#13#
Revisiones-Ciencias
Básicas-Microorganismos *** Reviews-Basic Sciences-Microorganisms
TRASPLANTE
RENAL *** RENAL TRANSPLANTATION
(Conceptos
/ Keywords: Renal-Kidney transplantation; Kidney donation-procurement; etc).
Enero /
January 2001 --- Marzo / March 2004
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[1]
TÍTULO / TITLE: - Treatment of hepatitis
B in special patient groups: hemodialysis, heart and renal transplant,
fulminant hepatitis, hepatitis B virus reactivation.
REVISTA
/ JOURNAL: - J Hepatol 2003;39 Suppl 1:S206-11.
AUTORES
/ AUTHORS: - Tillmann HL; Wedemeyer H; Manns MP
INSTITUCIÓN
/ INSTITUTION: - Department of Gastroenterology, Hepatology
and Endocrinology, Medizinische Hochschule Hannover, Carl-Neuberg-Strassel,
30623 Hannover, Germany. N.
Ref:: 81
----------------------------------------------------
[2]
TÍTULO / TITLE: - Subcutaneous black
fungus (phaeohyphomycosis) infection in renal transplant recipients:three
cases.
REVISTA
/ JOURNAL: - Transplantation 2004 Jan 15;77(1):140-2.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000107287.70512.E7
AUTORES
/ AUTHORS: - Yehia M; Thomas M; Pilmore H; Van Der
Merwe W; Dittmer I
INSTITUCIÓN
/ INSTITUTION: - Auckland Renal Transplant Group, Auckland
Hospital, Auckland, New Zealand. mahay@adhb.govt.nz
RESUMEN
/ SUMMARY: - We describe three cases of subcutaneous
phaeohyphomycosis developing in the lower limbs of renal transplant recipients
shortly after transplantation. Each case presented with dark-colored nodules
that subsequently ulcerated. Histopathologic examination revealed dematiaceous
fungal hyphae with a surrounding granulomatous reaction. The fungi were subsequently
identified as Alternaria alternatum in two cases and Phialophora richardsiae in
one case. In one case, the lesions resolved during a prolonged (6-month) course
of itraconazole without the requirement for surgical excision. In the other two
cases, combined medical and surgical treatment resulted in cure. A review of
the literature on phaeohyphomycosis is presented. N. Ref:: 11
----------------------------------------------------
[3]
TÍTULO / TITLE: - Disseminated ochroconis
gallopavum infection in a renal transplant recipient: the first reported case
and a review of the literature.
REVISTA
/ JOURNAL: - Clin Nephrol 2003 Dec;60(6):415-23.
AUTORES
/ AUTHORS: - Wang TK; Chiu W; Chim S; Chan TM; Wong SS;
Ho PL
INSTITUCIÓN
/ INSTITUTION: - Centre of Infection, Department of
Microbiology, Queen Mary Hospital, University of Hong Kong, Hong Kong, SAR,
China.
RESUMEN
/ SUMMARY: - Ochroconis gallopavum is a potentially
fatal dematiaceous fungus causing opportunistic infections in immunocompromised
hosts. We report the first case of disseminated O. gallopavum infection in a
13-year-old renal transplant recipient, which involved the brain, lung and
spleen. He was treated with amphotericin B, itraconazole and voriconazole, a
new antifungal agent first used to treat such an infection. Besides antifungal
treatment, all immunosuppressive agents were stopped and automated peritoneal
dialysis was resumed. The initial infection was under control with both
clinical and radiological improvements after treatment. However, the patient
later acquired Acremonium spp. peritonitis; he failed to respond to high-dose
amphotericin B, and finally succumbed. A total of 13 reported O. gallopavum
human infections, including the one described here, are reviewed. The most
common site of involvement is the brain and the crude mortality rate is up to
46%. As the disease is potentially lethal in immunocompromised hosts, empirical
antifungal coverage should be considered in post-renal transplant recipients
with suspected brain abscess. Early biopsy of lesion for histopathological and
microbiological diagnosis would be essential in managing such cases. N. Ref:: 23
----------------------------------------------------
[4]
TÍTULO / TITLE: - Hepatitis B and renal
transplantation: securing the sword of damocles.
REVISTA
/ JOURNAL: - Hepatology 2002 Nov;36(5):1041-5.
●●
Enlace al texto completo (gratuito o de pago) 1053/jhep.2002.36805
AUTORES
/ AUTHORS: - Perrillo RP N. Ref:: 37
----------------------------------------------------
[5]
- Castellano -
TÍTULO / TITLE:La enfermedad linfoproliferativa
difusa postrasplante renal y su relacion con el virus Epstein-Barr. Experiencia
de un centro. Diffuse lymphoproliferative disease after renal transplantation
and its relation with Epstein-Barr virus. Experience at one center.
REVISTA
/ JOURNAL: - Nefrologia. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://www.aulamedica.es/nefrologia/
●●
Cita: Nefrologia: <> 2002;22(5):463-9.
