Survival Rate of Renal Transplant and Factors Affecting Renal Transplant Failure

Pakfetrat, Maryam; Malekmakan, Leila; Jafari, Neda; Sayadi, Mehrab

doi:10.6002/ect.2021.0430

Cited by 4 publications

(1 citation statement)

References 71 publications

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“…Kidney transplantation represents the replacement treatment of choice in End Stage Kidney Disease (ESKD). Renal survival in the first year after transplantation is, in fact, greater than 95% in living donor transplants and 89% in deceased donor transplants [1].…”

Section: Introductionmentioning

confidence: 97%

EBV Reactivation in Transplant Recipients following SARS-CoV-2 Infection: A Retrospective Study

Stefanelli,

Alessi,

Di Bella

et al. 2023

Pathogens

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Reactivation and primary infection with a high Epstein Barr Virus (EBV) DNA level in kidney transplant patients could cause severe complications, including the development of Post-Transplantation Lymphoproliferative Disease (PTLD). While in the general population the reactivation of EBV after SARS-CoV-2 infection has been reported, very few data are available in transplant recipients. Our retrospective study aimed to evaluate a possible EBV reactivation in kidney transplant patients following SARS-CoV-2 infection and a possible impairment of the immune system. In addition, the effects of changes in immunosuppressive therapy on EBV DNA reactivation and vaccination were also evaluated. A total of 166 kidney transplant patients followed at the Kidney–Pancreas Transplant Ambulatory Nephrology Unit at Padova University Hospital were retrospectively considered for an observation period of 6 months from January 2020 to April 2023. EBV DNA level was measured by Rt-PCR and evaluated 6 months before and after SARS-CoV-2 infection. Patients’ serological states were established via quantification of anti-VCA and anti-EBNA (chemiluminescence). Patients’ immune systems were characterized by CD4+/CD8+ lymphocyte ratio (flow cytometry). EBV DNA was reactivated in 50% of the 166 patients with COVID-19 who completed the study. Older patients with more severe forms of COVID-19 had higher EBV reactivation (p < 0.05). EBV reactivation significantly increased in patients with severe SARS-CoV-2 infection requiring hospitalization compared to patients managed at home (p < 0.001). CD4+/CD8+ lymphocyte ratio was reduced in patients with a younger age of transplant (p < 0.01) and on a higher dose of steroids (p < 0.01). The results of our study confirm the role of immunodepression, especially in recent transplant patients and those on high steroids, in EBV reactivation. These results combined with the few available in the literature might contribute to providing an optimal management of immunosuppressive treatment for these patients in order to obtain an immune state unfavorable to the activation of latent viruses, including EBV.

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Section: Introductionmentioning

confidence: 97%

EBV Reactivation in Transplant Recipients following SARS-CoV-2 Infection: A Retrospective Study

Stefanelli,

Alessi,

Di Bella

et al. 2023

Pathogens

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Laparoscopic Living Donor Nephrectomy in a Donor With Situs Inversus Totalis: It is Not a Contraindication to Kidney Transplant

Liu

Zhang

Yin

et al. 2023

Transplantation Proceedings

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Non-hepatic Solid Organ Transplant in Patients with Inflammatory Bowel Disease: An ECCO CONFER Multicentre Case Series

Ribaldone

Vieujean

Julsgaard

et al. 2023

Journal of Crohn's and Colitis

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Background and Aims Solid organ transplantation, with the exception of liver, has rarely been reported in patients affected by inflammatory bowel diseases (IBD). Methods This is an ECCO-CONFER project collecting cases of solid organ transplants (with the exclusion of liver) that were performed in IBD patients. We evaluated the change in the IBD therapy, need for bowel resection due to medically refractory IBD, or need for hospitalization due to IBD relapse (“severe IBD course”) before and after transplantation. Results Thirty-four organ transplantations (28 kidney, five heart, one lung) in 33 IBD patients were collected (67% male; 55% Crohn’s disease, mean age 53 ± 16 years). The median follow-up was 4.3 years (IQR 3.2 – 10.7). Twenty-nine patients (87.9%) were treated with tacrolimus, 25 (76%) with systemic steroids, 22 (67%) with mycophenolate mofetil, 11 (33%) with everolimus, six with cyclosporine (18%). One patient was treated with infliximab, two patients with adalimumab, two patients with vedolizumab, one patient with ustekinumab. Overall, a severe IBD course was observed in three (9.3%) patients before transplantation and in four (11.7%) in the post-transplant setting (p = 0.26). Three cases of cancer (excluding skin non-melanoma) (9.1%) were recorded in post-transplantation period versus two in the pre-transplant (6.1%, p = 0.04). Six patients (18.2%) died during the period of observation. No deaths were associated with IBD or complications of the transplant. Conclusions In IBD patients, solid organ transplantation does not seem to impact on the IBD severity. However, the risk of malignancy needs further investigation.

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Survival Rate of Renal Transplant and Factors Affecting Renal Transplant Failure

Cited by 4 publications

References 71 publications

EBV Reactivation in Transplant Recipients following SARS-CoV-2 Infection: A Retrospective Study

EBV Reactivation in Transplant Recipients following SARS-CoV-2 Infection: A Retrospective Study

Laparoscopic Living Donor Nephrectomy in a Donor With Situs Inversus Totalis: It is Not a Contraindication to Kidney Transplant

Non-hepatic Solid Organ Transplant in Patients with Inflammatory Bowel Disease: An ECCO CONFER Multicentre Case Series

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