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Organ Transplant Patients (organ + transplant_patient)

Distribution by Scientific Domains

Medical Sciences	75%

Distribution within Medical Sciences

Transplantation	44%
Dermatology	33%

Selected Abstracts

The Importance of Skin Cancer Prevention in Organ Transplant Patients An Editorial to Paper by Salgo: ,Switch to Sirolimus in Long-Term Renal Transplant Recipients: Reduced Premalignancies and Nonmelanoma Skin Cancer in a Controlled, Prospective, Randomized, Blinded Study'

AMERICAN JOURNAL OF TRANSPLANTATION, Issue 6 2010
C. Mitchell
Renal transplant patients should be managed by dermatologists to prevent and manage skin cancer, a common cause of morbidity and mortality in organ transplant patients. See article by Salgo et al on page 1385. [source]

Sarcoidal granulomatous tenosynovitis of the hands occurring in an organ transplant patient

JOURNAL OF CUTANEOUS PATHOLOGY, Issue 8 2007
J. Andrew Carlson
Six years after kidney-pancreas transplant, a 47-year-old white man developed multiple subcutaneous and tenosynovial nodules of hands and wrists, limiting mobility. Biopsy of multiple nodules showed fibrosing, sarcoidal granulomas, some of which contained pigmented material. Microbiology, immunohistochemistry, scanning electron microscopy with backscattered electron imaging and energy dispersive X-ray analysis and polymerase chain reaction assays failed to show any infectious agents or foreign material. There was no historical, clinical or laboratory evidence of systemic sarcoidosis. It is not known whether the donor had sarcoidosis. Despite empiric antimycobacterial therapy and ongoing immunosuppressive therapy (corticosteroids, mycophenolate, cyclosporine), the man has progressively developed more nodules, limiting hand function. Sarcoidosis occurring in non-donor tisssue post-transplantation is an exceedingly rare complication of transplantation. We discuss this case and review the literature on sarcoidal tenosynovitis and sarcoidosis occurring post-transplantation. [source]

Mohs Micrographic Surgery as an Alternative Treatment Method for Cutaneous Mucormycosis

DERMATOLOGIC SURGERY, Issue 8 2003
F. Landon Clark BS
Background. Mucormycosis is an invasive fungal disease that most commonly occurs in immunocompromised patients. Early angioinvasion and dissemination can lead to the rapid demise of the patient. The growing number of organ transplant patients on pharmacologic immunosuppression has increased the risk for this opportunistic mycosis. Traditional therapy has included aggressive debridement and resection as well as antifungal medications. Objective. To demonstrate that the margin control and tissue-sparing technique of Mohs micrographic surgery can effectively eradicate mucormycosis infection and decrease morbidity. Methods. Case presentation of a 64-year-old transplant patient presenting with biopsy-proven cutaneous mucormycosis treated with Mohs micrographic surgery. Margin control was confirmed by a rapid Gomori methenamine silver stain. Results. There has been no recurrence at 1-year follow-up with full preservation of extremity function. Conclusion. The use of the Mohs technique combined with rapid Gomori methenamine silver staining for mucormycosis can be an effective tissue-sparing method for local control of this fungal infection. Mohs micrographic surgery should be considered for the cutaneous manifestations of mucormycosis. [source]

Thrombotic microangiopathies in bone marrow and organ transplant patients

JOURNAL OF CLINICAL APHERESIS, Issue 3 2002
Bruce C. McLeod
First page of article [source]

Cell specific internal translation efficiency of Epstein,Barr virus present in solid organ transplant patients

JOURNAL OF MEDICAL VIROLOGY, Issue 5 2007
Åsa Isaksson
Abstract The U leader exon in the 5, untranslated region of the Epstein,Barr virus nuclear antigen 1 (EBNA1) gene contains an internal ribosome entry site, the EBNA internal ribosome entry segment (IRES), which promotes cap-independent translation and increases the expression level of the EBNA1 protein. It was previously reported that immunosuppressed organ transplanted patients showed an alternatively spliced EBNA1 transcript, excluding the EBNA IRES element. To further investigate the function of the EBNA IRES, sequence analysis of the EBNA IRES mRNA was performed in samples from seven organ transplant patients. Two nucleotide changes, G,,,A at position 67531 and C,,,U at position 67585 were found in the EBNA IRES mRNA, relative to the corresponding genomic Epstein,Barr virus (EBV) sequence in all patients. Moreover, the patient derived EBNA IRES mRNA was shown to differ from the IRES mRNA derived from the cell line B95.8 at position 67531 and from the cell lines Rael and P3HR1 at positions 67531 and 67585. cDNA from the various EBNA IRES sequences were cloned into bicistronic vectors, respectively, and used in transient transfection experiments in six human cell lines. The patient specific sequence significantly decreased the IRES activity in T-cells, while the base changes had no significant impact on the activity in B- or in epithelial cells. The genetic mechanisms behind EBV-associated diseases are complex, involving gene regulation by alternative promoters, alternative splicing, and translational control. The nucleotide changes in the patient specific EBNA IRES transcript and its influence on the translational activity, might illustrate new strategies utilised by the EBV to adapt to the immune control in patients with EBV associated diseases. J. Med. Virol. 79:573,581, 2007. © 2007 Wiley-Liss, Inc. [source]