AUTORES
/ AUTHORS: - Franco A; Jimenez L; Aranda I; Alvarez L;
Gonzalez M; Rocamora N; Olivares J
INSTITUCIÓN
/ INSTITUTION: - Servicio de Nefrologia Hospital General
Alicante Maestro Alonso, 109 03010 Alicante. franco_ant@gva.es
RESUMEN
/ SUMMARY: - Post-transplant lymphoproliferative disorders
(PTLD) are a group of heterogeneous lymphoid proliferations in chronic
immunosuppressed recipients which appear to be related to Epstein Barr Virus
(EBV). Receptor EBV seronegativity, use of antilymphocyte antibodies and CMV
disease have been identified as risk factors that may tigger development of
PTLD. We have studied the incidence of PTLD and its relationship with EBV in
588 adult renal transplant recipients who were transplanted in our hospital
from 1988 to 2001. We have also evaluated the diagnostic and therapeutic
methods used, the risk factors and outcome of the patients who developed PTLD.
We identified 8 recipients (4 males and 4 females), range from 18 to 67 years
(mean age 45.6 years) with a median time between grafting and PTLD of 4.1 years
(0.1-7 years), who developed PTLD (1.3%). Only 1 patient received OKT3 and had
CMV disease, two of them (25%) had been treated with hight doses of
prednisolone, another was EBV seronegative, but the rest of them (50%) had no
risk factors. Two patients were diagnosed at autopsy, the diagnosis of 5 was
based on the histology of biopsy and the last one by CT scans of chest-abdomen
and cytology. The presence of EBV in the lymphoproliferative cells was assessed
in 5 out of the 7 studied patients (71.4%). The outcome of our recipients was
poor. Five out of 8 patients died shortly after diagnosis as a direct
consecuence of PTLD and another of an infectious complication of the treatment
(75%). The 2 patients alive started dialysis and 1 of them died 2 years later of
a non-related cause. In conclusion, PTLD is a relatively frequent disease with
a poor prognosis in renal transplant patients. It seems to have a close
relationship with EBV and can develop in the absence of the classical risk
factors. N. Ref:: 18
----------------------------------------------------
[6]
TÍTULO / TITLE: - The impact of
cytomegalovirus infections and acute rejection episodes on the development of
vascular changes in 6-month protocol biopsy specimens of cadaveric kidney
allograft recipients.
REVISTA
/ JOURNAL: - Transplantation 2003 Jun
15;75(11):1858-64.
●●
Enlace al texto completo (gratuito o de pago) 1097/01.TP.0000064709.20841.E1
AUTORES
/ AUTHORS: - Helantera I; Koskinen P; Tornroth T;
Loginov R; Gronhagen-Riska C; Lautenschlager I
INSTITUCIÓN
/ INSTITUTION: - Department of Virology, Helsinki
University Central Hospital and University of Helsinki, Helsinki, Finland.
RESUMEN
/ SUMMARY: - BACKGROUND: The role of cytomegalovirus
(CMV) in chronic kidney allograft rejection remains controversial. The purpose
of this study was to examine the impact of CMV infection on histopathologic
changes in 6-month protocol biopsy specimens of kidney allografts. METHODS:
Altogether, 52 renal allograft recipients were studied. CMV infection was diagnosed
by CMV antigenemia test, viral cultures from blood and urine, or both. CMV was
demonstrated in the biopsy specimens by antigen detection and hybridization in
situ. Acute rejections were diagnosed by biopsy histology, and biopsy specimens
were graded according to the Banff ‘97 classification. RESULTS: CMV infection
was diagnosed in 41 patients. The 11 patients in whom CMV infection was not
detected were used as controls. Acute rejection was diagnosed in 22 of 41 CMV
patients and in 6 of 11 control patients. CMV was demonstrated in the biopsy
specimens of 19 of 41 CMV patients. CMV was not associated with increased
glomerular, tubular, or interstitial changes. However, the arteriosclerotic
changes in small arterioles were significantly increased in the subgroup of
patients where CMV was demonstrated in the graft as compared with controls
(P<0.01). Analysis of the impact of acute rejection on arteriolar thickening
showed that only a positive history of both acute rejection and CMV found in
the graft was associated with significantly increased vascular changes compared
with CMV-free recipients (P<0.05). CONCLUSIONS: Neither CMV nor acute
rejection alone was associated with increased vascular or other histopathologic
changes in 6-month protocol biopsy specimens of kidney allografts, but a
previous history of both acute rejection and the presence of CMV in the graft
was associated with increased vascular changes.
----------------------------------------------------
[7]
TÍTULO / TITLE: - Adenovirus
pyelonephritis in a pediatric renal transplant patient.
REVISTA
/ JOURNAL: - Pediatr Nephrol 2003 May;18(5):457-61.
Epub 2003 Mar 18.
●●
Enlace al texto completo (gratuito o de pago) 1007/s00467-003-1080-x
AUTORES
/ AUTHORS: - Kim SS; Hicks J; Goldstein SL
INSTITUCIÓN
/ INSTITUTION: - Baylor College of Medicine, Texas, USA.
RESUMEN
/ SUMMARY: - Gross hematuria, graft pain, and rising
serum creatinine are classic signs of acute rejection, obstruction, or bacterial
pyelonephritis for patients with renal transplants. This presentation often
prompts percutaneous renal allograft biopsy. If subsequent evaluation fails to
show evidence of acute rejection, obstruction, or bacterial infection, viral
etiologies should be considered. We report a 14-year-old Hispanic female with a
living-related renal transplant who had gross hematuria, graft tenderness, and
increased serum creatinine, but did not have evidence of acute rejection,
obstruction, or bacterial pyelonephritis. To our knowledge, this is the first
report of adenovirus pyelonephritis in a transplanted kidney of a pediatric
patient, with isolation of adenovirus in the urine and in the allograft using
immunocytochemical techniques. N.
