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At least 19 recordsLinked to original sources

PubMed1978

Influenza vaccination in renal transplant recipients.

Renal transplant recipients receiving immunosuppressive therapy are prone to major pulmonary infections. Development of influenza virus infection may lead to renal allograft damage or rejection. These patients should therefore be protected against influenza viruses by vaccination. A satisfactory antibody response was found in 12 (60%) of 20 renal transplant recipients vaccinated. Among 15 control subjects, the antibody response was satisfactory in all participants (100%). Factors that might play a role in suppression of antibody response include use of immunosuppressive drugs and renal allograft function. Immunization is safe and does not appear to affect renal allograft function.

Adolescent↗

PubMed1975

Evidence of chronic persistent infections with polyomaviruses (BK type) in renal transplant recipients.

Ten renal transplant recipients showing a significant increase in human polyomavirus antibodies, indicative of an acute infection, were followed up serologically over periods ranging from two months to more than two years. Fifty-four serum specimens were available for the study and they were tested by both haemagglutination-inhibition and complement-fixation. Polyomavirus antigens were prepared from the BK and SV40-like strains of polyomaviruses, and from the SV40 virus. One strain of polyomavirus, related to the BK strain was isolated from the urine of one of these patients. Two other BK strains were recovered from the urine and kidney, respectively, of transplant recipients not included in this study. Sera of these two patients were not obtained until the transplantation was made; they were already highly positive for polyomavirus antibodies, precluding the demonstration of an increase in antibody titer. Serologic results have shown that HAI antibodies persist at high titers throughout the observation period. This persistence ranged from two to four months (four cases), seven to eleven months (three cases) and thirteen to twenty months (three cases). In none of the cases could a decrease of high titer be demonstrated. Moreover, density gradient studies have shown that specific IgM antibodies also tend to persist over many months. Similar serologic results were obtained in complement-fixation tests with a BK antigen. Titers were at least 1 in 30 in the study group, but were not observed among healthy blood donors. All sera were uniformly negative for SV40 and SV40-like antigens. One polyomavirus isolation was successful from urine obtained six months after initial serologic evidence for a polyomavirus infection. The other two viruses were isolated from materials taken four and seven months after first detection of polyomavirus antibodies at high titer. Both serologic evidence and viral isolations seem to indicate that polyomaviruses (BK type) might cause a chronic infection in humans.

Animals↗

PubMed2025

Characterization of gut microbiota and metabolites in renal transplant recipients during COVID-19 and prediction of one-year allograft function.

BACKGROUND: The gut-lung-kidney axis is pivotal in immune-related kidney diseases, with gut dysbiosis potentially exacerbating the severity of Coronavirus disease 2019 (COVID-19) in recipients of kidney transplant. This study aimed to characterize the gut microbiome and metabolome in renal transplant recipients with COVID-19 pneumonia over a one-year follow-up period. METHODS: A total of 30 renal transplant recipients were enrolled, comprising 17 with COVID-19 pneumonia, six with mild COVID-19, and seven without COVID-19. Fecal samples were collected at the onset of infection for gut microbiome and metabolome analysis. Generalized Estimating Equations (GEE) model and Latent Class Growth Mixed Model (LCGMM) were employed to dissect the relationships among clinical characteristics, laboratory tests, and gut microbiota and metabolites. RESULTS: Four microbial phyla (Deferribacteres, TM7, Fusobacteria, and Gemmatimonadetes) and 13 genera were significantly enriched across three recipients groups, correlating with baseline inflammatory response and allograft function. Additionally, 52 differentially expressed metabolites were identified, with seven significantly correlating with eight altered microbiota genera. LCGMM revealed two distinct classes of recipients, with those suffering from COVID-19 pneumonia exhibiting significantly elevated serum creatinine (Scr) trajectories over the one-year period. GEE further identified 12 genera and 181 metabolites closely associated with these trajectories; a multivariable model incorporating gut metabolites of 1-Caffeoylquinic Acid and PMK was found to effectively predict one-year allograft function. CONCLUSIONS: Our study indicates a possible interaction between the composition of the gut microbiota and metabolites community and COVID-19 in renal transplant recipients, particularly in relation to disease severity and the prediction of one-year allograft function.

