Complications In Renal Allograft Recipients Research Articles

Clinicopathologic Spectrum and Outcomes of Infections Diagnosed on Graft Biopsies and Nephrectomy in Live Renal Allograft Recipients: An Institutional Experience.

Modern immunosuppressive regimens have reduced rejection episodes in renal allograft recipients but have increased the risk of opportunistic infections. Infections are considered to be the second leading cause of death after cardiovascular complications in renal allograft recipients. Data on opportunistic infections affecting the allograft itself are scarce. The present study describes the spectrum of renal opportunistic infections and their outcomes diagnosed on renal allograft biopsies and nephrectomy specimens. Our retrospective observational study was conducted from December 2011 to December 2021. We analyzed infectious episodes diagnosed on renal allograft biopsies or graft nephrectomy specimens. We obtained clinical, epidemiological, and laboratory details for analyses from hospital records. BK virus nephropathy was the most common opportunistic infection affecting the allograft, accounting for 47% of cases, followed by bacterial graft pyelonephritis (25%). Mucormycosis was the most common fungal infection. The diagnosis of infection from day of transplant ranged from 14 days to 39 months. Follow-up periods ranged from 1 to 10 years. Mortality was highest among patients with opportunistic fungal infection (62%), followed by viral infections, and graft failure rate was highest in patients with graft pyelonephritis (50%). Among patients with BK polyomavirus nephropathy, 45% had stable graft function compared with just 33% of patients with bacterial graft pyelonephritis. BK polyoma virus infection was the most common infection affecting the renal allograft in our study. Although fungal infections caused the highest mortality among our patients, bacterial graft pyelonephritis was responsible for maximum graft failure. Correctly identifying infections on histology is important so that graft and patient life can be prolonged.

MPA dosing and MPA levels: Correlation with incidences of rejection and infectious complications in renal allograft recipients

MPA dosing and MPA levels: Correlation with incidences of rejection and infectious complications in renal allograft recipients

Subcutaneous Nodules and Infectious Complications in Renal Allograft Recipients

Renal transplant recipients are at increased risk of infectious diseases and subject to cutaneous infections because of the effects of immunosuppressive therapy. Some long-term descriptive follow-up studies confirm that skin infections are common among renal transplant recipients. We report the development of subcutaneous nodules among patients receiving renal transplantations from 1991 to 2009. Transplant recipients were followed by the Nephrology Unit at control visits according to the American Society Nephrology guidelines. Between 1991 to 2009, subcutaneous nodules were identified in 7 out of 774 renal transplant recipients. The male:female ratio was 5:2; median age at renal transplantation was 52 years (range 28–59). Subcutaneous nodules were identified at a median 3 years after transplantation. The 7 patients had the following diagnoses: systemic scedosporiasis ( n = 1); Mycobacterium avium complex infection ( n = 2) disseminated tuberculosis ( n = 2) Sporothrix schenckii infection ( n = 1); Trichophyton rubrum infection ( n = 1). Four patients died due to sepsis from disseminated infection. Subcutaneous nodules may reflect a systemic infectious pathology. In some cases, the investigation of cutaneous lesions is important to reach a definitive diagnosis for possible future disseminated infections.

Infective Complications in Renal Allograft Recipients: Epidemiology and Outcome

Introduction Successful renal transplantation strictly depends on good control of rejection and better prevention and treatment of infections, which remain serious threats. Methods This retrospective, observational study of 245 renal allograft recipients who underwent transplantation between January 2002 and December 2005 included a 21 ± 10 months follow-up. Results A total of 110 (44.9%) patients developed an infective process during the posttransplantation period, namely, 232 infective processes. Eighty patients developed at least 1 episode of urinary tract infection (UTI) 11 patients (4%) had a wound infection, and 30 patients (12%) had pneumonia. We diagnosed 35 cases of bacteremia (35%), whereas cytomegalovirus (CMV) infection was demonstrated in 40 patients (16%). Conclusions Immunosuppressive therapy, necessary to avoid acute and chronic rejection, exposes patients to a higher rate of infectious complications. The immunosuppressive protocols led to a relatively low incidence of infectious complications, mainly of little clinical significance. The highest incidence was evident by the sixth month after transplantation, when the immunosuppressive regimen exercised its most depressive effects on patient immune systems.

Increased Risk of Hemorrhagic Complications in Renal Allograft Recipients Receiving Systemic Heparin Early Posttransplantation

The aim of this paper is to document the risk of hemorrhagic complications in renal allograft recipients requiring systemic heparinisation within the first 2 weeks posttransplantation. Methods A retrospective chart review of 326 RA recipients from January 1998 to July 2003 was subjected to statistics by SPIDA with P values <.05 considered significant. Results 16/326 (4.9%) recipients were initiated on intravenous (IV) heparin within the study period. Enoxaparin was subsequently used in 10/16 (62.5%) of these recipients. Intravenous heparin was instituted at a median 8 (1–14) days posttransplantation. Hemorrhagic complications occurred in 10/16 (62.5%) recipients on IV heparin versus 11/310 (3.5%) nonanticoagulated RA recipients ( P = .0001). Hemorrhage occurred at a mean 9.75 (2–43) days into the course of IV heparin. The median peak APTT 24 hours prior to hemorrhage in RA recipients on heparin was 68.5 (58–180) versus a median peak APTT of 70 (50–140) among recipients on heparin who did not sustain a hemorrhagic complication ( P = .30). A major intervention (predominantly surgery) was required in 6/16 (37%) recipients on IV heparin versus 7/310 (2.2%) nonheparinised RA recipients ( P < .0001). Enoxaparin was instituted at a mean 22.5 (4–55) days posttransplantation. Delayed hemorrhage subsequently occurred in 4/10 (40%) recipients on enoxaparin. In conclusion, major and minor hemorrhagic complications occur more commonly among recipients requiring early post transplant IV heparin. Hemorrhage occurred despite APTT monitoring with APTT levels tending to be similar in RA recipients with versus without complications. Delayed hemorrage was also seen with the subsequent use of enoxaparin.

