infectious complications in renal transplant recipients

Ngày tải lên: 09/08/2014, 02:20

Ngày tải lên: 11/08/2014, 17:21

... linear models, linear regression, tacrolimus, renal transplantation Background Tacrolimus, a calcineurin inhibitor, remains the centerpiece of the maintenance treatment scheme in renal transplant ... combination of a calcineurin inhibitor (tacrolimus) with a purine inhibitor (mycophenolate mofetil or azathioprine) and a steroid (prednizolone). Tacroli- mus was given twice a day in individually ... determine the impact of CYP3A5*1 and CYP3A5*3 on the kinetics of tacrolimus in renal transplant recipients. Material and methods: Forty kidney recipients were selected to participate. Maintenance...

Ngày tải lên: 26/10/2012, 09:32

... regimens including pyrazin- amide, 31% received drug regimens including a fluoro- quinolone, and 17% received drug regimens including streptomycin. Induction drug regimens consisted of 2 drugs in 5% ... MTB infection was defined as including lung or mediastinal lymph node involvement. We de- fined multiorgan (ie, miliary) MTB infection as involve- ment of 2 or more organs (lymph nodes draining in- fected ... positive tubercu- lin skin test (TST) result in the absence of symptoms or clinical findings suggestive of active infection. In ana- lyzing LTBI treatment, we included studies reporting 10 or more...

Ngày tải lên: 29/03/2014, 03:20

Ngày tải lên: 13/08/2014, 20:22

Ngày tải lên: 14/08/2014, 07:21

... the find- ings. The clinical outcome, including renal function, is investigated in detail in the ongoing BENEFIT-EXT trial [25]. Conclusion In the present pilot study, the IMPDH activity in CD4+ cells ... alternative to CNIs following transplantation. It binds with high affinity to CD80 and CD86, thereby resulting in T cell anergy and apoptosis [21]. A phase 2 trial in renal allograft recipients (n = 218) ... activity in CD4+ cells, intracellular MPA concentrations were restored by incu- bating the isolated cells in filtrated plasma originating from the same sample. The IMPDH activity was deter- mined in...

Ngày tải lên: 18/06/2014, 15:20

... Medicine > Chapter 126. Infections in Transplant Recipients Infections in Transplant Recipients: Introduction The evaluation of infections in transplant recipients involves consideration of ... corneal transplants. e T. gondii usually causes disease in the brain. In hematopoietic stem cell Chapter 126. Infections in Transplant Recipients (Part 1) Harrison's Internal Medicine ... and monoclonal-antibody depletion procedures results in a higher incidence of contamination. In one series of patients receiving contaminated products, 14% had fever or bacteremia, but none...

Ngày tải lên: 07/07/2014, 15:20

... 126. Infections in Transplant Recipients (Part 2) In many transplantation centers, transmission of infections that may be latent or clinically inapparent in the donor organ has resulted in ... latent infections already. Nevertheless, most infections occur in a predictable time frame after transplantation (Table 126-2). Table 126- 2 Common Sources of Infections after Hematopoietic ... and Trypanosoma cruzi (the latter particularly in Latin America). Clinicians caring for prospective organ donors should also consider assessing stool for parasites, should ...

Ngày tải lên: 07/07/2014, 15:20

... becomes available. Promising new drugs that are now being assessed in clinical trials include maribavir, a benzimidazole ribonucleoside that inhibits a viral protein kinase activity (UL97). ... ulcerations occur in both the lower and the upper gastrointestinal tract, and it may be difficult to distinguish diarrhea due to GVHD from that due to CMV infection. The finding of CMV in the liver ... greatest concern in the second month after transplantation, particularly in allogeneic HSCT recipients. In cases in which the donor marrow is depleted of T cells (to prevent GVHD or eliminate a T...

Ngày tải lên: 07/07/2014, 15:20

... disease. Treatment of CMV pneumonia in HSCT recipients (unlike that in other clinical settings) involves both IV immune globulin (IVIg) and ganciclovir. In patients who cannot tolerate ganciclovir, ... antibodies to T cells). Although less likely in autologous transplantation, reactivation can occur in T cell–depleted autologous recipients (e.g., patients being given antibodies to T cells for the ... cervical adenopathy resembling the symptoms of infectious mononucleosis but more commonly presents as an extranodal mass. The incidence of EBV-LPD among allogeneic HSCT recipients is 0.6–1%, which...

