N Kamar

..New-onset diabetes mellitus (NODM)-a common complication of kidney transplantation-is associated with increases in graft loss, morbidity and mortality...

..Herein, we review the progress made in studying the epidemiology, hepatic, and extrahepatic manifestations, and the treatment of HEV infection, over the past 2 years...

..The aim of this review is to summarize the incidence, natural history, risk factors, and treatment of HEV infections in immunosuppressed patients. HEV-induced extrahepatic manifestations are described...

..Long-term kidney function seems to be predicted by the kidney vascular lesions...

..In this comprehensive minireview, we summarize the current knowledge on HEV infection in transplant patients, that is, its prevalence, incidence, natural history and therapy...

..14 [1.11-1.16]). This meta-analysis reveals that the association between PTA and DPWFG varies with PTA definition and adjustment for confounders. In all sub-meta-analyses, PTA was significantly associated with DCGL...

..Hepatitis E virus (HEV) infection is an emerging disease in industrialized countries. Few data regarding genotype 3 HEV extrahepatic manifestations exist...

..Adverse events overall, but not those with a suspected relation to EC-MPS, were higher with ECMPS 1,440 mg/d...

..In this study, we described p cytokines and cystatin C variations during and after hemodialysis in septic-shock patients with acute kidney injury (AKI)...

..The time from transplantation to diagnosis was significantly shorter and the total counts of lymphocytes and of CD2, CD3, and CD4 T cells were significantly lower in patients in whom chronic disease developed...

..In liver-transplant patients, in addition to anti-HCV therapy, rituximab might be also used...

..Hence, CMV reactivation is frequent after kidney transplantation. CMV prophylaxis in CMV seropositive kidney-transplant patients should be offered to avoid CMV-related side-effects...

..This might increase the number of kidney allografts from extended criteria donors...

..In both cases, a liver biopsy showed cirrhosis. We conclude that HEV infection cannot only evolve to chronic hepatitis, but can also be responsible for rapidly progressing cirrhosis in organ-transplant patients...

..After kidney transplantation, the use of rituximab is associated with a high risk of infectious disease and death related to infectious disease...

..Primary focal segmental glomerular sclerosis (FSGS) recurs in 20 - 40% of patients after kidney transplantation. Rituximab has been used to treat several glomerular diseases...

..The aim of this study was to assess the effects of tacrolimus in combination with either sirolimus (n = 10) or mycophenolate mofetil (n = 7) on renal function and renal histopathologic factors 6 and 12 months after kidney transplantation...

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..A study was implemented in a French population of kidney transplants. The incidence and risk factors of NODM were analysed. Diabetes was defined according to American Diabetes/World Health Organization guidelines...

..In conclusion, administration of 1 g of MMF was associated with a transient decrease in CD25 expression in addition to a temporary dramatic decrease in both T-cell proliferation and IMPDH activity...

..The diversification of the HVR-1 of the HCV genome might be used to predict liver fibrosis outcome...

..i.d...

..CNIs dose reduction or conversion to proliferating signal inhibitors may be a therapeutic alternative...

..To provide data on conversion of kidney transplant patients from sirolimus to everolimus...

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..Neurologic outcomes were complete resolution (n = 3), improvement with residual neurologic deficit (n = 3), and no improvement (n = 1). Neurologic disorders are an emerging extrahepatic manifestation of HEV infection...

..Chronic kidney disease is a common complication after liver transplantation. However, few reports regarding kidney histology exist for this setting...

..We assessed the antiviral effect of ribavirin monotherapy in patients with chronic HEV infection following kidney transplantation...

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..The discovery of quasispecies compartmentalization and its temporal association suggests that neurological symptoms could be linked to the emergence of neurotropic variants...

..Hepatitis-E virus (HEV) infection can be responsible for chronic hepatitis in solid-organ transplant patients...

..A virological response was sustained for 6 and 5 months in 2 patients after Peg-IFN-alpha-2a therapy was completed. A relapse was observed in the third patient...

..The reduction of immunosuppressive drugs could be considered as a first-line therapeutic option...

..High doses of ESA within the first month of kidney transplantation have no impact on anemia or renal function by 1 month post-transplant...

..We conclude that plasmapheresis should be started as soon as AHR is diagnosed, and be associated with a B-cell depleting agent. Rituximab may be considered as a first-line therapy...

..There was a trend toward a lower proportion of patients with MPA AUC0-12h below 30 mg x h/L in the concentration-controlled group. No difference in outcome was found between both groups...

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..The aim of our study was to prospectively assess 1-year allograft outcomes and the evolution of lymphocyte subsets in a group of renal transplant patients who had received intraoperative rabbit antithymocyte antibodies (RATG)...

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..17, P=0.045). Intrahepatic Th1 cytokine profile seems to be predominant in patients with extensive fibrosis and activity scores, suggesting that it might be responsible for liver injury in renal transplant patients...

..To date, there is no safe and efficient treatment of hepatitis C virus (HCV) infection after renal transplantation. Recently, there were encouraging reports after using amantadine in HCV-positive immunocompetent patients...

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..5% of delayed CsA-ME patients (n.s.). Both regimens were well tolerated. These data suggest that early or delayed introduction of CsA-ME results in similar renal function in renal transplant patients regardless of DGF risk level...

..We concluded that anemia was highly prevalent within the first year of post-OLT. This observation deserves further investigation and appropriate treatment...

