scholarly journals Slow Recovery from Critical Coronavirus Disease 2019 Pneumonia in an Immunosuppressed Renal Transplant Recipient with Early Acute Cardiorenal Syndrome

2020 ◽  
Vol 10 (6) ◽  
pp. 470-475 ◽  
Author(s):  
Lan Zhu ◽  
Hongge Shu ◽  
Huijun Li ◽  
Tao Qiu ◽  
Jiangqiao Zhou ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Transplant Recipient ◽  
Renal Transplant Recipient ◽  
Immunosuppressive Agents ◽  
Kidney Injury ◽  
Cardiorenal Syndrome ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Slow Recovery ◽  
Global Spread

With the global spread of SARS-Cov-2 infections, increasing numbers of COVID-19 cases have been reported in transplant recipients. However, reports are lacking concerning the treatment and prognosis of COVID-19 pneumonia in renal transplant recipients with acute cardiorenal syndrome. We report here the complete clinical course of a renal transplant recipient with critical COVID-19 pneumonia. In the early phase of SARS-Cov-2 infection, the patient exhibited extensive lung lesions and significant acute kidney and heart injuries, which required treatment in the ICU. After correcting the arrhythmia and heart failure, the patient recovered quickly from the acute kidney injury with a treatment of intensive diuresis and strict control of fluid intake. Without cessation of oral immunosuppressive agents, the patient presented a delayed and low antibody response against SARS-Cov-2 and reappeared positive for the virus twice after being discharged. Nevertheless, the patient’s pneumonia continued to improve and he fully recovered in 69 days. This effectively treated case may be meaningful and referable for the treatment of COVID-19 pneumonia in other transplant recipients with acute cardiorenal syndrome.

Detection of Toxoplasma Gondii Antibodies and DNA Among Renal Transplant Recipient and blood donor in Khartoum State, Sudan

2021 ◽  
pp. 135-141
Author(s):  
Elghazali Mohammed ◽  
Mustafa Yassin ◽  
Khalid Anan ◽  
Dina N Abdelrahman ◽  
Abdelrahim M. ElHussein ◽  
...  
Keyword(s):  
Toxoplasma Gondii ◽  
Renal Transplant ◽  
Transplant Recipient ◽  
Renal Transplant Recipient ◽  
Blood Donor ◽  
Blood Donors ◽  
Solid Organ ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Toxoplasma Gondii Infection

Background and Aim: Toxoplasma gondii infection arises in transplant recipient groups, but at varying frequencies. Reactivation of latent T. gondii infection in transplant patients is uncommon, but does occur. The incidence of reactivation is greater in patient groups receiving more aggressive immunosuppressive therapy. Early diagnosis and treatment should be considered in T. gondii-antibody-positive patients subjected to solid organ transplantation. The aim of this study was to estimate the seroprevalence of Toxoplasma gondii infection in renal transplant recipients in Khartoum, Sudan, using serological and molecular methods. Methods: This was a descriptive cross sectional, hospital based study, blood sample were collected from 108 participants; out of them 58 renal transplant recipient individuals and 50 healthy Blood donor attending Sudanese Kidney Association Hospital and Sudan Heart Center Blood Bank. Demographic data were collected by structured questionnaire. All samples were tested for anti-Toxoplasma IgG and IgM antibodies using ELISA, and PCR for detection of Toxoplasma DNA was performed. Results: The seropositivity of IgG anti-T. gondii antibodies was higher in renal transplant recipients than in blood donors (36.2% vs 32.0%). Anti-toxoplasma IgM was positive in one renal transplant recipient individual (1.70%), and no samples exhibit reactive IgM antibody for blood donors. None of the samples exhibited positivity to T.gondii DNA. Conclusion: the study showed a relatively high seroprevalence of T.gondii antibodies in renal transplant recipients and blood donor volunteers, on the other hand, the prevalence was much higher in the study conducted in pregnant woman in Sudan. Our study highlighted that asymptomatic blood donors, may constitute a significant risk of transmitting toxoplasmosis to susceptible recipients.

scholarly journals Severe hyperparathyroidism associated with prolonged hungry bone syndrome in a renal transplant recipient.

1997 ◽  
Vol 8 (10) ◽  
pp. 1626-1631
Author(s):  
A M Miles ◽  
M S Markell ◽  
N Sumrani ◽  
J Hong ◽  
E A Friedman
Keyword(s):  
Renal Transplantation ◽  
Renal Transplant ◽  
Transplant Recipient ◽  
Renal Transplant Recipient ◽  
Pathological Fracture ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Hungry Bone Syndrome ◽  
Persistent Hyperparathyroidism ◽  
Hungry Bone