Humans↗

PubMed1976

Secondary hyperparathyroidism in human kidney transplant recipients.

76 kidney transplant recipients who were up to 4 years post transplant, were studied to assess the incidence of secondary hyperparathyroidism. All patients had good renal function with a mean serum creatinine of 1.4 mg/100 ml. Secondary hyperparathyroidism, as evidenced by increased serum parathyroid hormone levels, was present in 53 of the 76 patients (66%) and radiologic bone disease in 26 of the 76 patients (34%), while hypercalcemia (serum calcium greater than 11.0 mg/100 ml) occurred in only 6 patients (8.5%). The incidence of secondary hyperparathyroidism decreased slightly with time following transplantation, but the degree of secondary hyperparathyroidism as indicated by the levels of serum parathyroid hormone at various times following renal transplantation was essentially similar. The causes for the persistence of this condition are not totally known, but it was found that its incidence was related to the duration of dialysis prior to transplantation.

Follow-Up Studies↗

PubMed1977

Steroid-induced glaucoma and cataract in renal transplant recipients.

Fifteen kidney transplant recipients were studied ophthalmologically for periods of one to five years following the transplantation. All subjects received maintenance immunosuppressive therapy which included azathioprine (IMURAN) and corticosteroids. Two patients developed posterior subcapsular cataracts. Seven patients (47%) developed increased intraocular pressure and one of these had glaucomatous field loss and disk cupping. The increased intraocular pressure responded favorably to topical treatment while the patients were under continuous treatment with systemic steroids and immunosuppressive drugs.

Administration, Oral↗

PubMed1978

Renal transplantation and viral infections. IV. A survey of herpes simplex virus excretion in relation to cellular specific immunity and humoral immunity among renal transplant recipients.

Fourteen renal transplant recipients were screened systematically for HVH virus infection, cellular and humoral HVH immunity and general cellular immunity evaluated by PHA response. This study demonstrates significant correlation between humoral and cellular responses to HVH before graft and virus isolation after graft. This virus excretion occurred simultaneously with a PHA response peak. Neither significant drops in cellular general or specific HVH immune response nor correlation between acute rejection episode and any studied parameters were observed.

Adult↗

PubMed1977

Plasma renin, plasma aldosterone and exchangeable sodium in normotensive and hypertensive kidney transplant recipients with and without transplant renal artery stenosis.

Blood pressure (BP), plasma renin concentration (PRC), plasma aldosterone concentration (PAC) and exchangeable sodium (ES) were studied in 19 kidney recipients on different fixed levels of sodium intake after successful kidney transplantation. The following groups of kidney recipients were investigated: group 1: 7 normotensives, group 2:7 hypertensives without transplant renal artery stenosis (TRAS), group 3:5 hypertensives with angiographically verified TRAS. Hypertension in the recipients without TRAS (group 2) was characterized by a positive correlation between BP and ES and a normal response of PRC and PAC to a fixed low (10 mEQ/day) and high (150 mEq/day) sodium intake. In contrast, hypertension in the recipients with TRAS (group 3) was characterized by a normal or varyingly increased PRC on a liberal sodium intake and a reduced response of PRC to sodium restriction, whereas PAC did not differ from the other groups of recipients. In one recipient in group 3 who underwent surgical correction for TRAS, PRC and PAC decreased before operation during sodium restriction, but BP remained high until after operation, when it normalized simultaneously with a decrease in ES. The results indicate that sodium retention is involved in the pathogenesis of posttransplant hypertension and suggest that an increased activity of the renin--angiotensin system is counterbalanced by an accumulation of sodium in TRAS.

Adult↗

PubMed1975

Virus infections in renal transplant recipients.

