Abstract:
:Histoplasma capsulatum is a dimorphic fungus that most often causes asymptomatic infection in the immunocompetent population. In immunocompromised patients, including solid organ transplant (SOT) and hematopoietic cell transplant (HCT) recipients, however, it is likely to cause severe life-threatening infection. Post-transplant histoplasmosis (PTH) in SOT is uncommon with an incidence of ≤1% and is even rarer in HCT patients. The majority of PTH in SOT is diagnosed in the first 2 years following transplantation. Histoplasmosis may result from endogenous reactivation of latent infection, de novo post-transplant acquisition, and donor-derived infection. Disseminated infection is common. Fever is the most common symptom and clinical features are often nonspecific, but patients with disseminated infection may present with a septic picture. Other features, including pancytopenia and hepatosplenomegaly, may not be prominent early in the course of illness. Contemporary histoplasma antigen assays are the most sensitive tests but cross-reactivity with antigens of other fungi, including with Aspergillus galactomannan, is not uncommon. Treatment should be continued for at least a year. Histoplasma antigen levels have prognostic value and can be used to monitor the response to therapy. The attributable mortality is approximately 10%. Routine screening of donors and recipients is not currently recommended.
journal_name
Clin Transplantjournal_title
Clinical transplantationauthors
Gajurel K,Dhakal R,Deresinski Sdoi
10.1111/ctr.13087subject
Has Abstractpub_date
2017-10-01 00:00:00issue
10eissn
0902-0063issn
1399-0012journal_volume
31pub_type
杂志文章,评审abstract::Although FK 506 has been shown to effectively reverse refractory renal allograft rejection, its ability to reverse accelerated renal allograft rejection as a primary agent has not been specifically addressed. Herein evidence of the ability of FK 506 to reverse accelerated renal allograft rejection is presented. A 16-y...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1997-08-01 00:00:00
abstract:BACKGROUND:With the growing numbers of liver transplant recipients, it is increasingly important to understand the risks of de novo malignancy after liver transplantation. AIM:To characterize the incidence of de novo malignancy after liver transplantation compared with a control non-transplant population. METHODS:We ...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.12171
更新日期:2013-07-01 00:00:00
abstract::Steroid-resistant acute rejection (SR-AR) and ductopenic rejection (DR) after liver transplantation are infrequent, but difficult to manage. We performed a retrospective review of patients with SR-AR or DR treated with sirolimus-based therapy. Since 2002, we have treated five patients with SR-AR and eight patients wit...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2008.00906.x
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Although liver transplantation may potentially cure hepatocellular carcinoma (HCC), the risk of HCC recurrence is 8%-20% at five years post-transplant. Pre-transplant alpha-fetoprotein (AFP) is a predictor of HCC recurrence, but it is unknown if pre-transplant AFP also predicts survival in patients with recu...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13634
更新日期:2019-07-01 00:00:00
abstract::Subclinical rejection (SCR) is quite common early following renal transplantation and decreases progressively with time. The immunological profile of the recipient, the immunosuppressive regimen used, and the occurrence of prior episodes of clinical acute rejection (AR) are all risk factors for SCR. SCR, in turn, is a...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/j.1399-0012.2008.00888.x
更新日期:2009-03-01 00:00:00
abstract::Anti-Xa monitoring for low molecular weight heparin (LMWH) is currently recommended in obese, renally impaired, and pregnant patients. Substantial evidence indicates that solid organ transplant (SOT) patients are at an increased risk of renal impairment, thus representing a population at risk of LMWH accumulation. The...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12240
更新日期:2013-11-01 00:00:00
abstract::Renal transplantation offers patients with end-stage renal disease the best opportunity for rehabilitation and long-term survival. However, there is a critical shortage of transplantable kidneys worldwide. This plays well into the hands of transplanters and entrepreneurs involved in commercial renal transplantation, p...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1995-08-01 00:00:00
abstract::In Norway living kidney donors account for approximately 40% of all renal transplants. There is a shortage of information about how living kidney donors experience the donation process during the initial recovery from surgery. The aim of this study was to explore physical and psychosocial issues related to the experie...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00304.x
更新日期:2005-02-01 00:00:00
abstract::The use of tacrolimus (FK506) in adult kidney-transplant recipients has been the subject of a number of single- and multi-center studies. This review article focuses on those studies in which tacrolimus was used either as rescue therapy in patients who developed refractory rejection on cyclosporine (CyA)-based regimen...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:
更新日期:1998-12-01 00:00:00
abstract::Citrullinaemia is a rare autosomal recessive disorder due to a deficiency of argininosuccinate synthetase (ASS). While the clinical course of the adult onset form (Type II) is unpredictable, many patients undergo sudden deterioration with progressive cerebral oedema. Two patients with Type II citrullinaemia were refer...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1997-10-01 00:00:00
abstract:BACKGROUND:Methamphetamine (MA) has cumulative deleterious effects on multiple organ systems. A history of MA exposure in kidney donors may affect adversely graft function in recipients. METHODS:Between September 2000 and March 2004, all deceased kidney donors were identified from the local registry (97 donors). Twent...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2007.00703.x
更新日期:2007-09-01 00:00:00
abstract::Subclinical acute rejection (SAR) occurs in about 30% of stable renal transplant patients and may be a risk factor for a poor allograft outcome. In the present study, the prevalence and clinical features of subclinical rejection, and the expression of immune activation markers in surveillance graft biopsies were asses...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00170.x
更新日期:2004-08-01 00:00:00
abstract::Recent changes in Center for Medicare & Medicaid Services (CMS) condition for participation, using benchmark volume/outcomes requirements for certification, have been implemented. Consequently, the ability of a transplant center to assess its risk tolerance is important in successful management. An analysis of SRTR da...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2012.01658.x