Although widely believed to resolve within 6 to 12 months of successful renal transplantation, hyperparathyroidism may persist or develop after renal transplantation and eventually require parathyroidectomy. Avid calcium retention by demineralized bones (hungry bone syndrome) is well-recognized after parathyroidectomy and usually resolves after a few weeks. This report documents the case of a renal transplant recipient with persistent hyperparathyroidism who developed a pathological fracture of the pelvis and required parathyroidectomy 1 year after transplant and then manifested severe and prolonged hungry bone syndrome lasting for more than 20 months postoperatively. The clinical features and treatment of hyperparathyroidism in renal transplant recipients are discussed, as are diagnosis, pathogenesis, and management of hungry bone syndrome. Recognition of renal transplant recipients at greater risk for severe hungry bone syndrome should permit earlier and more aggressive management of this sometimes protracted complication of parathyroid surgery.

scholarly journals Pacemaker-related Candida parapsilosis fungaemia in an immunosuppressed renal transplant recipient

2021 ◽  
Vol 14 (7) ◽  
pp. e242917
Author(s):  
Josephine Hebert ◽  
Ellen Barr ◽  
Colm Magee
Keyword(s):  
Renal Transplant ◽  
Transplant Recipient ◽  
Renal Transplant Recipient ◽  
Candida Parapsilosis ◽  
Opportunistic Infections ◽  
Blood Cultures ◽  
Renal Transplant Recipients ◽  
Pulmonary Emboli ◽  
Transplant Recipients ◽  
Pacemaker Leads

Renal transplant recipients are at risk for opportunistic infections due to their immunosuppressed state. We describe the case of a 59-year-old renal transplant recipient who presented with sepsis and bilateral pulmonary emboli due to Candida parapsilosis. She was treated with intravenous caspofungin and had a transoesophageal echocardiogram, which revealed vegetations on her pacemaker leads. She then underwent surgery to replace her pacemaker; however, her blood cultures remained positive for C. parapsilosis postoperatively. Her antifungal was switched to liposomal amphotericin B and flucytosine for 6 weeks, which yielded sterile blood cultures, and she was then initiated on lifelong fluconazole. Her recovery was complicated by tacrolimus toxicity 1 month after discharge due to fluconazole-induced CYP3A inhibition.

scholarly journals 1078. Renal Transplant Recipient Resistomes Reveal Expansive Sub-Clinical Burden of Resistance After Treatment for ESBL-Producing Bacterial Infections

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S566-S567
Author(s):  
Michael Woodworth ◽  
Roth Conrad ◽  
Amanda F Strudwick ◽  
Ahmed Babiker ◽  
Stephanie M Pouch ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Antimicrobial Resistance ◽  
Transplant Recipient ◽  
Renal Transplant Recipient ◽  
Antibiotic Treatment ◽  
Median Number ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Gene Profiles ◽  
Stool Samples

Abstract Background Renal transplant recipients have frequent infection and colonization with antibiotic resistant (AR) bacteria. However, little is known about the burden of AR following targeted antibiotic treatment. Methods This was a prospective study conducted as part of a single center clinical trial at Emory University. Demographic and clinical data regarding transplant and AR bacterial infection were abstracted. Stool samples were collected from renal transplant recipients treated with antibiotics for ESBL-producing gram negative infections. Bacterial cultures with AR-selective media and Illumina short-read sequencing were performed on stool samples. Confirmatory phenotypic isolate AR testing was performed with the Vitek2 platform. Resistome profiles were produced by assembling short reads into scaffolds using MetaSPAdes, predicting protein coding sequences using Prodigal and classifying proteins as antimicrobial resistance determinants using AMRFinderPlus. AMRFinderPlus results for patients were then compared to fecal metagenomes from 3 healthy Human Microbiome Project controls. Differences in AR genes in renal transplant patients vs controls were compared. Results Metagenome sequencing was performed for 6 (5 female) patient stool samples. Stools were collected a median of 30 days after infection. The median number of AR genes per patient metagenome was 48.5 (range 23 to 87 genes). The median number of AR genes per control metagenome was 24 (range 16 to 25 genes). We detected 97 unique AR genes across all samples, 63 of which (65%) were detected in patient samples but not controls. All AR genes found in control metagenomes were present in at least one patient metagenome. No AR genes detected in patients were common to all patients. Subsets of clinically relevant genes corresponded with patient stool AR bacteria culture results. Antimicrobial resistance gene detection heatmap for renal transplant recipient stool samples after antibiotic treatment for ESBL infection. Conclusion Viable AR bacteria and diverse AR gene profiles were frequently detected from renal transplant recipient stool samples after antibiotic treatment for infection. These data suggest that AR bacterial colonization and AR gene profiles may require distinct treatments other than systemic antibiotics for eradication. Disclosures All Authors: No reported disclosures

scholarly journals FP247The urinary microbiome during acute kidney injury in renal transplant recipients versus non-transplant recipients

2019 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Daniela Knafl ◽  
Wolfgang Winnicki ◽  
Alexander Zimprich ◽  
Christoph Hotzy ◽  
Wolfgang Barousch ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Transplant ◽  
Kidney Injury ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Urinary Microbiome

