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Clinical characteristics and outcomes of hospitalized kidney transplant recipients with COVID-19 infection in China during the Omicron wave:a single-center cohort study

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2024年第6期25卷 529-540页

作者： Duo LV Xishao XIE Qinyun YANG Zhimin CHEN Guangjun LIU Wenhan PENG Rending WANG Hongfeng HUANG Jianghua CHEN Jianyong WU Department of Clinical Pharmacy the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research Hangzhou 310003China kidney Disease Center the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Key Laboratory of kidney Disease Prevention and Control Technology Zhejiang ProvinceHangzhou 310003China Institute of Nephrology Zhejiang UniversityHangzhou 310003China Zhejiang Clinical Research Center of kidney and Urinary System Disease Hangzhou 310003China The Third Grade Laboratory under the National State Administration of Traditional Chinese MedicineHangzhou 310003China Information Center the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China

Background:Following the short-term outbreak of coronavirus disease 2019(COVID-19)in December 2022 in China,clinical data on kidney transplant recipients(KTRs)with COVID-19 are ***:We conducted a single-center retrospective study to describe the clinical features,complications,and mortality rates of hospitalized KTRs infected with COVID-19 between Dec.16,2022 and Jan.31,*** patients were followed up until Mar.31,***:A total of 324 KTRs with COVID-19 were *** median age was 49 *** median time between the onset of symptoms and admission was 13 ***,azvudine,and nirmatrelvir/ritonavir were administered to 67(20.7%),11(3.4%),and 148(45.7%)patients,***-nine(9.0%)patients were treated with more than one antiviral ***-eight(14.8%)patients were treated with tocilizumab and 53(16.4%)patients received baricitinib *** acute kidney injury(AKI)occurred in 81(25.0%)patients and 39(12.0%)patients were admitted to intensive care *** infections were observed in 55(17.0%)***(15.4%)patients lost their *** 28-d mortality rate of patients was 9.0%and 42(13.0%)patients died by the end of *** Cox regression analysis identified that cerebrovascular disease,AKI incidence,interleukin(IL)-6 level of>6.8 pg/mL,daily dose of corticosteroids of>50 mg,and fungal infection were all associated with an increased risk of death for hospitalized ***:Our findings demonstrate that hospitalized KTRs with COVID-19 are at high risk of *** administration of immunomodulators or the late application of antiviral drugs does not improve patient survival,while higher doses of corticosteroids may increase the death risk.

关键词： Coronavirus disease 2019(COVID-19) kidney transplant Hospitalization Mortality

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Acute pancreatitis as a complication of acute COVID-19 in kidney transplant recipients

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World Journal of Clinical Cases 2024年第6期12卷 1104-1110页

作者： Nikolina Basic-Jukic Ivana Juric Lea Katalinic Vesna Furic-Cunko Vibor Sesa Anna Mrzljak Department of Nephrology Arterial HypertensionDialysis and TransplantationUniversity Hospital Centre ZagrebZagreb 10000Croatia Department of Medicine School of MedicineZagreb 10000Croatia Department of Gastroenterology and Hepatology University Hospital Centre ZagrebZagreb 10000Croatia

BACKGROUND Acute pancreatitis is a rare extrapulmonary manifestation of coronavirus disease 2019(COVID-19)but its full correlation with COVID-19 infection remains *** To identify acute pancreatitis’occurrence,clinical presentation and outcomes in a cohort of kidney transplant recipients with acute *** A retrospective observational single-centre cohort study from a transplant centre in Croatia for all adult renal transplant recipients with a functioning kidney allograft between March 2020 and August 2022 to record cases of acute pancreatitis during acute *** were obtained from hospital electronic medical *** acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection was proven by a positive SARS-CoV-2 real-time reverse transcriptase-polymerase chain reaction on the nasopharyngeal *** Four hundred and eight out of 1432(28.49%)patients who received a renal allograft developed COVID-19 *** analyzed cohort included 321 patients(57%males).One hundred and fifty patients(46.7%)received at least one dose of the anti-SARS-CoV-2 vaccine before the *** hundred twenty-five(39.1%)patients required hospitalization,141(44.1%)developed pneumonia and four patients(1.3%)required mechanical *** included immunosuppression modification in 233 patients(77.1%)and remdesivir in 53 patients(16.6%),besides the other supportive *** the study cohort,only one transplant recipient(0.3%)developed acute pancreatitis during acute COVID-19,presenting with abdominal pain and significantly elevated pancreatic *** survived without complications with a stable kidney allograft *** Although rare,acute pancreatitis may complicate the course of acute COVID-19 in kidney transplant *** mechanism of injury to the pancreas and its correlation with the severity of the COVID-19 infection in kidney transplant recipients warrants further research.