Ref:: 26
----------------------------------------------------
[8]
TÍTULO / TITLE: - HCV-associated renal
diseases after liver transplantation.
REVISTA
/ JOURNAL: - Int J Artif Organs 2003 Jun;26(6):452-60.
AUTORES
/ AUTHORS: - Fabrizi F; Aucella F; Lunghi G;
Bunnapradist S; Martin P
INSTITUCIÓN
/ INSTITUTION: - Division of Nephrology and Dialysis,
Maggiore Hospital, IRCCS, Milano, Italy. fabrizi@policlinico.mi.it N. Ref:: 43
----------------------------------------------------
[9]
TÍTULO / TITLE: - Delayed renal allograft
dysfunction and cystitis associated with human polyomavirus (BK) infection in a
renal transplant recipient: a case report and review of literature.
REVISTA
/ JOURNAL: - Clin Nephrol 2003 Dec;60(6):405-14.
AUTORES
/ AUTHORS: - Gupta M; Miller F; Nord EP; Wadhwa NK
INSTITUCIÓN
/ INSTITUTION: - Division of Nephrology, Department of
Medicine, School of Medicine, State University of New York at Stony Brook, New
York 11794, USA.
RESUMEN
/ SUMMARY: - Human polyomavirus type BK (BKV)
associated nephritis (BKVAN) has recently emerged as an important cause of
renal allograft dysfunction and failure. Early recognition of this entity as a
cause of allograft dysfunction is extremely important since misdiagnosis can
accelerate graft loss. We report a case of BKVAN that presented with symptoms
related to cystitis, and review the risk factors, the diagnostic tools and the
approach to treatment of BK virus associated allograft nephropathy. N. Ref:: 32
----------------------------------------------------
[10]
TÍTULO / TITLE: - Disseminated
acanthamebiasis in a renal transplant recipient with osteomyelitis and
cutaneous lesions: case report and literature review.
REVISTA
/ JOURNAL: - Clin Infect Dis 2002 Sep 1;35(5):e43-9. Epub
2002 Aug 2.
AUTORES
/ AUTHORS: - Steinberg JP; Galindo RL; Kraus ES; Ghanem
KG
INSTITUCIÓN
/ INSTITUTION: - Department of Pathology, Johns Hopkins
Medical Institutions, Baltimore, MD 21209, USA.
RESUMEN
/ SUMMARY: - Disseminated acanthamebiasis is a rare
disease that occurs predominantly in patients with human immunodeficiency virus
(HIV) infection or acquired immunodeficiency syndrome but also in
immunosuppressed transplant recipients. Few reports have focused on
non-HIV-infected patients, in whom the disease is more likely to go unsuspected
and undiagnosed before death. We describe a renal transplant recipient with
Acanthamoeba infection and review the literature. The patient presented with
osteomyelitis and widespread cutaneous lesions. No causative organism was
identified before death, despite multiple biopsies with detailed histological
analysis and culture. Disseminated Acanthamoeba infection was diagnosed after
death, when cysts were observed in histological examination of sections of skin
from autopsy, and trophozoites were found in retrospectively reviewed skin
biopsy and surgical bone specimens. In any immunosuppressed patient, skin
and/or bone lesions that fail to show improvement with broad-spectrum
antibiotic therapy should raise the suspicion for disseminated acanthamebiasis.
Early recognition and treatment may improve clinical outcomes. N. Ref:: 32
----------------------------------------------------
[11]
TÍTULO / TITLE: - B19 virus infection in
renal transplant recipients.
REVISTA
/ JOURNAL: - J Clin Virol. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://www.elsevier.com/gej-ng/29/46/32/show/Products/VIRUSINT/index.htt
●●
Cita: J Clinical Virology: <> 2003 Apr;26(3):361-8.
AUTORES
/ AUTHORS: - Cavallo R; Merlino C; Re D; Bollero C;
Bergallo M; Lembo D; Musso T; Leonardi G; Segoloni GP; Ponzi AN
INSTITUCIÓN
/ INSTITUTION: - Virology Unit, Department of Public Health
and Microbiology, University of Turin, Via Santena 9, 10126, Turin, Italy. rossana.cavallo@unito.it
RESUMEN
/ SUMMARY: - BACKGROUND: B19 virus infection with
persistent anaemia has been reported in organ transplant recipients. Detection
of B19 virus DNA in serum is the best direct marker of active infection.
OBJECTIVE: The present study evaluated the incidence and clinical role of
active B19 virus infection in renal transplant recipients presenting with
anaemia. STUDY DESIGN: Forty-eight such recipients were investigated by nested
PCR on serum samples. The controls were 21 recipients without anaemia. Active
HCMV infection was also investigated as a marker of high immunosuppression.
