What Is the Impact of Hypogammaglobulinemia on the Rate of Infections and Survival in Solid Organ Transplantation? A Meta-Analysis

2013 ◽  
Vol 13 (10) ◽  
pp. 2601-2610 ◽  
Author(s):  
D. F. Florescu ◽  
A. C. Kalil ◽  
F. Qiu ◽  
C. M. Schmidt ◽  
U. Sandkovsky
Keyword(s):  
Organ Transplantation ◽  
Meta Analysis ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
The Impact

scholarly journals COVID‐19 in solid organ transplantation: an analysis of the impact on transplant activity and wait lists

2020 ◽  
Vol 34 (1) ◽  
pp. 209-212
Author(s):  
Maria Irene Bellini ◽  
Francesco Tortorici ◽  
Marco Capogni
Keyword(s):  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
The Impact

scholarly journals The Impact of Donor and Recipient Genetic Variation on Outcomes After Solid Organ Transplantation

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Yanni Li ◽  
Lianne M. Nieuwenhuis ◽  
Brendan J. Keating ◽  
Eleonora A.M. Festen ◽  
Vincent E. de Meijer
Keyword(s):  
Genetic Variation ◽  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
The Impact

scholarly journals Multicenter Analysis of 80 Solid Organ Transplantation Recipients With Post-Transplantation Lymphoproliferative Disease: Outcomes and Prognostic Factors in the Modern Era

2010 ◽  
Vol 28 (6) ◽  
pp. 1038-1046 ◽  
Author(s):  
Andrew M. Evens ◽  
Kevin A. David ◽  
Irene Helenowski ◽  
Beverly Nelson ◽  
Dixon Kaufman ◽  
...  
Keyword(s):  
Overall Survival ◽  
Organ Transplantation ◽  
Bone Marrow Involvement ◽  
Solid Organ Transplantation ◽  
Progression Free Survival ◽  
Lymphoproliferative Disease ◽  
Solid Organ ◽  
Post Transplantation ◽  
Cart Analysis ◽  
The Impact

Purpose Adult post-transplantation lymphoproliferative disease (PTLD) has a reported 3-year overall survival (OS) of 35% to 40%. The impact of rituximab on the outcome of PTLD is not well defined. Methods We examined the clinical features and outcomes among a large cohort of solid organ transplantation (SOT) –related patients with PTLD who were recently treated at four Chicago institutions (from January 1998 to January 2008). Results Eighty patients with PTLD were identified who had a median SOT-to-PTLD time of 48 months (range, 1 to 216 months). All patients had reduction of immunosuppression as part of initial therapy, whereas 59 (74%) of 80 patients received concurrent first-line rituximab with or without chemotherapy. During 40-month median follow-up, 3-year progression-free survival (PFS) for all patients was 57%, and the 3-year overall survival (OS) rate was 62%. Patients who received rituximab-based therapy as part of initial treatment had 3-year PFS of 70% and OS 73% compared with 21% (P < .0001) and 33% (P = .0001), respectively, without rituximab. Notably, of all relapses, only 9% (4 of 34 patients) occurred beyond 12 months from PTLD diagnosis. On multivariate regression analysis, three factors were associated with progression and survival: CNS involvement (PFS, 4.70; P = .01; OS, 3.61; P = .04), bone marrow involvement (PFS, 2.95; P = .03; OS, 3.14; P = .03), and hypoalbuminemia (PFS, 2.96; P = .05; OS, 3.64; P = .04). Furthermore, a survival model by multivariate CART analysis that was based on number of adverse factors present (ie, 0, 1, ≥ 2) was formed: 3-year PFS rates were 84%, 66%, 7%, respectively, and 3-year OS rates were 93%, 68%, 11%, respectively (P < .0001). Conclusion This large, multicenter, retrospective analysis suggests significantly improved PFS and OS associated with early rituximab-based treatment in PTLD. In addition, clinical factors at diagnosis identified patients with markedly divergent outcomes.