关键词： Acute pancreatitis COVID-19 kidney transplant Angiotensin-converting enzyme-2 receptor Immunosuppressive agents

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Kaposi Sarcoma after kidney transplant: A Clinical Case Report

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Open Journal of Nephrology 2024年第1期14卷 115-123页

作者： Meryem Benbella Zaineb Kaouiri Imane Saidi Naima Ouzedoun Tarik Bouattar Department of Nephrology-Dialysis-Renal transplantation Ibn Sina University Hospital in Rabat Rabat Morocco Faculty of Medicine and Pharmacy in Rabat Mohammed V University Rabat Morocco

Kaposi sarcoma is a neoplasm caused by human herpesvirus 8 (HHV8) that most commonly affects immunosuppressed patients. The skin is the most affected area, but other sites can be involved such as the lung, digestive tract and lymph nodes. The classical presentation involves a violaceous skin lesion that can be small or hidden, leading to a delay in diagnosis. We report a clinical case of a kidney transplant patient, who presented, 14 months after kidney transplant, with unilateral edema of the inferior member and cutaneous rash misdiagnosed and taken initially for erysipelas. The diagnosis of Kaposi’s sarcoma was retained, on a lymph node biopsy of an inguinal adenopathy. The evolution was marked by a local and general improvement after systemic chemotherapy, reducing Tacrolimus and discontinuation of Mycophenolate mofetil. Graft function remained stable during the follow-up.

关键词： Kaposi kidney transplant HHV8 Immunosuppression

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Echerichia coli Infection—Associated Glomerulonephritis in a kidney transplant Patient: A Case Report

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Open Journal of Nephrology 2024年第1期14卷 81-85页

Post infectious Glomerulonephritis (PIGN) in renal allograft is a rare entity. Only a few Cases have been described in the literature. The post streptococcal glomerulonephritis is the classic example in native kidney. A wide variety of organism has been associated with PIGN in renal allograft such as Staphylococcus, Cytomegalovirus and Polyomavirus. We describe one case of Infection associated glomerulonephritis due to Echericha Coli, developed 5 years after kidney transplantation, in 47 years old female patient. The Clinical presentation was characterized by a peripheral edema and high blood pressure, and biological tests showed a nephrotic syndrome, an acute kidney injury, a consumption of Complement fractions. The renal biopsy revealed a diffuse endocapillary cell proliferation with preponderant deposits of C3. Total recovery was achieved 4 months after Methyprednisolone pulse and Cyclophasphamid with antimicrobial treatment.

关键词： Glomerulonephritis Echerichia coli kidney transplant

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Donor-Derived Transmission of Scedosporiosis in kidney transplant Recipients from a Systemic lupus erythematosus donor

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Current Medical Science 2023年第2期43卷 417-420页