RESULTS AND CONCLUSIONS: In 11/48 (23%) patients B19 virus DNA was demonstrated
in serum versus only 1/21 (5%) of the controls. Ten of these 11 patients had
already been seropositive at transplantation and active infection occurred in
eight of them during the first 3 months after transplantation. The remaining
patient experienced a primary infection 9 months after transplantation. Eight
(73%) of these 11 patients displayed a concomitant HCMV infection and four
(36%) showed increasing serum creatinine levels but none developed
glomerulopathy; 3/11 (27%) recovered spontaneously from anaemia whereas 8/11
(73%) needed therapy. In conclusion, the relatively high occurrence (23%) of
B19 virus infection in patients presenting with anaemia, suggests that it
should be considered in the differential diagnosis of persistent anaemia in
renal transplant recipients. Presence of the viral DNA should be assessed early
from transplantation and the viral load should be monitored to follow
persistent infection and better understand the relation between active
infection and occurrence of anaemia, and to assess the efficacy of IVIG therapy
and/or immunosuppression reduction in clearing the virus. N. Ref:: 56
----------------------------------------------------
[12]
TÍTULO / TITLE: - Eradication of
parvovirus B19 infection after renal transplantation requires reduction of
immunosuppression and high-dose immunoglobulin therapy.
REVISTA
/ JOURNAL: - Nephrol Dial Transplant. Acceso gratuito
al texto completo a partir de los 2 años de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://ndt.oupjournals.org/
●●
Cita: Nephrology Dialysis Transplantation: <> 2002 Oct;17(10):1840-2.
AUTORES
/ AUTHORS: - Liefeldt L; Buhl M; Schweickert B;
Engelmann E; Sezer O; Laschinski P; Preuschof L; Neumayer HH
INSTITUCIÓN
/ INSTITUTION: - Department of Nephrology, Charite,
Humboldt-University Berlin, Germany. lutz.liefeldt@charite.de N. Ref:: 17
----------------------------------------------------
[13]
TÍTULO / TITLE: - Atypical generalized
zoster with suspicious esophageal involvement and early relapse in an adult
renal transplant recepient.
REVISTA
/ JOURNAL: - Transplant Proc 2002 Jun;34(4):1174-7.
AUTORES
/ AUTHORS: - Oh KH; Ahn C; Kim YS; Han JS; Kim S; Lee
JS; Kim EC; Oh MD; Chung JH
INSTITUCIÓN
/ INSTITUTION: - Department of Internal Medicine, Seoul
National University Hospital, Seoul, North Korea. N. Ref:: 18
----------------------------------------------------
[14]
TÍTULO / TITLE: - Viral infections and
their impact on chronic renal allograft dysfunction.
REVISTA
/ JOURNAL: - Transplantation 2001 Jun 15;71(11
Suppl):SS24-30.
AUTORES
/ AUTHORS: - Soderberg-Naucler C; Emery VC
INSTITUCIÓN
/ INSTITUTION: - Karolinska Institute, Huddinge, Sweden.
RESUMEN
/ SUMMARY: - Viral infections, particularly those
involving HCMV, are an important complication of renal transplantation.
Transplantation protocols and treatment regimens that increase HCMV infection and
disease may promote the development of CRAD and impair long-term renal
allograft survival. Investigators are beginning to illuminate the mechanisms by
which HCMV infection may cause chronic rejection in general and transplant
vascular sclerosis in particular. Migration and proliferation of SMCs within
the intimal layer of blood vessels is an important component of transplant
vascular sclerosis, and HCMV appears to facilitate both of these processes.
Current management strategies for HCMV focus on prevention, either using a
focal preemptive therapeutic approach or by administering antiviral therapies
to all or at-risk patients. N.
Ref:: 74
----------------------------------------------------
[15]
TÍTULO / TITLE: - Mycoplasma hominis
infection in renal transplantation.
REVISTA
/ JOURNAL: - Nephrol Dial Transplant. Acceso gratuito
al texto completo a partir de los 2 años de la fecha de publicación.
●●
Enlace a la Editora de la Revista http://ndt.oupjournals.org/
●●
Cita: Nephrology Dialysis Transplantation: <> 2002 Mar;17(3):495-6.
AUTORES
/ AUTHORS: - Pastural M; Audard V; Bralet MP; Remy P;
Salomon L; Tankovic J; Buisson CB; Lang P
INSTITUCIÓN
/ INSTITUTION: - Service de. Nephrologie, Universite Paris
XII, Creteil, France. N.
Ref:: 12
----------------------------------------------------
[16]
TÍTULO / TITLE: - Candida fasciitis
following renal transplantation.
REVISTA
/ JOURNAL: - Transplantation 2001 Aug 15;72(3):477-9.
AUTORES
/ AUTHORS: - Wai PH; Ewing CA; Johnson LB; Lu AD;
Attinger C; Kuo PC
INSTITUCIÓN
/ INSTITUTION: - Department of Surgery, Georgetown
University Medical Center, Washington, DC, USA.
