scholarly journals A call for caution in the immunocompromised: COVID-19 associated with mortality in a vaccinated lung transplant recipient

2021 ◽  
Author(s):  
John I Hogan ◽  
Camille N Kotton
Keyword(s):  
Transplant Recipient ◽  
Lung Transplant ◽  
Fatal Outcome ◽  
Lung Transplant Recipient ◽  
Transplant Recipients ◽  
Radiographic Evidence ◽  
Secondary Infections

Abstract We describe a vaccinated lung transplant recipient who experienced a fatal outcome associated with COVID-19. Tocilizumab was administered. The patient exhibited clinical and radiographic evidence of colitis during the course of multiple secondary infections. This report emphasizes the need for more conservative precautions to prevent COVID-19 infection in transplant recipients.

scholarly journals Lung Transplant Recipient with Pulmonary Alveolar Proteinosis

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Sofya Tokman ◽  
M. Frances Hahn ◽  
Hesham Abdelrazek ◽  
Tanmay S. Panchabhai ◽  
Vipul J. Patel ◽  
...  
Keyword(s):  
Transplant Recipient ◽  
Lung Transplant ◽  
Pulmonary Alveolar Proteinosis ◽  
Mammalian Target Of Rapamycin ◽  
Organ Transplant ◽  
Lung Transplant Recipient ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Solid Organ Transplant Recipients ◽  
Alveolar Proteinosis

Pulmonary alveolar proteinosis (PAP) is a progressive lung disease characterized by accumulated surfactant-like lipoproteinaceous material in the alveoli and distal bronchioles. This accumulation is the result of impaired clearance by alveolar macrophages. PAP has been described in 11 solid organ transplant recipients, 9 of whom were treated with mammalian target of rapamycin inhibitors. We report a case of a lung transplant recipient treated with prednisone, mycophenolate mofetil (MMF), and tacrolimus who ultimately developed PAP, which worsened when MMF was replaced with everolimus.

scholarly journals Multifactorial Hyponatremia in a Lung Transplant Recipient: A Case Report of Pseudohyponatremia, SIADH and Secondary Adrenal Insufficiency

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A143-A144
Author(s):  
Rani Shayto
Keyword(s):  
Abdominal Pain ◽  
Transplant Recipient ◽  
Lung Transplantation ◽  
Lung Transplant ◽  
Lymphoproliferative Disorders ◽  
Lung Transplant Recipient ◽  
Transplant Recipients ◽  
History Of ◽  
Lung Transplant Recipients ◽  
Posttransplant Lymphoproliferative Disorders

Abstract Background: Lung transplant recipients are prone to developing multifactorial hyponatremia from immunosuppressive therapies and posttransplant lymphoproliferative disorders. Clinical Case: A 77-year-old male with a history of lung transplantation in 2017 presented for a 3-month history of confusion, decline in executive function and chronic abdominal pain. Vital signs were BP 137/81 mmHg, HR 81 bpm, RR 14 per minute, SPO2 99% and afebrile. The patient was clinically euvolemic with a presenting sodium was 129 mmol/L, and was treated with 2.5L IV 0.9% saline. Home immunosuppression with cyclosporine, azathioprine and prednisone 5 mg/d were continued. Sodium declined to 126 mmol/L on day 4 prompting endocrine consult. Labs prior to fluid administration were consistent with iso-osmolar hyponatremia: sOsm 283 mOsm/kg and uOsm 409 mOsm/kg. Pseudohyponatremia was suspected and electrophoresis and immunofixation revealed a free kappa light chain gammopathy. Evaluation when sodium was 126 mmol/L was now consistent with hypotonic hyponatremia: sOsm 273 mOsm/kg, uOsm 398 mOsm/kg, and urine sodium 56mmol/L. TSH was normal and AM cortisol was 11.9 ug/dL (3.7–19.4 ug/dL), drawn while on maintenance prednisone. Lab findings and improvement of abdominal pain after receiving high dose prednisone for CT contrast-allergy prophylaxis raised our suspicion for SIADH and undertreated secondary AI. Retrospective chart review revealed tacrolimus use after lung transplant before its discontinuation 9 months prior to admission. Chronic hyponatremia was noted a few months post lung transplantation, with a nadir of 120 mmol/L and only mild improvement despite tacrolimus discontinuation and empiric fludrocortisone use. The patient was treated with a 1L fluid restriction, doubling of prednisone to 10 mg/d and cessation of fludrocortisone for lack of concern for primary. Abdominal symptoms resolved, mental status improved, and serum sodium rose to 132 mmol/L over the next few days, later normalizing to 135–140 mmol/L on follow up. The patient was eventually diagnosed with Waldenström macroglobulinemia. Conclusion: Hyponatremia in lung transplant recipients can be multifactorial. Calcineurin inhibitors and steroids are part of typical immunosuppressive regimens and can lead to hyponatremia through salt wasting nephropathy or SIADH(1), and undertreated secondary AI, respectively. Posttransplant lymphoproliferative disorders occur in up to 9% of cases(2) and must be suspected as an etiology of hyponatremia. References: 1.Cowan AJ, Johnson CK, Libby EN. Plasma cell diseases and organ transplant: A comprehensive review. Am J Transplant. 2018;18(5):1046–58.2.Aris RM, Maia DM, Neuringer IP, Gott K, Kiley S, Gertis K, et al. Post-transplantation lymphoproliferative disorder in the Epstein-Barr virus-naïve lung transplant recipient. Am J Respir Crit Care Med. 1996;154(6 Pt 1):1712–7.

scholarly journals BDUMP: A Rare Case of Vision Loss in a Lung Transplant Recipient

2021 ◽  
Vol 40 (4) ◽  
pp. S509-S510
Author(s):  
M. Barraza ◽  
J. Rosenheck ◽  
B.C. Keller ◽  
I. Livshitz ◽  
M.M. Howsare
Keyword(s):  
Transplant Recipient ◽  
Rare Case ◽  
Lung Transplant ◽  
Vision Loss ◽  
Lung Transplant Recipient

Splenic abscess caused by Toxocara spp. in a lung transplant recipient, Marseille, France

2021 ◽  
Author(s):  
Quentin Balacheff ◽  
Jean‐Baptiste Lovato ◽  
Benjamin Coiffard ◽  
Coralie L’Ollivier ◽  
Nadim Cassir ◽  
...  
Keyword(s):  
Transplant Recipient ◽  
Lung Transplant ◽  
Splenic Abscess ◽  
Lung Transplant Recipient

scholarly journals Hemophagocytic Lymphohistiocytosis in a Lung Transplant Recipient

2021 ◽  
Vol 40 (4) ◽  
pp. S510
Author(s):  
D. Rudym ◽  
M. Lesko ◽  
S. Chang ◽  
Z. Kon ◽  
K. Sureau ◽  
...  
Keyword(s):  
Transplant Recipient ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Lung Transplant ◽  
Lung Transplant Recipient

Acute Rehabilitation in a Lung Transplant Recipient Infected with Covid-19: Case Report

2021 ◽  
pp. 1-10
Author(s):  
Cristiane Meirelles ◽  
Sidra Dhiraprasiddhi ◽  
Adannaya E. Nzeogu ◽  
Sara Clements ◽  
Colleen Wallace ◽  
...  
Keyword(s):  
Case Report ◽  
Transplant Recipient ◽  
Lung Transplant ◽  
Lung Transplant Recipient ◽  
Acute Rehabilitation
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