更新日期:2012-05-01 00:00:00
abstract::Steroid withdrawal has potential risks (rejection) and benefits (fewer complications). Most data on steroid-related complications predates cyclosporine (CsA). We tabulated the incidence of posttransplant complications considered to be steroid-related in 748 adult kidney transplant recipients (with at least 1 year of f...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
abstract::The aim of this study was to improve outcomes in living donor liver transplantation (LDLT) patients with portal vein thrombosis (PVT). Of 246 adult patients who underwent LDLT with a right lobe graft between January 2000 and May 2007, PVT was diagnosed in 50 patients (20.3%), who were further subdivided into partial (...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2010.01217.x
更新日期:2011-01-01 00:00:00
abstract::The effect of storage temperature on early graft function following liver transplantation was investigated by analyzing the results following transplantation during three periods in which different techniques for graft storage were used. The techniques involved ice-packing (period 1), storage in a standard operating ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1992-04-01 00:00:00
abstract::Research with human transplant recipients has shown that mycophenolate mofetil (MMF) is a powerful and selective immunosuppressant for maintenance therapy following renal transplantation. An additional body of work suggests that it might also be a valuable tool for arresting ongoing rejection episodes. One randomized,...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:
更新日期:1996-02-01 00:00:00
abstract:BACKGROUND:Cardiac allograft vasculopathy (CAV) limits survival after heart transplantation (HTx). Between immunologic and non-immunologic factors, reactive oxygen species generation has been proposed as pathogenetic mechanism. This study was aimed at evaluating redox status in HTx recipients and verifying whether it c...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2005.00352.x
更新日期:2005-06-01 00:00:00
abstract::Kidney outcomes in early post-liver transplantation (LT) are crucial for long-term prognosis, but difficult to predict. Among 203 adult LT patients, we studied the value of plasma neutrophil gelatinase-associated lipocalin (NGAL) measured pre-LT for predicting acute kidney injury (AKI), kidney-replacement therapy with...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12394
更新日期:2014-08-01 00:00:00
abstract::ABO-incompatible kidney transplantation (ABO-ILKT) has been reported to have a higher rate of early complications and higher medical costs than ABO-compatible kidney transplantation (ABO-CLKT). We aimed to compare the clinical outcomes, complications, and medical costs between ABO-ILKTs and ABO-CLKTs at 2 years post-t...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.13591
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Cyclosporine (CsA) and tacrolimus (Tac) in heart transplantation (HTx) have been compared but with certain drawbacks. We compared both drugs in a prospective analysis with medium-term follow-up. METHODS:Hundred and six patients were randomized to receive CsA or Tac (53 per group). Target levels of CsA were ...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-0012.2010.01309.x
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Mycobacterium tuberculosis (TB) is a common pathogen worldwide, and it may cause significant infection after solid organ transplantation (SOT). We reviewed all reported TB cases to provide an update on its epidemiology, clinical presentation, management, and outcome after SOT. METHODS:MEDLINE, EMBASE, and O...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/ctr.13259
更新日期:2018-06-01 00:00:00
abstract:INTRODUCTION:Atherosclerosis is a serious complication and leading cause of mortality in renal transplant recipients (RTRs). Hyperlipidemia may be associated with progression of renal disease and chronic allograft dysfunction. Similarities in the pathogenesis of glomerulosclerosis and atherosclerosis have been proposed...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00162.x
更新日期:2004-06-01 00:00:00
abstract::Daclizumab (DAC) is a molecularly engineered humanized IgGa monoclonal Ab directed against the alpha chain of the interleukin-2 receptor (IL2R). Inhibiting the amplification of the immune response by blocking IL2R can reduce the frequency of acute rejection without the attendant risk of infection. The purpose of this ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2000.14040902.x
更新日期:2000-08-01 00:00:00
abstract::Enteric drainage of secretions by anastomosing the donor duodenum to the recipient's small bowel has become common in pancreatic transplantation. While it eliminates many problems, endoscopic access to the transplanted duodenum and pancreas is made difficult. After a pancreas kidney transplant, the patient presented w...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00111.x
更新日期:2004-02-01 00:00:00
abstract::Invasive fungal infections are a feared complication in kidney transplant recipients (KTRs). Here we present the University of Wisconsin experience with 5 invasive fungal infections-aspergillosis, cryptococcosis, histoplasmosis, blastomycosis, and coccidioidomycosis-in KTRs transplanted between 01/01/1994 and 06/30/20...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.13289
更新日期:2018-07-01 00:00:00
abstract::The aging of the on-dialysis population raises the issue of whether to propose elderly patients for kidney transplantation and how to manage their immunosuppression. This study aimed to analyze the outcome of kidney transplantation on an Italian series of elderly recipients. We included in this retrospective study all...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13036
更新日期:2017-10-01 00:00:00
abstract::Renal transplantation was performed in a 24-yr-old woman with type AA systemic amyloidosis. Renal biopsy at 11 yr post-transplantation showed no amyloid recurrence, but the presence of mesangial proliferative glomerulonephritis and focal segmental glomerular sclerosis. Renal function was satisfactory with the exceptio...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::Coronary artery disease (CAD) is a pathology often found in patients with end-stage lung disease. Although in the past CAD might have been considered an absolute contraindication, modern revascularization techniques have helped increase the number of transplants performed in this population. However, discrepancies in ...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/ctr.14078
更新日期:2020-11-01 00:00:00
abstract::We prospectively studied efficacy and safety outcomes of two 10-mg doses of intravenous basiliximab on day 0 and day 4 for induction therapy in 17 consecutive de novo heart transplant recipients. By the 2-week assessment post-transplant, there were no deaths, graft failures, or acute cellular rejections (ACRs) ISHLT g...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13132
更新日期:2017-12-01 00:00:00