RESUMEN
/ SUMMARY: - BACKGROUND: We describe a rare case of
necrotizing fasciitis involving Candida albicans, an organism that has been
reported to have a minimal potential for invasive soft tissue infection. In
this case, immunosuppression, chronic renal failure, and a history of diabetes
mellitus were predisposing factors. METHODS: The medical record and
histopathologic material were examined. The clinical literature was reviewed
for previous cases of C albicans necrotizing fasciitis. RESULTS: A review of
the literature showed that in solid organ transplant recipients, localized
fungal soft tissue infection is infrequent, with only 35 cases reported between
1974 and 1992. Necrotizing fasciitis caused by C albicans is extremely rare in
the modern era of solid organ transplantation. CONCLUSIONS: The management of
transplant patients at risk for invasive fungal infection warrants a high index
of suspicion for fungal necrotizing fasciitis in the setting of wound infection
and merits a thorough investigation for atypical pathogens. N. Ref:: 8
----------------------------------------------------
[17]
TÍTULO / TITLE: - Genitourinary
tuberculosis after renal transplantation: report of 3 cases and review.
REVISTA
/ JOURNAL: - Clin Infect Dis 2001 Feb 15;32(4):662-6.
Epub 2001 Feb 7.
AUTORES
/ AUTHORS: - Dowdy L; Ramgopal M; Hoffman T; Ciancio G;
Burke G; Roth D; Mies C; Jones B; Miller J
INSTITUCIÓN
/ INSTITUTION: - Division of Infectious Diseases,
Department of Medicine, University of Miami School of Medicine, Miami, FL
33136, USA. ldowdy@med.miami.edu
RESUMEN
/ SUMMARY: - Mycobacterium tuberculosis infection of
the genitourinary tract is an uncommon disease in renal transplant recipients
and presentation is atypical. Genitourinary tuberculosis is associated with
graft rejection, and this diagnosis should be considered for renal transplant
recipients with unexplained fever and constitutional symptoms. N. Ref:: 8
----------------------------------------------------
[18]
TÍTULO / TITLE: - Polyomavirus BK
nephropathy: a (re-)emerging complication in renal transplantation.
REVISTA
/ JOURNAL: - Am J Transplant 2002 Jan;2(1):25-30.
AUTORES
/ AUTHORS: - Hirsch HH
INSTITUCIÓN
/ INSTITUTION: - Department of Internal Medicine,
University of Basel, Switzerland. hans.hirsch@unibas.ch
RESUMEN
/ SUMMARY: - Persisting polyomavirus replication is now
widely recognized as a (re-)emerging cause of renal allograft dysfunction. Up
to 5% of renal allograft recipients can be affected about 40weeks (range 6-150)
post-transplantation. Progression to irreversible failure of the allograft has
been observed in up to 45% of all cases. The BK virus strain is involved in the
majority of the cases. Risk factors may include treatment of rejection episodes
and increasing viral replication under potent immunosuppressive drugs such as
tacrolimus, sirolimus or mycophenolate. The diagnosis requires the histological
demonstration of nuclear polyomavirus inclusions in affected tubular epithelial
cells. Interstitial inflammatory infiltrates and fibrosis become more prominent
in the persisting disease and may be difficult to distinguish from (coexisting)
rejection. Detection of polyomavirus-inclusion bearing cells (‘decoy cells’) in
the urine and quantification of BK virus DNA in the plasma have been proposed
as surrogate markers for polyomavirus replication and allograft disease,
respectively. Antiviral treatment is not yet established; however, reports of
treatment with cidofovir are encouraging. Current management aims at the
judicious modification and/or reduction of immunosuppression which, in view of
preceding or concurrent rejection, is not without risk. N. Ref:: 51
----------------------------------------------------
[19]
TÍTULO / TITLE: - Chromomycosis due to
Exophiala jeanselmei in a renal transplant recipient.
REVISTA
/ JOURNAL: - Eur J Dermatol 2003 May-Jun;13(3):305-7.
AUTORES
/ AUTHORS: - Pena-Penabad C; Duran MT; Yebra MT;
Rodriguez-Lozano J; Vieira V; Fonseca E
INSTITUCIÓN
/ INSTITUTION: - Department of Dermatology, Complejo
Hospitalario Juan Canalejo, Servicio de Dermatologia, Xubias de Arriba, 84,
15006. a Coruna, España.
RESUMEN
/ SUMMARY: - Chromomycosis is a rare mycotic infection
that is more frequent in tropical and subtropical regions. Dematiaceous fungi
are the causal agents of this mycosis. Several cases of chromomycosis in organ
transplant recipients have been reported. We present a case of chromomycosis by
Exophiala jeanselmei in a Spanish male who had received a renal transplant
several months previously, and was receiving treatment with tacrolimus,
prednisone and mycophenolate mofetil. Very few cases of chromomycosis due to
Exophiala have been reported, and this is, to our knowledge, the first European
case. N. Ref:: 16
----------------------------------------------------
[20]
TÍTULO / TITLE: - A model for
reactivation of CMV from latency.
REVISTA
/ JOURNAL: - J Clin Virol. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://www.elsevier.com/gej-ng/29/46/32/show/Products/VIRUSINT/index.htt
●●
Cita: J Clinical Virology: <> 2002 Aug;25 Suppl 2:S123-36.
AUTORES
/ AUTHORS: - Hummel M; Abecassis MM
INSTITUCIÓN
/ INSTITUTION: - Department of Surgery, Division of Organ
Transplantation, Northwestern University Medical School, Chicago, IL 60611,
USA. m-hummel@northwestern.edu
RESUMEN
/ SUMMARY: - BACKGROUND: Reactivation of CMV from
latency results in serious morbidity and mortality in immunocompromised
transplant recipients. The mechanism by which CMV reactivates from latency has
not been well understood. OBJECTIVE: In this review we discuss three models for
reactivation from latency and present evidence in favor of the model that
reactivation is a multi-step process which is initiated by the allogeneic
response to the transplanted organ. Study design (J. Virol. 75 (2001) 4814).