Urinary Excretion of Kidney Injury Molecule -1 in Renal Transplant Recipients

2012 ◽  
Vol 94 (10S) ◽  
pp. 1166
Author(s):  
S. Kesiraju ◽  
P. Paritala ◽  
C. Uma Maheswara Rao ◽  
A. S. Murthy ◽  
V. S. Reddy ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Urinary Excretion ◽  
Kidney Injury ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Kidney Injury Molecule 1

Cardiorenal syndrome in renal transplant recipients - It’s the fistula at fault: A case series

2018 ◽  
Vol 32 (11) ◽  
pp. e13417 ◽  
Author(s):  
Padmaraj Samarendra ◽  
Mohan Ramkumar ◽  
Vivek Sharma ◽  
Sarita Kumari
Keyword(s):  
Renal Transplant ◽  
Case Series ◽  
Cardiorenal Syndrome ◽  
Renal Transplant Recipients ◽  
Transplant Recipients

P1763TUBERCULOSIS IN RENAL TRANSPLANT RECEPIENTS - DO RITUXIMAB AND OTHER IMMUNOSUPRESSION HAVE A ROLE?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Anupma Kaul ◽  
Dharmendra Bhaduria ◽  
Narayan Prasad ◽  
Amit Gupta
Keyword(s):  
Renal Transplantation ◽  
Renal Transplant ◽  
Immunosuppressive Agents ◽  
Induction Agent ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Transplant Patients ◽  
Significant Difference ◽  
High Prevalence ◽  
Mean Time

Abstract Background and Aims Rituximab is an anti CD 20 agent used widely in renal transplant recipients. Its use is associated with various infections;however, its association with Tuberculosis (TB) is not well established and has not been studied in post renal transplantation patients. Method This is a single centre, retrospective analysis of 56 renal transplant recipients who received rituximab for various reasons and 287 post renal transplant patients who did not receive rituximab during the study period from January 2013 to June 2017. The association between use of rituximab and incidence of TB was studied. Other factors associated with tuberculosis were also investigated. Results Baseline characteristics were similar in both the groups. Mean time for occurrence of TB was 18.4 + 10.6 months after renal transplantation. Rituximab use was not significantly associated with tuberculosis or any other infection. Higher number of rejection episodes (60% vs 32.72%, p=0.029) was the only factor associated with greater incidence of TB. However, no specific type of rejection was associated with tuberculosis. Use of plasmapheresis in post transplant period for treatment of humoral rejections was associated with significantly higher incidence of TB (33.33% vs 13.41%, p=0.031), however when pre- transplant plasmapheresis was also considered, there was no significant difference. The choice of induction agent was not associated with higher incidence of TB. Conclusion Use of rituximab is not associated with higher incidence of TB when compared to other immunosuppressive agents. Routine screening and prophylaxis may not be advisable especially in a country like India with high prevalence of TB; as it will further delay transplantation and may adversely affect the outcome of the patients.

scholarly journals Acute kidney injury in renal transplant recipients undergoing cardiac surgery

2020 ◽  
Vol 36 (1) ◽  
pp. 185-196
Author(s):  
Gregory L Hundemer ◽  
Anand Srivastava ◽  
Kirolos A Jacob ◽  
Neeraja Krishnasamudram ◽  
Salman Ahmed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Risk Factor ◽  
Renal Transplant ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Trough Levels

Abstract Background Acute kidney injury (AKI) is a key risk factor for chronic kidney disease in the general population, but has not been investigated in detail among renal transplant recipients (RTRs). We investigated the incidence, severity and risk factors for AKI following cardiac surgery among RTRs compared with non-RTRs with otherwise similar clinical characteristics. Methods We conducted a retrospective cohort study of RTRs (n = 83) and non-RTRs (n = 83) who underwent cardiac surgery at two major academic medical centers. Non-RTRs were matched 1:1 to RTRs by age, preoperative (preop) estimated glomerular filtration rate and type of cardiac surgery. We defined AKI according to Kidney Disease: Improving Global Outcomes criteria. Results RTRs had a higher rate of AKI following cardiac surgery compared with non-RTRs [46% versus 28%; adjusted odds ratio 2.77 (95% confidence interval 1.36–5.64)]. Among RTRs, deceased donor (DD) versus living donor (LD) status, as well as higher versus lower preop calcineurin inhibitor (CNI) trough levels, were associated with higher rates of AKI (57% versus 33% among DD-RTRs versus LD-RTRs; P = 0.047; 73% versus 36% among RTRs with higher versus lower CNI trough levels, P = 0.02). The combination of both risk factors (DD status and higher CNI trough level) had an additive effect (88% AKI incidence among patients with both risk factors versus 25% incidence among RTRs with neither risk factor, P = 0.004). Conclusions RTRs have a higher risk of AKI following cardiac surgery compared with non-RTRs with otherwise similar characteristics. Among RTRs, DD-RTRs and those with higher preop CNI trough levels are at the highest risk.

Sign in / Sign up

Export Citation Format

Share Document