HHV-6 and HHV-7 antigenemia related to CMV infection after liver transplantation

JOURNAL OF MEDICAL VIROLOGY, Issue 6 2006
Maiju Härmä
Abstract Background Betaherpesviruses human herpesvirus-6 and -7 (HHV-6, HHV-7), which are closely related to cytomegalovirus (CMV), have been reported in transplant patients. In this retrospective study, we investigated the occurrence of HHV-6 and HHV-7 antigenemia in relation to symptomatic CMV infection after liver transplantation. Methods: Sample material from 64 adult liver transplant recipients was included in the study. The patients were monitored weekly for CMV, HHV-6, and HHV-7. CMV infections were diagnosed by pp65-antigenemia and viral cultures. Concomitantly HHV-6 and HHV-7 antigens were demonstrated in peripheral blood mononuclear cells by monoclonal antibodies against both variants A and B and immunoperoxidase staining. Altogether 540 post-transplant blood specimens were analyzed. Results: Nineteen patients (30%) developed symptomatic CMV pp65 antigenemia during the first 3 months (mean 33 days, range 5,62 days) post-transplantation and were treated with intravenous ganciclovir. Concurrent HHV-6 antigenemia was detected in 16/19 (median 9 days, range 6,24 days) and HHV-7 antigenemia 15/19 patients (median 17 days, range 5,58 days) after transplantation. HHV-6 appeared before CMV in most cases (12/16), HHV-7 usually together with CMV. In those cases that HHV-6 preceded CMV antigenemia, it also was a possible cause of graft dysfunction. HHV-7 and CMV were so closely overlapping, that no symptoms could solely be linked with HHV-7. Conclusion: HHV-6 and HHV-7 antigenemia usually occurred together with symptomatic CMV infection after liver transplantation. HHV-6 preceded CMV, but HHV-7 appeared together with CMV. Further investigation of the clinical significance of HHV-6 and HHV-7 antigenemia in organ transplant patients is necessary. J. Med. Virol. 78:800,805, 2006. © 2006 Wiley-Liss, Inc. [source]

Exogenous Interferon-, Immunotherapy for Invasive Fungal Infections in Kidney Transplant Patients

AMERICAN JOURNAL OF TRANSPLANTATION, Issue 8 2010
D. Armstrong-James
The incidence of invasive fungal infections (IFIs) in nonneutropenic solid organ transplant patients is increasing. We report our clinical experience with the use of interferon-, (IFN-,) immunotherapy in seven renal transplant patients who developed life threatening, disseminated IFIs refractory to conventional antifungal drug therapy. The infections were all microbiologically and histologically proven. The rapid cure of these disseminated infections with exogenous IFN-, injections was not associated with impaired kidney allograft function despite the use of liposomal amphotericin B in all cases. No clinical toxicity from the IFN-, immunotherapy was seen and no IFI relapsed during long-term follow-up. Our experience is both uncontrolled and in patients with unpredictable fungal infection-related outcomes. However, compared to standard approaches, the accelerated cure of life threatening, disseminated IFIs with 6 weeks of combination antifungal drug therapy and IFN-, immunotherapy saved lives, retained allograft function and led to substantial cost savings in this small patient group. [source]

The Importance of Skin Cancer Prevention in Organ Transplant Patients An Editorial to Paper by Salgo: ,Switch to Sirolimus in Long-Term Renal Transplant Recipients: Reduced Premalignancies and Nonmelanoma Skin Cancer in a Controlled, Prospective, Randomized, Blinded Study'