Mice latently infected with murine cytomegalovirus (MCMV) were used as donors
for allogeneic or syngeneic kidney transplants into immunocompetent recipients.
The contralateral donor kidneys were used as controls. Transplanted kidneys
were removed at various times after transplant and analyzed for expression of
viral genes associated with productive infection and for expression of
inflammatory cytokines. Electrophoretic mobility shift assay was performed on
nuclear extracts of control and transplanted kidneys to examine activation of
AP-1 and NFkappaB. Latently infected mice were also injected with tumor
necrosis factor (TNF) to examine the effect of TNF alone on induction of MCMV
immediate-early (IE) gene expression. Transgenic major immediate early
promoter-lacZ mice carrying a beta-galactosidase reporter gene under the
control of the human cytomegalovirus (HCMV) IE promoter/enhancer were used as
donors for allogeneic kidney transplants to study the effect of allogeneic
transplantation on induction of HCMV IE gene expression. RESULTS: Allogeneic,
but not syngeneic transplantation induces MCMV IE-1 expression and expression
of inflammatory cytokines, including TNF. Allogeneic transplantation activates
transcription factors, including NFkappaB and AP-1. TNF alone can induce MCMV
IE-1 gene expression and activation of NFkappaB and AP-1 in some tissues.
CONCLUSIONS: We propose that induction of IE-1 gene expression is the first
step in reactivation of the virus in an immunocompromised transplant recipient,
and that it occurs as a result of the allogeneic response, which induces
expression of TNF and subsequent activation of NFkappaB, and
ischemia/reperfusion injury, which induces activation of AP-1. We speculate
that the natural stimulus for reactivation in an immunocompetent host is an
inflammatory immune response to infection and that allogeneic transplantation
mimics this process. N.
Ref:: 90
----------------------------------------------------
[21]
TÍTULO / TITLE: - Hepatitis C virus and
renal transplantation.
REVISTA
/ JOURNAL: - Transplant Proc 2002 Sep;34(6):2433-5.
AUTORES
/ AUTHORS: - Van Thiel D; Nadir A; Shah N
INSTITUCIÓN
/ INSTITUTION: - Division of Gastroenterology and
Hepatology, Stritch School of Medicine, Loyola University of Chicago, Loyola
University Medical Center, Maywood, Illinois 60153, USA. dvanthi@lumc.edu N. Ref:: 22
----------------------------------------------------
[22]
TÍTULO / TITLE: - Successful treatment of
Staphylococcus aureus bacterial endocarditis in a renal transplant recipient.
REVISTA
/ JOURNAL: - Transpl Infect Dis 2003 Sep;5(3):144-6.
AUTORES
/ AUTHORS: - D’Cunha PT; Davenport DS; Fisher KA
INSTITUCIÓN
/ INSTITUTION: - Department of Medicine, Division of
Nephrology and Hypertension, Henry Ford Health System, Detroit, Michigan 48202,
USA. pdcunha1@hfhs.org
RESUMEN
/ SUMMARY: - We report the successful treatment of
Staphylococcus aureus endocarditis in a renal transplant recipient with
preservation of his renal allograft. A 44-year-old man presented to the
emergency room with sudden onset of fevers and rigors 7 weeks after renal
transplantation. Infective endocarditis was diagnosed by Duke’s Criteria (Durack
et al. New criteria for the diagnosis of infective endocarditis. Am J Med 1994:
96: 200-209) with multiple positive blood cultures for S. aureus and a mitral
valve vegetation on transesophageal echocardiogram. He was treated with
intravenous antibiotics for 6 weeks with continuation of his immunosuppression.
He has remained clinically stable for over 5 years. Although the treatment of
S. aureus endocarditis in immunosuppressed transplant patients has
traditionally resulted in loss of their allograft, prompt diagnosis and
appropriate antibiotics with continued immunosuppressive therapy resulted in a
successful outcome and allograft preservation in this case. N. Ref:: 14
----------------------------------------------------
[23]
TÍTULO / TITLE: - A case of persistent
anemia in a renal transplant recipient: association with parvovirus B19
infection.
REVISTA
/ JOURNAL: - Scand J Infect Dis 2002;34(1):71-5.
AUTORES
/ AUTHORS: - Choi SH; Chang SP; Won JC; Lee JS; Chi HS;
Yang WS; Park SK
INSTITUCIÓN
/ INSTITUTION: - Department of Internal Medicine, Ulsan
University College of Medicine, Seoul, South Korea.