534 serum samples from 73 renal transplant recipients, 41 haemodialysis patients, and 99 blood and organ donors were examined serologically for antibodies against Cytomegalo, H. simplex (types 1 and 2), Varicella-zoster, Epstein-Barr, Adeno, Influenza, Parainfluenza, Respiratory syncytial, Measles, Picorna- and human Polyoma- Viruses. Serum specimens were stored in the lyophilized state until examined thus enabling a simultaneous testing of all samples belonging to one patient. All antigens, complement, and control antisera were prepared, lyophilized, and standardized in this laboratory. This has enabled the use of single batches of any preparation throughout the study. Serologic results with antigens of the Herpesvirus group (CMV, HSV and VZV) compared favourably with previous results showing that infections with these agents, especially with CMV, can frequently be encountered among transplant recipients. Our results have indicated a moderately increased incidence of infections with some Herpesviruses in haemodialysis patients as well. Infections with VZV, for instance, were as frequently demonstrated in these patients, as in transplant patients although the former received no immunosuppressive therapy. Serologic results with non-Herpesvirus antigens indicated an increased incidence of infections with Polyomavirus, Myxoviruses (Influenza, Parainfluenza and RS) and Picornaviruses among transplant recipients. The incidence of acute infections with RS virus among adults was unusually high and there is no evidence so far to indicate such a high frequency of RS infections in any other group of adults. We were unable to demonstrate acute infections with non-Herpesviruses among haemodialysis patients, even though most of the patients were followed over a period of more than 2 years. Virus isolation attempts were performed with samples of urines and biopsy or autopsy samples. 23 out of 28 cytopathic agents recovered from urines, throat-swabs and/or from organs of transplant recipients were identified as CMV. Two HSV type 1, 1 HSV type 2, and 2 Coxsackie B type 3 viruses were also isolated. No viruses were isolated from a series of 31 kidneys randomly selected among autopsy cases.

Antibodies, Viral↗

PubMed1976

Lymphocyte tissue culture studies on human heart transplant recipients. III. Prediction of outcome of transplantation based on immunologic studies.

Using in vitro lymphocyte tissue culture screening tests human heart transplant recipients during the academic year 1973/1974 were evaluated and an attempt made to predict their post-operative rejection course. The tests involved screening for serum depressive factors and screening for the recipient's lymphocyte reactivity. A scoring system was devised whereby the laboratory results could be converted to a predicted rejection score. Of the nine patients studied, eight are still doing well. Three recipient's who had a high postoperative rejection score as determined by an independent clinical team, were correctly identified pre-operatively and one of them had to be retransplanted. These screening tests may be helpful in the future in the selection of recipients.

Cells, Cultured↗

PubMedDate not supplied

Gastrointestinal complications in 248 kidney transplant recipients.

In 248 kidney transplant recipients, 28 (11%) developed serious gastrointestinal complications after the transplantation. Upper gastrointestinal bleeding was the most common complication and accounted for 19 of the cases. Most of the haemorraging occurred during the first 6 months after transplantation and in conjunction with an episode of graft rejection. The mortality following upper gastrointestinal bleeding was 58%. Other serious complications encountered were lower gastrointestinal bleeding (4 cases), perforation of the colon (4 cases) and mesenteric vascular occlusion (1 case). Overall mortality was 43%.

Adult↗

PubMed1979

Epstein-Barr virus antibody responses and clinical illness in renal transplant recipients.

Among 88 renal transplant recipients evaluated for a change in Epstein-Barr virus (EBV) antibody status in the period after transplant, 22 showed a 4-fold rise and eight showed an 8-fold or greater rise in EBV antibody. Among the patients with an 8-fold or greater EBV ANTIBODY RISE, THE OCCURRENCE OF FEVER WAS FREQUENT, ONE PATIENT DEVELOPED A LYMPHOPROLIFERATIVE reaction, and one died with a malignant EBV infection. Patients without pretransplant antibody showed a longer mean time to antibody rise (104 +/- 23 days) than did those patients with pretransplant antibody (19 +/- 7 days). The longer incubation period in patients without pretransplant antibody was in the expected range for primary EBV infections. Both primary and secondary (reactivation) EBV infections occur in renal transplant patients. These infections may be assoicated with prolonged fever, and in unusual circumstances, may cause dramatic lymphoproliferative disease.

