Opportunistic infections in the cardiac transplant patient

Thaler, Scott J.; Rubin, Robert H.

doi:10.1097/00001573-199603000-00013

Cited by 22 publications

(4 citation statements)

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“…Among risk factors for 5‐year mortality conditional on survival to 1 year, treatment for infection before transplant discharge has been associated with a 37% increase in the risk of mortality (2). The risk of opportunistic infection in the cardiac transplant patient is determined by the interaction between the epidemiologic exposures that the patient encounters and the patient's state of immunosuppression (3). Risk factors for cumulative infections during the first 6 months after heart transplantation include, among others, older recipient age, ventilator support at transplant, and ventricular assist device at transplant (4).…”

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confidence: 99%

IgG monitoring to identify the risk for development of infection in heart transplant recipients

Sarmiento¹,

Rodrı́guez-Molina²,

Fernàndez-Yáñez

et al. 2006

Transplant Infectious Dis

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Infectious complication represents a significant source of morbidity and mortality in heart transplant recipients. To assess humoral immunity markers that can predict the development of infection, 38 consecutive recipients of heart transplants performed at a single center were prospectively studied. Induction therapy included daclizumab. Immunoglobulin (IgG, IgA, IgM) and complement factors (C3, C4, and factor B) were performed by nephelometry in peripheral blood samples obtained before transplantation, and 7 days and 1 month after transplantation. During a mean follow-up of 16.9 months, 13 patients had at least one episode of infection (34.2%). Eight of these were cytomegalovirus (CMV) infections treated with intravenous ganciclovir, 2 were bacterial pneumonia, 1 patient had bacterial septicemia, 1 patient had urinary tract infection, and 1 patient had pulmonary nocardiosis. No significant association was found between infection and age, sex, immunosuppression, CMV serostatus of donor and recipient, or treated rejection episodes. Pre-transplant IgG (below median value=1140 mg/dL; relative risk [RR] 3.69; 95% confidence interval [CI] 1.01-13.54; P=0.04) and post-transplant IgG levels at day 7 (below median value=679 mg/dL; RR 11.21; CI 1.04-89.48; P=0.022) were associated with an increase in the risk for developing infections. Early monitoring of immunoglobulin levels might help to identify the risk for developing infection in heart transplantation.

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mentioning

confidence: 99%

IgG monitoring to identify the risk for development of infection in heart transplant recipients

Sarmiento¹,

Rodrı́guez-Molina²,

Fernàndez-Yáñez

et al. 2006

Transplant Infectious Dis

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“…Unfortunately this case also highlights the morbidity that may arise from KS. Immunosuppression can be considered as ‘a complex function whose major determinants are the immunosuppressive programme and the presence or absence of infection with a group of immunomodulating viruses’ 45. We feel that our case is an example of this and provides an argument for the consideration of pretreatment screening for HHV8 in patients with AD who are being considered for treatment with CSA, especially in those from endemic areas.…”

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confidence: 80%

Kaposi sarcoma in an patient with atopic dermatitis treated with ciclosporin

et al. 2013

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There are four clinical subtypes of Kaposi sarcoma (KS): classic, endemic, epidemic and iatrogenic. The geographical prevalence of the endemic variant matches areas of human herpes virus type 8 (HHV8) seroprevalence. The iatrogenic variant, seen in immunosuppressed patients, can be associated with significant morbidity and mortality. This is the first report of KS described in the context of atopic dermatitis (AD) treated with ciclosporin (CSA). We report a case of KS in an HHV8 seropositive Congolese patient following immunosuppression with CSA for AD. Treatment has been challenging, protracted and associated with significant morbidity. Immunosuppressive therapies are increasingly used for inflammatory dermatological conditions, including AD. This case highlights the importance of HHV8 screening of patients from endemic regions or those with other risk factors. It also highlights the importance of early recognition of a condition associated with significant morbidity and even mortality to facilitate appropriate treatment.

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“…Da eine effektive Imnmnsuppression immer zu einer Depression der lnfektabwehr im Organismus des Organemp-f~ingers Ctihrt [15], stellt das pr~i-und postoperative Infektmanagement einen wesentlichen Bestandteil einer erfolgreichen Therapie dar. CI OKT 3: OKT 3 richter sich als monoldonaler Antik6rper gegen das CD3-Molekfil des T-Zell-Rezeptorkomplexes.…”

Section: Infektionsdiagnostik Und-therapieunclassified

Immunsuppression nach Herz- und Lungentransplantation

Wendler

Schäfers

1997

Med Klin

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In the last two decades heart and lung transplantation have evolved to an accepted treatment of endstage heart and lung failure. A differentiated immuno-suppressive regimen is the long term basis of successful transplantation and must be adopted to the individual patient. Rejection and immunosuppression with potential side effects must be balanced to achieve optimal outcome in each patient. In the long-term follow up an efficient diagnosis and treatment of rejection probably also results in reduction of chronic organ failure and improvement of general postoperative results. In cases of vasculopathy after heart transplantation or obliterative bronchiolitis after lung transplantation alternative immunosuppressive drugs are options in the medical therapy. We present our postoperative management protocol after heart and lung transplantation. Potential problems, new immunosuppressive options and side-effects of immunosuppression are discussed.

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Opportunistic infections in the cardiac transplant patient

Cited by 22 publications

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IgG monitoring to identify the risk for development of infection in heart transplant recipients

IgG monitoring to identify the risk for development of infection in heart transplant recipients

Kaposi sarcoma in an patient with atopic dermatitis treated with ciclosporin

Immunsuppression nach Herz- und Lungentransplantation

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