作者： Cheng ZENG Yong-sheng MA Jun-ying ZHOU Cheng-biao XUE Yan XIONG Wei ZHOU Li-hua ZHOU Jian-guo LI Shao-jun YE Qi-fa YE Zhongnan Hospital of Wuhan University Institute of Hepatobiliary Diseases of Wuhan UniversityTransplant Center of Wuhan UniversityNational Quality Control Center for Donated Organ ProcurementHubei Key Laboratory of Medical Technology on TransplantationHubei Clinical Research Center for Natural Polymer Biological LiverHubei Engineering Center of Natural Polymer-based Medical MaterialsWuhan430071China Department of Laboratory Medicine Zhongnan Hospital of Wuhan UniversityWuhan430071China Intensive Care Unit Zhongnan Hospital of Wuhan UniversityWuhan430071China The Third Xiangya Hospital of Central South University Research Center of National Health Ministry on Transplantation Medicine Engineering and TechnologyChangsha410013China

Donor-derived infection(DDI)associated with Scedosporium spp is extremely rare,and results in a very poor *** present study reports a probable DDI due to Scedosporium boydii(***)from a donor with neuropsychiatric systemic lupus *** recipients developed Scedosporiosis after kidney transplantation from the same *** 1 died of central nervous system infection due to *** based on the clinical presentations,and the positive metagenomic next-generation sequencing(mNGS)and culture results for the cerebrospinal *** other recipient with urinary tract obstruction due to ***,which was identified through the positive culture and mNGS results of the removed stents,was successfully treated by stent replacement and voriconazole *** disseminated donor infection and the transmission of *** should be given attention,particularly when the donor and recipients have primary immunodeficiency *** screening of donors and recipients for *** using mNGS may be helpful in guiding antifungal prophylaxis and treatment recipients,due to its higher sensitivity and shorter diagnostic time relative to other traditional techniques.

关键词： kidney transplant Scedosporium boydii fungal infection donor-derived infection

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Emergency department visits and hospital admissions in kidney transplant recipients during the COVID-19 pandemic:A hospitalbased study

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World Journal of transplantation 2022年第8期12卷 250-258页

作者： Wachira Wongtanasarasin Phichayut Phinyo Department of Emergency Medicine Faculty of MedicineChiang Mai UniversityChiang Mai 50200Thailand Department of Emergency Medicine UC Davis School of MedicineSacramentoCA 95817United States Department of Family Medicine Faculty of MedicineChiang Mai UniversityChiang Mai 50200Thailand Center for Clinical Epidemiology and Clinical Statistics Faculty of MedicineChiang Mai UniversityChiang Mai 50200Thailand

BACKGROUND Several studies have demonstrated that the coronavirus disease 2019(COVID-19)has affected daily living and the healthcare *** previous study has described the consequences of COVID-19 on emergency department(ED)visits and hospital admission among kidney transplant(KT)*** To investigate the impact of the COVID-19 pandemic on ED visits and hospital admissions within 1 year in patients who underwent KT in *** We conducted a retrospective study at a university hospital in *** reviewed the hospital records of KT patients who visited the ED during the outbreak of COVID-19(from January 2020 to December 2021).We used the previous 2 years as the control period in the *** obtained baseline demographics and ED visit characteristics for each KT *** outcomes of interest were ED visits and ED visits leading to hospital admission within the 1^(st)year following a *** rate of ED visits and ED visits leading to hospital admissions between the two periods were compared using the stratified Cox proportional hazards *** A total of 263 patients were included in this study:112 during the COVID-19 period and 151 during the control *** were 34 and 41 ED visits after KT in the COVID-19 and control periods,*** rate of first ED visit at 1 year was not significantly different in the COVID-19 period,compared with the control period[hazard ratio(HR)=1.02,95%confidence interval(CI):0.54-1.92;P=0.96].The hospital admission rate was similar between periods(HR=0.92,95%CI:0.50-1.69;P=0.78).CONCLUSION ED visits and hospital admissions within the 1st year in KT recipients were not affected by the COVID-19 *** these findings,we believe that communication between post-KT patients and healthcare providers is essential to highlight the importance of prompt ED visits for acute health conditions,particularly in post-KT patients.