RESUMEN
/ SUMMARY: - We report an unexplained anemia that
persisted for 4 months in a renal transplant patient who was receiving
immunosuppression therapy that included prednisolone, tacrolimus and
azathioprine. A bone marrow biopsy demonstrated pure erythroid hypoplasia and
occasional giant pronormoblasts with intranuclear inclusions, characteristic of
a parvovirus B19 infection. Both the serum and bone marrow cells were positive
by parvovirus B19 DNA PCR. The anemia resolved 6 weeks after the administration
of intravenous immunoglobulin (IVIG). Four months later, anemia redeveloped and
IVIG was infused again. Hemoglobin levels were, however, still subnormal after
1 month of treatment and tacrolimus was then switched to cyclosporin A,
resulting in a clear improvement. A parvovirus B19 infection should be included
in the differential diagnosis of renal transplant recipients who present with
anemia associated with a low reticulocyte count. Tacrolimus may possibly impair
the clearance of a parvovirus B19 infection.
N. Ref:: 21
----------------------------------------------------
[24]
TÍTULO / TITLE: - Management of hepatitis
B after renal transplantation: an update.
REVISTA
/ JOURNAL: - J Nephrol. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://www.jnephrol.com/
●●
Cita: Journal of Nephrology: <> 2002 Mar-Apr;15(2):113-22.
AUTORES
/ AUTHORS: - Fabrizi F; Lunghi G; Poordad FF; Martin P
INSTITUCIÓN
/ INSTITUTION: - Division of Nephrology and Dialysis,
Institute of Hygiene and Preventive Medicine, Ospedale Maggiore Policlinico,
IRCCS, Milano, Italy. fabrizi@policlinico.mi.it
RESUMEN
/ SUMMARY: - Hepatitis B Virus (HBV) infection remains
an important cause of liver disease in renal transplant (RT) recipients and the
outcome of HBV infected RT recipients is less favorable than that of
noninfected RT recipients. The concern about graft loss induced by interferon (IFN)
therapy precludes its use; lamivudine, a second-generation analog, has been
recently approved for the treatment of hepatitis B and promises to be highly
effective in this setting. Several uncontrolled trials have reported a high
rate of biochemical (ranging between 80% and 100%) and virological (ranging
between 67% and 100%) response in RT recipients, comparable to immunocompetent
patients. Lamivudine has an excellent safety profile in RT recipients. However,
the emergence of viral mutations leading to resistance has been reported during
lamivudine therapy in RT recipients. In addition, numerous issues remain to be
clarified about lamivudine use after RT including the management of viral
resistance, the role of HBV genotypes in the response to lamivudine, and the
duration of therapy and response. The combination of newer nucleoside analogues
with lamivudine, analogous to HIV, may further improve the efficacy of
antiviral therapy against HBV after RT.
N. Ref:: 85
----------------------------------------------------
[25]
TÍTULO / TITLE: - Renal transplantation
and polyomavirus infection: recent clinical facts and controversies.
REVISTA
/ JOURNAL: - Transpl Infect Dis 2003 Jun;5(2):65-71.
AUTORES
/ AUTHORS: - Kazory A; Ducloux D
INSTITUCIÓN
/ INSTITUTION: - Department of Nephrology and Renal
Transplantation, Saint-Jacques Hospital, 25000 Besancon, France. akazory@chu-besancon.fr
RESUMEN
/ SUMMARY: - Although many articles have been published
on polyomavirus-induced pathologies in transplant recipients, our knowledge
regarding their clinical aspects remains relatively limited. In fact, the
number of questions and controversies on the subject seems even to be
increasing as new publications continue to appear. This article presents some
of these controversies through a brief review of recent clinical facts about
the three polyomaviruses that infect humans—JC virus, simian virus 40, and BK
virus—as they relate to renal transplantation.
N. Ref:: 88
----------------------------------------------------
[26]
TÍTULO / TITLE: - Cat scratch disease and
acute rejection after pediatric renal transplantation.
REVISTA
/ JOURNAL: - Pediatr Transplant 2002 Aug;6(4):327-31.
AUTORES
/ AUTHORS: - Dharnidharka VR; Richard GA; Neiberger RE;
Fennell RS 3rd
INSTITUCIÓN
/ INSTITUTION: - The Division of Pediatric Nephrology,
Shands Children’s Hospital and University of Florida College of Medicine,
Gainesville, Florida 32610, USA. vikasmd@ufl.edu
RESUMEN
/ SUMMARY: - Cat scratch disease (CSD) can lead to
unexplained fever, generalized lymphadenopathy and organomegaly in
immunocompetent individuals. CSD has rarely been reported in immunocompromised
transplant recipients, where its clinical features would mimic the more common
post-transplant lymphoproliferative disease (PTLD). We report three cases of
CSD seen recently in children who had received prior kidney transplants. The
three children were between 7 and 9 yr old, and had received kidney transplants
2-4 yr prior, with stable renal function. In each case, there was unexplained
fever with either lymphadenopathy or organomegaly. The diagnosis of CSD was
suggested by a history of new cats being introduced into each household and
confirmed in all cases by the serological presence of a significant titer (>
1 : 64) of IgM antibodies to Bartonella henselae. Tests for other bacterial
infections, cytomegalovirus and Epstein-Barr virus infections were negative.
All the patients showed a clinical improvement with anti-microbial therapy. In
patients A and B, the CSD was associated with an acute rejection episode
shortly after diagnosis. The rejection episodes were reversed by intravenous
steroid pulse therapy. Only four cases of CSD have been previously reported
following solid organ transplantation. Acute rejection following CSD has not
been previously reported. CSD should be included in the differential diagnosis
of fever in the post-transplant setting, especially where PTLD is suspected. N. Ref:: 12
----------------------------------------------------
[27]
TÍTULO / TITLE: - Management of hepatitis
B and C in renal failure and renal transplant recipients.