Successful treatment of multiple actinic keratoses in organ transplant patients with topical 5% imiquimod: a report of six cases

BRITISH JOURNAL OF DERMATOLOGY, Issue 2 2006
C. Ulrich
Summary Background, Nonmelanoma skin cancer represents a significant cause of morbidity in organ transplant recipients (OTRs). Cutaneous malignancies, mainly invasive squamous cell carcinoma and its precursor actinic keratosis (AK), appear approximately 5,10 years after organ transplantation. Impaired wound healing and high recurrence rates in immunocompromised patients treated with destructive therapies such as cryosurgery or topical 5-fluorouracil represent frequently known complications. Objectives, To evaluate the safety and efficacy of imiqimod 5% in the treatment of AKs in OTRs. Methods, Six OTRs (two kidney, two heart, one lung and one liver) with extensive AKs were treated with imiquimod 5% cream two to three times weekly in an open-label uncontrolled, nonrandomized pilot study. Results, In five of six patients treated with imiquimod 5% cream all AK lesions were cleared after 12,16 weeks. One patient showed partial response. Local adverse events at the site of application included erythema, oedema and mild erosion. No wound infection or scarring was observed in any of these patients. All graft-related laboratory parameters were stable during and after treatment. Immunosuppressive therapy remained unchanged throughout the treatment. Conclusions, These results suggest that imiquimod 5% cream may be useful for the local treatment of precancerous AK lesions in OTRs. [source]

Safety of allogeneic Epstein,Barr virus (EBV)-specific cytotoxic T lymphocytes for patients with refractory EBV-related lymphoma

BRITISH JOURNAL OF HAEMATOLOGY, Issue 3 2002
Qi Sun
Summary. Epstein,Barr virus (EBV) causes lymphomas in immunocompromised individuals such as recipients of stem cell or organ transplants and patients with acquired immunodeficiency syndrome (AIDS). EBV has also been detected in the Reed,Sternberg cells of approximately 50% of all cases of Hodgkin's disease (HD). The purpose of this study was to examine the safety, and the clinical and immunological effects of infusing allogeneic EBV-specific cytotoxic T lymphocytes (CTL) for patients with refractory EBV-positive malignancies. In this pilot study, we have treated four patients with EBV-related lymphoma using allogeneic EBV-specific CTL. Two patients received EBV-specific CTL derived from partially human leucocyte antigen (HLA)-matched donors and the other two from HLA-matched siblings. No complications were observed as a result of the CTL infusions and all patients showed increased levels of EBV-specific CTL precursors (CTLp) post infusion. Of the two organ transplant patients, one had refractory disease and has sustained a complete remission following the T-cell infusions. The second has also been disease free since T-cell infusions, although the efficacy cannot be definitively attributed to CTL therapy because this patient received local radiation therapy prior to immunotherapy. A patient with AIDS-related, EBV-positive lymphoma had disease progression following CTL infusions. One HD patient received HLA 4/6 matched T cells from an unrelated donor and showed a decrease in the size of affected lymph nodes and resolution of B-symptoms post infusion. In conclusion, adoptive immunotherapy with allogeneic EBV-specific CTL is safe and mayhave efficacy in patients with high-risk or refractory EBV-related tumours. [source]

Symptom experience associated with immunosuppressive drugs after liver transplantation in adults: possible relationship with medication non-compliance?

CLINICAL TRANSPLANTATION, Issue 6 2008
G. Drent
Abstract:, Symptom experience (occurrence and perceived distress) associated with side effects of immunosuppressive medications in organ transplant patients may well be associated with poorer quality of life and medication non-compliance. The aims of this study were: first, to assess symptom experience in clinically stable adult patients during long-term follow-up after liver transplantation; and second, to study the relationship between symptom experience and medication non-compliance. This cross-sectional study included 123 liver transplant patients. Symptom experience was assessed using the "Modified Transplant Symptom Occurrence and Symptom Distress Scale" (29-item version) at the annual evaluation. According to the duration of follow-up, patients were divided into a short-term (1,4 yr) and a long-term (5,18 yr) cohort. Medication non-compliance was measured using electronic monitoring. Results showed that increased hair growth was the most frequent symptom in both sexes. Symptom distress was more serious in women than in men. The most distressing symptom in women was excessive and/or painful periods, while in men this was impotence. Clear differences were revealed at item level between symptom occurrence and symptom distress in relationship with the two time cohorts and between sexes. No relationship was found between symptom experience and prednisolone non-compliance. [source]