关键词： Emergency department visit Hospital admission kidney transplant COVID-19 Acute health conditions

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Dosing strategies for de novo once-daily extended release tacrolimus in kidney transplant recipients based on CYP3A5 genotype

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World Journal of transplantation 2023年第6期13卷 368-378页

作者： Adam Diamond Sunil Karhadkar Kenneth Chavin Serban Constantinescu Kwan N.Lau Oscar Perez-Leal Kerry Mohrien Nicole Sifontis Antonio Di Carlo Department of Pharmacy Temple University HospitalPhiladelphiaPA 19140United States Department of Surgery Temple University HospitalPhiladelphiaPA 19140United States Department of Medicine Temple University School of MedicinePhiladelphiaPA 19140United States Department of Pharmaceutical Sciences Jayne Haines Center for Pharmacogenomics and Drug SafetyTemple University School of PharmacyPhiladelphiaPA 19140United States Department of Pharmacy Practice Temple University School of PharmacyPhiladelphiaPA 19140United States

BACKGROUND Tacrolimus extended-release tablets have been Food and Drug Administrationapproved for use in the de novo kidney transplant *** requirements often vary for tacrolimus based on several factors including variation in metabolism based on CYP3A5 *** who express CYP3A5 often require higher dosing of immediate-release tacrolimus,but this has not been established for tacrolimus extended-release tablets in the de novo *** To obtain target trough concentrations of extended-release tacrolimus in de novo kidney transplant recipients according to CYP3A5 *** Single-arm,prospective,single-center,open-label,observational study(***:NCT037-13645).Life cycle pharma tacrolimus(LCPT)orally once daily at a starting dose of 0.13 mg/kg/day based on actual body *** weight is more than 120%of ideal body weight,an adjusted body weight was *** dose was adjusted to maintain tacrolimus trough concentrations of 8-10 ng/*** analysis of CYP3A5 genotype was performed at study *** Mean time to therapeutic tacrolimus trough concentration was longer in CYP3A5 intermediate and extensive metabolizers vs CYP3A5 non-expressers(6 d vs 13.5 d vs 4.5 d;P=0.025).Mean tacrolimus doses and weight-based doses to achieve therapeutic concentration were higher in CYP3A5 intermediate and extensive metabolizers vs CYP3A5 non-expressers(16 mg vs 16 mg vs 12 mg;P=0.010)(0.20 mg/kg vs 0.19 mg/kg vs 0.13 mg/kg;P=0.018).CYP3A5 extensive metabolizers experienced lower mean tacrolimus trough concentrations throughout the study period compared to CYP3A5 intermediate metabolizers and non-expressers(7.98 ng/mL vs 9.18 ng/mL vs 10.78 ng/mL;P=00.008).No differences were identified with regards to kidney graft function at 30-d *** adverse events were reported for 13(36%)*** Expression of CYP3A5 leads to higher starting doses and incremental dosage titration of extended-release

关键词： Immunosuppression kidney transplant Dosing Tacrolimus Therapeutic drug monitoring Genotype

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kidney transplant from donors with hepatitis B: A challenging treatment option

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World Journal of Hepatology 2021年第8期13卷 853-867页

作者： Praopilad Srisuwarn Vasant Sumethkul Department of Medicine Faculty of Medicine Ramathibodi HospitalMahidol UniversityBangkok 10400Thailand

Utilizing kidneys from donors with hepatitis B is one way to alleviate the current organ shortage ***,the risk of hepatitis B virus(HBV)transmission remains a challenge that undermines the chance of organs being *** is particularly true with hepatitis B surface antigen(HBsAg)positive donors despite the comparable long-term outcomes when compared with standard *** reduce the risk of HBV transmission,a comprehensive approach is *** includes assessment of donor risk,optimal allocation to the proper recipient,appropriate immunosuppressive regimen,optimizing the prophylactic therapy,and post-transplant *** review provides an overview of current evidence of kidney transplants from donors with HBsAg positivity and outlines the challenge of this *** topics include donor risk assessment by adopting the nucleic acid test coupled with HBV DNA as the HBV screening,optimal recipient selection,importance of hepatitis B immunity,role of nucleos(t)ide analogues,and hepatitis B immunoglobulin.A summary of reported long-term outcomes after kidney transplantation and proposed criteria to utilize kidneys from this group of donors was also defined and discussed.