Ocular complications in renal allograft recipients

Ocular complications in renal allograft recipients

Biliary tract complications in renal allograft recipients: two case reports

Biliary tract complications in renal allograft recipients: two case reports

Gastrointestinal Complications After Renal Transplantation

Gastrointestinal complications are responsible for substantial morbidity and mortality among renal allograft recipients in developing countries. During a 10 year period, 166 (62.6%) of 265 allograft recipients developed gastrointestinal complications. This figure reflects the high incidence of infectious complications, especially acute diarrheas. Also notable was the incidence of esophageal candidiasis (7.2%), ischemic colitis (2.6%), and gastrointestinal and peritoneal tuberculosis (3.0%). Almost one quarter of the complications developed in the first 6 months after transplantation. Mortality was the highest with acute ischemic colitis (100%), pancreatitis (60%), and upper gastrointestinal hemorrhage (40%). Improvements in standards of living and sanitary conditions, pre transplant evaluation and assessment of risk factors, prophylaxis with anti ulcer drugs, early diagnosis, and appropriate treatment are needed to decrease the frequency and severity of gastrointestinal complications in renal allograft recipients.

Ocular Complications in Renal Allograft Recipients

Ocular complications in renal allograft recipients are a significant cause of morbidity. Of 80 renal transplant recipients, 42 (52.5%) developed ocular complications. These included posterior subcapsular cataract in 22 patients (27.5%), opportunistic ocular infections by CMV, cryptococcus, mucormycosis, herpes simplex and herpes zoster in five (6.25%), steroid-induced raised intraocular pressure in four (5%) and primary disease-related vascular complications in ten (12.5%). Our findings highlight the importance of regular ocular examination of all allograft recipients in the post-transplant period.

Favorable effects of fish oil concentrate on risk factors for thrombosis in renal allograft recipients.

The incidence of thromboembolic complications in renal allograft recipients is very high. Since fish oil has antithrombotic properties, we administered 18 capsules of fish oil concentrate (1.5 g of eicosapentaenoic acid, EPA, and 0.7 g of docosahexaenoic acid) per day to 14 renal allograft recipients for 6 months. Another group of recipients served as controls. In the treated group the levels of EPA and docosahexaenoic acid in erythrocyte membrane lipids increased significantly after the fish oil treatment. Red blood cell filterability significantly increased in the treated group compared with the case of the control group. Epinephrine-induced platelet aggregation increased significantly in the control group, and this change was significantly different from that of the treated group (almost a null change). At the end of the study, the ratio of the main urinary metabolite of prostacyclin I2/3 to the metabolite of thromboxane A2/3 was significantly higher in the treated group than in the control group. In conclusion, we suggest that fish oil concentrate may favorably affect risk factors for thromboembolic complications in renal allograft recipients.

Thromboembolic Complications in Renal Allograft Recipients. A Report From the Prospective Randomized Study of Cyclosporine Versus Azathioprine-Antilym-phocyte Globulin

No AccessJournal of UrologyTransplantation1 Oct 1988Thromboembolic Complications in Renal Allograft Recipients. A Report From the Prospective Randomized Study of Cyclosporine Versus Azathioprine-Antilym-phocyte Globulin N.V. Raghavaiah N.V. RaghavaiahN.V. Raghavaiah More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)41871-4AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Thromboembolic Complications in Renal Allograft Recipients. A Report From the Prospective Randomized Study of Cyclosporine Versus Azathioprine-Antilym-phocyte Globulin." The Journal of Urology, 140(4), p. 903 © 1988 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 140Issue 4October 1988Page: 903 Advertisement Copyright & Permissions© 1988 by The American Urological Association Education and Research, Inc.MetricsAuthor Information N.V. Raghavaiah More articles by this author Expand All Advertisement Loading ...

Colorectal Complications of Renal Allograft Transplantation

The occurrence of perforated sigmoid diverticulitis in a renal transplant recipient stimulated a review of colorectal complications in renal allograft recipients. One hundred twenty-five renal transplantations were performed in 113 patients between January 1968 and December 1975. Six patients (5%) were identified as having colorectal complications and five of these patients died as a direct result. Chart analysis of these 113 transplant recipients identified 55 patients as having undergone colonic evaluation (contrast enema, postmortem examination), with seven of these 55 (13%) found to have diverticulosis and major colonic complications eventually developing in four of these seven. Since the mortality from the complications of colorectal diseases in immunosuppressed patients is so prohibitive, in patients with diverticulosis and a previous history suggestive of diverticulitis, consideration should be given to exclusion from transplantation or elective segmental colectomy prior to transplantation.