Visceral Leishmaniasis in a Renal Transplant Recipient

Campderá, F. Gómez; Berenguer, Juan; Anaya, Fernando; Valderrábano, Fernando

doi:10.1159/000013329

Cited by 8 publications

(22 citation statements)

References 5 publications

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“…At the end of the process, we included 66 retrospective case reports and 4 retrospective case series. According to the modified Newcastle–Ottawa Scale, 11 items were classified as low-quality [ 7 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ], 34 as average-quality [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ], and 25 as high-quality studies [ 4 , 10 , 59 , 60 , 61 …”

Section: Resultsmentioning

confidence: 99%

“…Patients’ age ranged from 12 to 76 years, with a single pediatric case [ 23 ] and 18 recipients older than 60 years [ 10 , 17 , 31 , 33 , 35 , 47 , 58 , 63 , 64 , 66 , 70 , 72 , 73 , 75 , 81 ]. In the study by Alves da Silva et al [ 22 ] enrolling 20 patients, the mean age at diagnosis was 37 (±10.7) years.…”

Section: Resultsmentioning

confidence: 99%

“…The donor type was available for 112/159 (70.4%) patients: 64 received a deceased donor kidney [ 7 , 17 , 22 , 27 , 28 , 30 , 31 , 35 , 39 , 40 , 46 , 47 , 50 , 51 , 52 , 53 , 54 , 60 , 61 , 63 , 65 , 66 , 69 , 72 , 73 , 78 , 79 , 81 ] and 50 had a living donor [ 4 , 17 , 21 , 22 , 23 , 26 , 29 , 30 , 34 , 38 , 40 , 54 , 57 , 59 , 62 , 67 , 68 , 70 , 71 , 72 , 76 , 77 , 79 ].…”

Section: Resultsmentioning

confidence: 99%

“…Maintenance immunosuppression was very heterogeneous. Most patients were on a CNI-based triple-agent scheme with tacrolimus ( n = 54) [ 17 , 20 , 21 , 23 , 24 , 25 , 26 , 27 , 30 , 31 , 34 , 40 , 41 , 49 , 58 , 59 , 62 , 66 , 72 , 73 , 79 , 81 ] or cyclosporin ( n = 45) [ 4 , 17 , 29 , 30 , 33 , 35 , 36 , 39 , 40 , 45 , 46 , 47 , 50 , 51 , 53 , 54 , 60 , 61 , 63 , 64 , 65 , 69 , 70 , 71 , 74 , 75 , 78 , 79 ], AZA ( n = 51) […”

Section: Resultsmentioning

confidence: 99%

“…Administration of mTORi was reported in four cases [ 43 , 72 , 77 ]. Data were missing for 14 patients [ 7 , 10 , 15 , 16 , 22 , 32 , 52 , 54 ] and partially reported for 8 recipients [ 17 , 26 , 28 , 47 , 64 ]. Characteristics of KT recipients with Leishmaniasis are summarized in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

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Epidemiology, Clinical Characteristics, Diagnostic Work Up, and Treatment Options of Leishmania Infection in Kidney Transplant Recipients: A Systematic Review

Favi

Santolamazza²,

Botticelli³

et al. 2022

TropicalMed

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Current knowledge on Leishmania infection after kidney transplantation (KT) is limited. In order to offer a comprehensive guide for the management of post-transplant Leishmaniasis, we performed a systematic review following the latest PRISMA Checklist and using PubMed, Scopus, and Embase as databases. No time restrictions were applied, including all English-edited articles on Leishmaniasis in KT recipients. Selected items were assessed for methodological quality using a modified Newcastle–Ottawa Scale. Given the nature and quality of the studies (case reports and retrospective uncontrolled case series), data could not be meta-analyzed. A descriptive summary was therefore provided. Eventually, we selected 70 studies, describing a total of 159 cases of Leishmaniasis. Most of the patients were adult, male, and Caucasian. Furthermore, they were frequently living or travelling to endemic regions. The onset of the disease was variable, but more often in the late transplant course. The clinical features were basically similar to those reported in the general population. However, a generalized delay in diagnosis and treatment could be detected. Bone marrow aspiration was the preferred diagnostic modality. The main treatment options included pentavalent antimonial and liposomal amphotericin B, both showing mixed results. Overall, the outcomes appeared as concerning, with several patients dying or losing their transplant.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Epidemiology, Clinical Characteristics, Diagnostic Work Up, and Treatment Options of Leishmania Infection in Kidney Transplant Recipients: A Systematic Review

Favi

Santolamazza²,

Botticelli³

et al. 2022

TropicalMed

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Updated diagnosis and graft involvement for visceral leishmaniasis in kidney transplant recipients: a case report and literature review

et al. 2022

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Purpose Visceral leishmaniasis (VL) has become a rising concern to transplantation teams, being associated with graft dysfunction and reduced survival of renal transplant recipients. Here, we describe a case of VL occurring in a kidney transplant (KT) recipient in Italy, a country in which Leishmania infantum is endemic and we reviewed the literature on the clinical course and diagnosis of VL in KT recipients residing or travelling to southern Europe. Results The VL case was diagnosed 18 months after transplant and 28 days after the onset of symptoms by quantitative PCR (qPCR) on peripheral blood. A graft biopsy showed renal involvement, and PCR performed on graft tissue displayed the presence of Leishmania DNA. The retrospective confirmation of Leishmania-positive serology in a serum sample collected before transplantation, as well as the absence of anti-Leishmania IgG in the graft donor strongly suggest that reactivation of a latent parasitic infection caused VL in the current case. Conclusion VL is often underdiagnosed in transplant recipients, despite the presence of latent Leishmania infection being reported in endemic countries. This case report, as well as the literature review on leishmaniasis in KT recipients, underline the importance of rapid VL diagnosis to promptly undergo treatment. Serology is scarcely sensitive in immunocompromised patients, thus molecular tests in peripheral blood should be implemented and standardized for both VL identification and follow-up.

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