Ngày tải lên: 07/07/2014, 15:20

... the Chapter 126. Infections in Transplant Recipients (Part 6) PCR can be used to monitor EBV production after hematopoietic stem cell transplantation. High or increasing viral loads predict ... resulted in disease in HSCT recipients, although some cases of virus-associated marrow aplasia have been reported in the peritransplantation period. The relatively low seroprevalence of KSHV in the ... critical in an assessment of posttransplantation infections. to have activity against the different forms of latent EBV infection. Preventing lytic replication in these patients would theoretically...

Ngày tải lên: 07/07/2014, 15:20

... therapy (when indicated), and rapid diagnosis and treatment of infections can be lifesaving in SOT recipients, who, unlike most HSCT recipients, continue to be immunosuppressed. SOT recipients ... (Chap. 177). Intranasal pleconaril, a capsid-binding agent, is being studied for the treatment of enterovirus infection. Rhinoviruses and coronaviruses are frequent co-pathogens in HSCT recipients; ... acute infections in recipients of SOT are different from those that infect HSCT recipients because SOT recipients do not go through a period of neutropenia. As the transplantation procedure involves...

Ngày tải lên: 07/07/2014, 15:20

... 126. Infections in Transplant Recipients (Part 8) Kidney Transplantation (See Table 126-4) Table 126-4 Common Infections after Kidney Transplantation Period after Transplantation Infection ... chest imaging and/or no previous treatment Chest imaging; PPD and/or cell- based assay a Serologic examination, PPD testing, and interferon assays may be less reliable after transplantation. ... of Infections in Transplant Recipients Risk Factor Organism Prophylactic Antibiotics Examination(s) a Travel to or residence in area with known risk of fungal infection Coccidioides,...

Ngày tải lên: 07/07/2014, 15:20

... Chapter 126. Infections in Transplant Recipients (Part 9) Middle-Period Infections Because of continuing immunosuppression, kidney transplant recipients are predisposed to lung infections ... Legionella pneumophila infection (Chap. 141) led to the closing of renal transplant units in hospitals with endemic legionellosis. About 50% of all renal transplant recipients presenting with fever ... JC virus (polyomavirus hominis types 1 and 2) have been cultured from the urine of kidney transplant recipients (as they have from that of HSCT recipients) in the setting of profound immunosuppression....

Ngày tải lên: 07/07/2014, 15:20

... 126. Infections in Transplant Recipients (Part 10) Kidney transplant recipients are also subject to infections with other intracellular organisms. These patients may develop pulmonary infections ... bacteremia ≥1 month after renal transplantation and should be seriously considered in renal transplant recipients presenting with fever and headache. Kidney transplant recipients may develop ... and fungi (e.g., Candida) are often involved. In rare cases, mediastinitis in heart transplant recipients can also be due to Mycoplasma hominis (Chap. 168). Since this organism requires an anaerobic...

Ngày tải lên: 07/07/2014, 15:20

... lung transplant recipients with symptomatic CMV disease have pneumonia. Difficulty in distinguishing the radiographic picture of CMV infection from other Chapter 126. Infections in Transplant ... prophylaxis is stopped—a pattern observed increasingly in recent years. With recovery from peritransplantation complications and, in many cases, a decrease in immunosuppression, the recipient is ... Cryptococcus. Mediastinitis may occur at an even higher rate among lung transplant recipients than among heart transplant recipients and most commonly develops within 2 weeks of surgery. In the absence...

Ngày tải lên: 07/07/2014, 15:20

... these findings may suggest graft rejection, rejection is typically accompanied by marked elevation of Chapter 126. Infections in Transplant Recipients (Part 12) Late Infections The incidence ... but also in the spleen, pericolic area, and pelvis. Treatment includes antibiotic administration and drainage as necessary. Liver transplant patients have a high incidence of fungal infections, ... patients. Transplant recipients who develop cholangitis may have high spiking fevers and rigors but often lack the characteristic signs and symptoms of classic cholangitis, including abdominal pain...

Ngày tải lên: 07/07/2014, 15:20

... and yeast infections. Most pancreatic transplants are drained into the bowel, whereas the remaining transplants (~20%) are drained into the bladder. A cuff of duodenum is used in the anastomosis ... Organ Transplantation Indwelling IV Catheter Infections The prolonged use of indwelling IV catheters for administration of medications, blood products, and nutrition is common in diverse transplantation ... CMV infection, EBV-LPD, and infections with opportunistic pathogens in patients receiving a pancreatic transplant are similar to those in other SOT recipients. Miscellaneous Infections in Solid...

Ngày tải lên: 07/07/2014, 15:20

Ngày tải lên: 07/07/2014, 15:20