Gastrointestinal Side Effects of Post-Transplant Therapy

2016 ◽  
Vol 25 (3) ◽  
pp. 367-373 ◽  
Author(s):  
Valerian Ciprian Lucan ◽  
Luisa Berardinelli
Keyword(s):  
Side Effects ◽  
Immunosuppressive Therapy ◽  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Post Transplant ◽  
Medication Side ◽  
Gastrointestinal Side Effects ◽  
Inflammatory Drugs ◽  
The Impact

Modern immunosuppressive therapy has produced a real revolution in renal and organ transplantation but it comes with the price of multiple side effects. There are many gastrointestinal (GI) complications that are the consequence of transplant immunosuppressant medication. In fact, for any immunosuppressant therapy, certain standardized precepts and attitudes that aim to reduce the incidence and the impact of the medication side effects must be applied. Many patients undergo renal transplantation and the physicians have to be aware of the advantages and the risks associated. This article reviews the main GI complications that may arise as a consequence of immunosuppressive therapy after solid organ transplantation, focusing on renal and renal/pancreas transplantation, as well as the ways in which the incidence of these complications can be reduced. Management of the post-transplant therapy is mandatory in order to increase not only the grafts’ and the patients’ survival, but also their quality of life by the occurrence of fewer complications. Abbreviations: Aza: azathioprine; CMV: cytomegalovirus; CsA: cyclosporine A; GI: gastrointestinal; MMF: mycophenolate mofetil; NSAID: non-steroidal anti-inflammatory drugs; Tac: tacrolimus.

scholarly journals Pediatric solid organ transplantation in the era of COVID-19: A follow-up study

2021 ◽  
Author(s):  
Mojtaba Shafiekhani ◽  
Kourosh Kazemi ◽  
Ali Bahador ◽  
Mohammad Hadi Imanieh ◽  
Parisa Karimzadeh
Keyword(s):  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Organ Transplant ◽  
Screening Methods ◽  
Solid Organ ◽  
High Grade Fever ◽  
Gi Symptoms ◽  
Hospitalization Period ◽  
The Impact

Abstract Background: We aimed to evaluate the impact of COVID-19 outbreak on pediatric transplant outcomes and determine whether to continue pediatric transplant activity or not, and how policies intended our center has been effective in preventing COVID-19 among organ transplant recipients.Methods: We conducted a single-center, retrospective, cohort study of hospitalized pediatrics after organ transplantation at Shiraz transplant center since March to August 2020. All liver and kidney transplanted children were included the study and their laboratory and clinical related COVID-19 characteristics were followed up till 3 months after transplantation during hospitalization period and then weekly by the transplant committee.Results:Fifty-one patients underwent transplantation including 11 kidney and 40 liver recipients. The mean age of the pediatric cases was 6.72±5.47 years. A total of 11 patients died due to post-transplant complications, while none of the patients presented any sign or symptoms in favor of COVID-19 in the hospital course after transplantation. Six transplants including 2 kidney and 4 liver were canceled when positive PCR tests were detected in their donors before the surgery. In the three months of follow up, two patients presented with symptoms including high grade fever, malaise, rhinorrhea, and GI symptoms. Both patients had two negative PCR, and no radiologic or laboratory results regarding COVID-19 were also detected. One had positive influenza PCR, while the second one had a positive serologic test for EBV; CT, computed tomography Conclusion: transplant programs could continue their activities during the COVID-19 pandemic with specific case selection, accurate screening methods and following protective protocols.

scholarly journals Everolimus and Malignancy after Solid Organ Transplantation: A Clinical Update

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Hallvard Holdaas ◽  
Paolo De Simone ◽  
Andreas Zuckermann
Keyword(s):  
Organ Transplantation ◽  
Mtor Inhibitor ◽  
De Novo ◽  
Case Reports ◽  
Meta Analysis ◽  
Mammalian Target Of Rapamycin ◽  
Solid Organ Transplantation ◽  
Population Data ◽  
Solid Organ ◽  
Mtor Inhibition

Malignancy after solid organ transplantation remains a major cause of posttransplant mortality. The mammalian target of rapamycin (mTOR) inhibitor class of immunosuppressants exerts various antioncogenic effects, and the mTOR inhibitor everolimus is licensed for the treatment of several solid cancers. In kidney transplantation, evidence from registry studies indicates a lower rate ofde novomalignancy under mTOR inhibition, with some potentially supportive data from randomized trials of everolimus. Case reports and small single-center series have suggested that switch to everolimus may be beneficial following diagnosis of posttransplant malignancy, particularly for Kaposi’s sarcoma and nonmelanoma skin cancer, but prospective studies are lacking. A systematic review has shown mTOR inhibition to be associated with a significantly lower rate of hepatocellular carcinoma (HCC) recurrence versus standard calcineurin inhibitor therapy. One meta-analysis has concluded that patients with nontransplant HCC experience a low but significant survival benefit under everolimus monotherapy, so far unconfirmed in a transplant population. Data are limited in heart transplantation, although observational data and case reports have indicated that introduction of everolimus is helpful in reducing the recurrence of skin cancers. Overall, it can be concluded that, in certain settings, everolimus appears a promising option to lessen the toll of posttransplant malignancy.

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