Adolescent↗

PubMed1979

Urinary tract infections in kidney transplant recipients.

In 65 kidney transplant recipients who were followed up for a mean period of 14.7 months, the incidence of urinary tract infection (UTI), and how the incidence was affected by length of graft survival, age, HLA-A and HLA-B matches, complications, duration of Foley catheter use, and other aspects, were examined. The total incidence of infection included an unexpectedly high rate of late infections. The incidence was found to be statistically increased with nephrectomy, splenectomy, recatheterization, and age older than 40 years. There was no correlation noted with graft source, antigen match, graft loss, or previous history of UTI. A group of patients with persistent UTI was noted and an inability to suppress UTI with long-term therapy with antibiotics was found. The asymptomatic nature of most of the UTIs confirmed the need for frequent periodic cultures of urine in the immunosuppressed patient.

Adult↗

PubMed1977

A longitudinal study of varicella-zoster virus infections in renal transplant recipients.

A serum bank maintained for renal transplant recipients allowed for a longitudinal study of antibody responses before and after herpes zoster. Renal transplant recipients without herpes zoster served as controls. Antibody responses to varicella-zoster virus, herpes simplex virus type 1, and cytomegalovirus were measured. The serological responses following herpes zoster were prompt and sustained (in the majority of cases), transient, or not present at all. Zoster without an eruption occurred (apparent only on retrospective chart review) and furnished an explanation for unexplained unilateral pain syndromes in these patients. Asymptomatic rises in titer of antibody to varicella-zoster virus not explained by rises in antibody to herpes simplex virus occurred in both groups. This latter finding points to an unstable relation between virus and host and supports and hypothesis of Hope-Simpson that subclinical release of virus with resulting antigenic stimulation may maintain immunity to varicella-zoster virus. Patients with herpes zoster and controls did not differ in several humoral immune parameters that might have explained the occurrence of herpes zoster. There was no evidence that herpes zoster precipitated renal graft rejection.

Antibodies, Viral↗

PubMed2026

Trimethoprim/sulfamethoxazole-triggered drug-induced hypersensitivity syndrome in an HLA B*13:01-positive kidney transplant recipient: a case report with implications for HLA-severe cutaneous adverse reaction associations in transplant care.

Drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms (DIHS/DRESS) is a severe cutaneous adverse reaction (SCAR) with a reported mortality rate of approximately 2-10%. DIHS/DRESS typically develops 2-8 weeks after exposure to an offending drug. An important focus of contemporary SCAR research is the growing evidence that specific human leukocyte antigen (HLA) alleles confer a markedly increased risk of drug-specific hypersensitivity reactions. We report a case of a kidney transplant recipient who developed DIHS/DRESS after prolonged trimethoprim/sulfamethoxazole (TMP/SMX) prophylaxis and carried the HLA-B13:01 allele. HLA-B13:01 is a strong genetic risk factor for TMP/SMX-induced DIHS/DRESS, particularly in Southeast Asian populations. Herein, we highlight the potential clinical relevance of pre-transplant HLA typing in predicting SCAR risk in transplant recipients. TMP/SMX-associated DIHS/DRESS may be under-recognized in transplant settings, where awareness of HLA-associated risk remains limited despite robust evidence from non-transplant populations. Transplant clinicians should be aware that DIHS/DRESS can occur outside the typical latency period, especially during immunosuppressant tapering, highlighting the need to integrate pharmacogenomic risk assessments into transplant care.

Humans↗

PubMed1975

Chronic antigenic stimulation, herpesvirus infection, and cancer in transplant recipients.