关键词： Hepatitis B virus Organ donor Recipient allocation kidney transplant Transmission Long term outcomes

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Short- and Long-Term Outcomes of Cardiac Surgery in kidney transplant Recipients: A Review—kidney transplant and Cardiac Surgery

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World Journal of Cardiovascular Surgery 2023年第12期13卷 181-200页

作者： Nael Al-Sarraf Department of Cardiac Surgery Dabbous Cardiac Center Adan Hospital Kuwait City Kuwait

Background: Cardiovascular diseases remain the leading cause of death in kidney transplant patients and increasing proportion of these patients are referred to cardiac surgery. Data on short- and long-term outcomes of these patients are limited to single center reports with no randomized trials and no prospective studies published previously. The aim of this review was to report both short- and long-term outcomes of these patients. Methods: Literature review was conducted using three databases from inception to June 2022. Multiple search terms were used and limited to English language. Thirty-one relevant articles were included. Outcomes of interest were short-term mortality, long-term survival, renal allograft failure and infection in kidney transplant patients undergoing cardiac surgery. Results: Cardiac risk factors (diabetes mellitus, hypertension, hyperlipidemia) were prevalent in kidney transplant patients. 30-days mortality ranged across the studies from zero to 18.8%. The 1-year survival ranged from 71% - 97% and 5-years survival ranged from 31% - 95.7%. Commonest causes of death were cardiac and sepsis. Multiple predictors of mortality were reported. Postoperative acute kidney injury ranged from 0 - 74% with most of them being transient. kidney graft failure ranged from 0 - 45% with 5-year kidney graft survival rates ranged between 37% - 80%. Post-operative infection rates ranged from 1% - 25% and the most common sites were pneumonia followed by septicemia and surgical site infections. Conclusion: Cardiac surgery can be performed in kidney transplant patients with good short- and long-term results.

关键词： kidney transplant Cardiac Surgery Graft Failure Dialysis Immunosuppression

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Presentation and outcomes of chronic rhinosinusitis following liver and kidney transplant

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2021年第9期7卷 139-145页

作者： Aviv Spillinger Christopher M.Low Byron M.Smith Janalee K.Stokken Erin K.O'Brien Garret Choby Deportment of Otoloryngolosy-Head and Neck Surgery Mayo ClinicRochesterMN55905USA Biomedical Statistics and Informatics Mayo ClinicRochesterMN55905USA

non-invasive chronic rhinosinusitis(CRS)following liver or kidney transplant and determine factors associated with disease-related complications,selection of endoscopic sinus surgery(ESS),and disease resolution in this *** design:Retrospective chart ***:An academic tertiary care center(Mayo Clinic,Rochester,Minnesota).Subjects and methods:Liver and kidney transplant recipients evaluated by Mayo Clinic otolaryngologists for CRS between 1998 and 2018 were *** and multivariate logistic regression analyses were used to determine patient factors and treatment modalities associated with developing complications,selection of ESS,and disease ***:Fifty-seven patients met inclusion *** patients developed intraorbital or intracranial complications of their *** modeling demonstrated that the presence of polyps(P=0.036)was associated with undergoing ESS within one year of presentation.A higher Lund-Mackay(LM)computed tomography score(P=0.023)and older age(P=0.018)were significantly associated with decreased disease *** other factors were significantly associated with the use of endoscopic sinus surgery within one year of otolaryngology presentation or resolution of CRS in this ***:The risk of developing CRS-related intraorbital or intracranial complications in this immunecompromised patient cohort may be lower than originally *** liver-and kidney-recipients stable on immunosuppressive medication for many years,prognostic factors for CRS may mirror those for immunocompetent patients.

关键词： Rhinosinusitis Chronic rhinosinusitis Non-invasive rhinosinusitis kidney transplant Liver transplant Immunocompromised Immunosuppressed

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