based regimens, immunosuppressive protocols including this inhibitor of calcineurin-a key enzyme involved in T cell activation 1 -decreased the incidence of acute rejections from 40% to 50% to 20% to 30% and increased one-year survival rates of the grafts from 60% to between 80% and 90%. 2 Thirty years later, CsA remains a cornerstone of immunosuppressive therapy for recipients of both renal and nonrenal transplants worldwide. However, standard recommended doses are associ-

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Section: Discussionsupporting

confidence: 61%

ABCB1 Genotypes Predict Cyclosporine-Related Adverse Events and Kidney Allograft Outcome

Cattaneo

Ruggenenti

Baldelli

et al. 2009

Journal of the American Society of Nephrology

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“…(one third of cases) and E. coli, the second commonest (one-fifth), presumably reflecting geographic differences in the prevalence of uropathogenic organisms. 14 The prevalences of lower respiratory tract and CMV infections were similar to other reports. 11 The eight cases of hospitalization owing to CMV infections were all observed after the end of the 3-month chemoprophylaxis period, as reported elsewhere.…”

Section: Discussionsupporting

confidence: 78%

“…This incidence was lower than that in our study, possibly owing to variable criteria for patient admission and the presence of day care units in many USA centers that have contributed to reduced hospital in-patient admissions. 14,15 These variables reflect the difficulty in comparing infection prevalences among centers and countries. The frequency of infection episodes was higher in Group B compared to Group A and the difference was statistically significant, p ¼ 0.035 first 3 months post-Tx (Table 4).…”

Section: Discussionmentioning

confidence: 99%

Study of intercurrent infection pattern in hepatitis C seropositive renal transplant recipients, relationship with T-cell function

et al. 2016

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Background:We assessed the effect of hepatitis C seropositivity on the percentage of various Tcells in living donor renal transplant recipients (LDRTRs) and their association with intercurrent infections post renal transplantation (post-Tx). Methods: One hundred and thirty-three matching LDRTRs [A (seronegative) (68 patients) and B (seropositive) (65 patients) by ELISA] were studied prospectively 10 days, 6 months and 12 months post-Tx for intercurrent infections, acute rejection and T-cell% by flow cytometry.þ , CD4/CD8 were significantly higher 10 days post-Tx in Group B compared to Group A, p < 0.001. A significant increase in CD8% was seen 6-month post-Tx among Group B compared to Group A. No difference was detected between groups in (CD4 þ , CD8 þ , CD4/CD8, CD3-CD16/65

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“…Ancak rejeksiyonların belirgin düzeyde azalmasına rağmen, bu başarı greft sağkalımına aynı oranda yansımamaktadır 3 . Bunun nedenlerinden biri de hem pediatrik hem de erişkin transplant hastalarında, şu ana kadar bilinen ya da yeni ortaya çıkan enfeksiyon etkenlerine sıklıkla rastlanılmasıdır 4 . Son 15 yıl içeri-sinde tanımlanan ve günümüzde renal transplantasyonun başarısının önündeki en önemli engellerden biri olarak görülen BK virus ile ilişkili nefropatinin (BKVN) etkeni olan BK virus (BKV), yeni ortaya çıkan enfeksiyon etkenlerine iyi bir örnektir 5 .…”

Section: Introductionunclassified

BK Virus Infections in Pediatric Kidney Transplant Recipients

Mutlu¹,

Sağlık²,

Koyun³

et al. 2013

Mikrobiyol Bul

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* Bu çalışmada kullanılan hasta verilerinin bir kısmı, 4. Ulusal Viroloji Kongresi (23-26 Haziran 2011, İstanbul)'nde sunulmuştur. ÖZETPrimer BK virus (BKV) enfeksiyonları genellikle erken çocukluk döneminde kazanılmakta ve asemptomatik olarak geçirilmektedir. Dünyadaki erişkin popülasyonlarda BKV seroprevalansı %90'a kadar ulaşa-bilir. Primer enfeksiyondan sonra virus ürogenital sistemde latent olarak kalmaktadır. Renal transplant alı-cılarında, BKV'nin neden olduğu primer enfeksiyonlar ve reaktivasyonlar, hastaların %10'unu etkileyebilmekte ve önlem alınmadığı taktirde bu hastaların yarısından fazlası BKV nefropatisi (BKVN) nedeniyle böbreklerini kaybetmektedir. BKVN'ye bağlı greft kaybını engellemenin tek yolu, transplantasyon sonrasında BK virus enfeksiyonlarının takibi ve BKVN geliştiren hastaların erken dönemde tanınıp etkin bir biçimde tedavi edilmeleridir. Bu çalışmada, pediatrik renal transplant alıcılarında, transplantasyon sonrası dönemde, idrar ve plazma örneklerinden, gerçek zamanlı polimeraz zincir reaksiyonu (rtPCR) ile BKV enGeliş Tarihi

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Infection Frequency and Profile in Different Age Groups of Kidney Transplant Recipients

Abstract: The two extremes of transplant recipient age display very different risks for infection claim frequency and profile.

Cited by 70 publications

References 18 publications

ABCB1 Genotypes Predict Cyclosporine-Related Adverse Events and Kidney Allograft Outcome

ABCB1 Genotypes Predict Cyclosporine-Related Adverse Events and Kidney Allograft Outcome

Study of intercurrent infection pattern in hepatitis C seropositive renal transplant recipients, relationship with T-cell function

BK Virus Infections in Pediatric Kidney Transplant Recipients

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