An increased incidence of malignancy has been reported in transplant recipients. The pathogenesis of this increase was originally attributed to immunosuppressive therapy. However, not all tumours are increased in proportion to their occurrence in the general population-75% of reported tumours are lymphorproliferative or carcinoma of the skin, lip, or cervix. This cannot be explained by impaired immunosurveillance, and alternative hypotheses must be considered. 90% of transplant recipients develop clinical or serological evidence of herpesvirus infection. Herpesviruses have been implicated in the pathogenesis of lymphorproliferative tumours and carcinoma of the skin and cervix. They can remain in latent form and be reactivated by allogeneic stimulation and/or immunosuppression. These viruses localise to skin, cervix, and neural tissue-i.e., exactly those sites where cancer develops in transplant patients. Herpesvirus infections in association with the presence of an allogeneic graft in an immunosuppressed patient may be responsible for the increased incidence of both lymphoproliferative tumours and carcinoma of the skin, lip, and cervix in the transplant recipient.

Antibodies, Viral↗

PubMed1979

Variation in plasma prednisolone concentrations in renal transplant recipients given enteric-coated prednisolone.

Renal transplant recipients receiving intermittent haemodialysis and kept under normal ward conditions showed appreciable differences in plasma prednisolone concentrations after therapeutic doses of enteric-coated prednisolone tablets. This gross day-to-day variation occurred irrespective of the dosage used. Breakfast given before prednisolone tended to reduce the rate of absorption of the drug, the effect being quantitatively most pronounced with large doses. Haemodialysis had no apparent effect on the elimination of prednisolone from plasma. Such erratic blood concentrations of prednisolone as observed in these patients, possibly resulting from variable absorption, may be potentially hazardous. Hence use of enteric-coated tablets in renal transplant recipients should be viewed with caution.

Adolescent↗

PubMedDate not supplied

Plasma renin activity in the evaluation of hypertension in renal transplant recipients.

Plasma renin activity (PRA) was measured in nine renal transplant recipients, seven of which had transplant renal artery stenosis. Surgical correction of the stenosed renal transplant artery was performed in six patients. After corrective surgery of the stenosed artery hypertension (mean arterial pressure before operation 156 mmHg) improved (mean arterial pressure postoperatively 110 mmHg) in four patients with high peripheral PRA (17.3+/-3.9 ng/ml. hr). Two patients, one hypertensive, the other normotensive with low PRA (1.5+/-0.05 ng/ml. hr) had no change in their blood pressure after corrective surgery. In three hypertensive renal transplant recipients the PRA of the venous effluent of the own kidneys and the renal transplant were studied selectively. Selective PRA determinations revealed the source of inappropriate renin secretion offering a basis for surgical management of the assocaited hypertension.

Adult↗

PubMed2026

Genetic Diversity of BK Polyomavirus Among Renal Transplant Recipients in Yunnan, China.

BK polyomavirus (BKV) infection, a common complication following kidney transplantation, can lead to BKV-associated nephropathy (BKVN). Molecular genetic studies have classified BKV into four genotypes (I-IV); however, comprehensive molecular characterization of BKV strains circulating in China remains limited. This study aimed to elucidate the predominant subtypes and clinical infection characteristics of BKV strains among kidney transplant recipients in Yunnan, a province in southwestern China. PCR-amplified BKV DNA sequences from kidney transplant recipients were aligned with reference strains and subjected to phylogenetic analysis. The viral VP1 gene was successfully amplified from 180 participants, spanning 16 ethnic groups. Genotype I was the predominant viral strain (56.66%, 102/180), followed by genotype IV (43.33%, 78/180), while genotypes II and III were not detected. Among genotypic subtypes, IVc-1 was most prevalent (40.0%, 72/180), followed by Ic (38.3%, 69/180) and Ib-1 (18.3%, 33/180). IVa-1 and IVa-2 were rare, identified in only 0.6% (n = 1) and 2.2% (n = 4) of cases, respectively. No significant differences in sex, age, BKVN incidence, BK viremia, or viruria were observed between patients with BKV-I and BKV-IV infections. Among the five confirmed BKVN cases, two were genotyped as subtype Ic, one as Ib-1, and two as IVc-1. Clinical phenotypes were also comparable between patients with BKV-I and BKV-IV infections. This study represents the largest single-center sequencing analysis of BKV in kidney transplant recipients in China, offering a valuable genomic resource for future research.

Humans↗