REVISTA
/ JOURNAL: - Trop Gastroenterol 2002
Apr-Jun;23(2):49-53.
AUTORES
/ AUTHORS: - Amarapurkar D; Das HS
INSTITUCIÓN
/ INSTITUTION: - Department of Gastroenterology and
Hepatology, Bombay Hospital And Medical Research Center, Mumbai. deepakn@bom3.vsnl.net.in N. Ref:: 79
----------------------------------------------------
[28]
TÍTULO / TITLE: - Transplanting kidneys
from donors with prior hepatitis B infection: one response to the organ
shortage.
REVISTA
/ JOURNAL: - J Nephrol. Acceso gratuito al texto
completo.
●●
Enlace a la Editora de la Revista http://www.jnephrol.com/
●●
Cita: Journal of Nephrology: <> 2002 Nov-Dec;15(6):605-13.
AUTORES
/ AUTHORS: - Fabrizio F; Bunnapradist S; Martin P
INSTITUCIÓN
/ INSTITUTION: - Division of Nephrology, Dialysis and
Transplantation, Maggiore Hospital, Policlinico IRCCS, Milano, Italy. fabrizi@policlinico.mi.it
RESUMEN
/ SUMMARY: - While the number of cadaveric organ donors
remains relatively stable, the number of patients awaiting transplantation
continues to increase, creating a shortage of donor organs. To address this
imbalance, there is interest in transplanting organs formerly considered
marginal or undesirable. Thus, more organs are currently transplanted from
living donors, older donors, hemodynamically unstable donors, non-heart-beating
donors and donors with markers of prior hepatitis B virus (HBV) infection. A
large number (up to 93.8%) of liver transplant seronegative recipients from
anti-HBc antibody positive donors have acquired HBsAg after liver
transplantation in the absence of immunoprophylaxis. Based on experience in
liver transplantation programs, transmission of HBV from donors without HBsAg
but with antibody to HBV core antigen (anti-HBc), although conventionally
defined as evidence of resolved infection, can have adverse consequences on
both graft and recipient. On the contrary, HBV appears to be in-frequently
transmitted from HBsAg negative/anti-HBcAb positive kidney donors: the incidence
of de novo HBsAg seropositivity after renal transplantation ranges between 0
and 5.2%. A significantly higher incidence of anti-HBc antibody seroconversion
(without developing HBsAg) after renal transplantation with anti-HBc antibody
positive donors was seen. However, anti-HBc antibody positive renal allografts
should be considered, especially for recipients who have been successfully
immunized with HBV vaccine. Prospective long-term studies are in progress to
assess the risk of de novo HBV infection (HBsAg seroconversion) in renal
transplant recipients who have not been successfully immunized with vaccine
against HBV. N.
Ref:: 58
----------------------------------------------------
[29]
TÍTULO / TITLE: - BK virus infection in
renal transplant recipients.
REVISTA
/ JOURNAL: - Pediatr Transplant 2001 Dec;5(6):398-405.
AUTORES
/ AUTHORS: - Lin PL; Vats AN; Green M
INSTITUCIÓN
/ INSTITUTION: - Departments of Pediatrics and Surgery,
Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania
15213-2583, USA.
RESUMEN
/ SUMMARY: - BK virus (BKV) is increasingly being
recognized as an important pathogen among renal transplant recipients. To date,
only limited information is known about BKV infections in this population;
definitive data regarding the epidemiology, diagnosis, treatment, and outcome
of BKV infection are lacking. Therefore, further investigations are needed.
This article reviews our current understanding of BKV infections among renal
transplant patients. N.
Ref:: 43
----------------------------------------------------
[30]
TÍTULO / TITLE: - Infections in the
transplant recipient.
REVISTA
/ JOURNAL: - Med Health R I 2002 Apr;85(4):125-7.
AUTORES
/ AUTHORS: - Fischer SA
INSTITUCIÓN
/ INSTITUTION: - Division of Infectious Diseases, Brown
Medical School, Providence, RI, USA. Sfischer@Lifespan.org N. Ref:: 22
----------------------------------------------------
[31]
TÍTULO / TITLE: - Polyoma virus in renal
transplant recipients.
REVISTA
/ JOURNAL: - Nephrol Nurs J 2002 Jun;29(3):247-50; quiz
251-2.
AUTORES
/ AUTHORS: - Weiskittel PD
INSTITUCIÓN
/ INSTITUTION: - University Hospital, Cincinnati, OH, USA.
RESUMEN
/ SUMMARY: - Infection and rejection have been the most
critical complications following renal transplantation. Rejection rates have
decreased recently with the advent of new and more powerful immunosuppressive
agents. However, infection continues to be a serious complication. The use of
broad-spectrum antibiotics and the development of antiviral agents have
provided effective tools to combat the infectious processes traditionally seen
in renal transplant recipients. Recently, a new viral illness has been
identified in this population. Polyoma virus infection has been identified as
the cause of allograft dysfunction and graft loss. This paper reviews the
current prevalence and outcome of renal transplant patients infected with
polyoma virus. N.
Ref:: 16
----------------------------------------------------