..0443). The only factor that predicted treatment for the first episode of HCMV DNAemia was an alkaline phosphatase level >150 UI/mL at the time of the first HCMV reactivation [odds ratio 20 (1.96 to 203.3); P = .01]...

..As expected, intralymphocytic interleukin-2 (IL-2) and tumor necrosis factor-alpha (TNF-alpha) expressions were higher in patients not receiving CNIs...

..The rate of HCV recurrence was 56.25%. In addition, HCV RNA serum concentrations increased significantly posttransplantation (>1 log). In conclusion, RATG induction therapy is safe and efficient in HCV-positive liver recipients...

..2), donor age >45 years (odds ratio = 11.4) and lymphocyte count at M2 <1300/mm(3) (odds ratio = 7.33). This study showed that the major factors associated with CMV infection were recipient CMV status, donor age, and lymphocyte count...

..JCV replication must still be diagnosed and differentiated from BK virus infection because of its non-aggressive course...

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..We assessed whether conversion from tacrolimus (TAC) to cyclosporine (CsA) was associated with a reduction in hepatitis C virus (HCV) viral load among HCV-positive liver transplant (OLT) patients...

..CONCLUSION: ARF is quite common after OLT and significantly increases the post-operative time at the hospital, thereby increasing the OLT cost. Its independent predictive factors are mainly related to perioperative events...

..Most patients were highly sensitized with 1 (0-4) HLA (classes I + II) incompatibility between donor and recipient...

..It impact upon renal function remains unknown. Nevertheless when proteinuria is present it disappears...

..Darbepoetin alfa is used to treat renal anemia; however, little information is available concerning its use during the posttransplant period, especially in HCV-positive patients treated with ribavirin for active hepatitis C...

..Gastrointestinal adverse events were responsible for dose reduction or interruption in only 5% of patients...

..Remission was observed before the third rituximab injection. After a follow-up of 42 months, the patient was still in remission, i.e., microalbuminuria of 107 mg/day...

..CONCLUSION: The prevalence of anemia is 25% at M12; DGF, renal function at M12, and anemia at M6 were independent risk factors of anemia at M12...

..Despite its efficiency to dramatically decrease proteinuria, its impact on renal function remains unknown...

..CONCLUSION: Conversion from CNIs to sirolimus in renal transplant patients with chronic allograft nephropathy was associated with improved renal function; however, 33% of the patients developed overt proteinuria...

..After renal transplantation, the prevalence of BK virus (BKV) viruria, viremia, and nephritis (BKVAN) has been estimated at 30%, 13%, and 8%, respectively...

..Cyclosporine might have beneficial effects on the natural course of HCV infection after renal transplantation...

..We concluded that FTY720 may be a useful drug to inhibit chronic vascular rejection...

..At last follow-up, DSA had disappeared or decreased in four cases. Rituximab therapy, in addition to PE, might be of benefit for RT patients presenting with AHR...

..Among the cancers, skin neoplasms represented 30% in group I and 26% in group II (P = ns). CONCLUSION: Adjusting RATG doses according to the CD2 lymphocyte count is safe, and a less expensive than using full doses...

..Although recombinant human erythropoietin (rHuEPO) is used in post-transplant anemic patients, little information is available concerning the use of darbepoetin-alfa (DA) in this population...

..During the acute phase, plasmapheresis and steroid pulses can be used. However, future prospective, controlled, and randomized studies are still required to establish evidence-based guidelines to treat HCV-related glomerulopathies...

..We concluded that rituximab therapy is effective in cryoglobulin-related renal dysfunction in renal transplant patients but, due to chronic immunosuppression, this may be achieved at the expense of infectious complications...

..Although rare, HSV-2-disseminated infection, in the context of organ transplantation may be life-threatening, but can be cured if ACV therapy is initiated early in the course of this disease...

..Because of the potential side effects of linezolid, i.e. myelosuppression and possibly nephrotoxicity, we recommend close monitoring of these parameters when linezolid therapy is attempted in kidney transplant patients...

..Humoral alloreactivity toward HLA may thus play a causal role for the development of CVR and this opens new possibilities for the treatment of CVR...

..The hepatocellular injury episode resolved after the patient had been placed on oseltamivir therapy. This observation suggests that acute hepatocellular injury could be linked to the influenza H1N1 virus...

..Thanks to modern laboratory technique, and a formidable antiviral armamentarium, viral infections in organ transplant patients i) can be easily detected at early stages, and ii) can be efficiently treated...

..In conclusion, DVA is a frequent cause of chronic diarrhea in SOT recipients. MPA therapy is the most frequent cause of DVA. An OGD should be proposed to all transplant recipients who present with persistent diarrhea...

..A few cases of acute renal failure with glomerular syndrome, caused by S. enteritidis infection, have been reported in the literature, but none have been proven by histological findings...

..75 T/L), daily dosage at M1 of cyclosporine and tacrolimus, and OLT for causes other than alcohol abuse. CONCLUSION: Anemia is highly prevalent within the first year post-OLT. This deserves further investigation and appropriate treatment...

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..Finally, in chronic hemodialysis who are not candidate for renal transplantation IFN-alpha therapy can be discussed according the patients' age and general health status...

..To examine the prevalence of cryoglobulinemia (Cryo) and autoimmune markers in renal-transplant recipients in a stable condition, and to determine its risk factors and impact upon allograft function...

..We conclude that these biomarkers used in whole-blood assays are suitable for PD of immune modulators in clinical trials...

..In conclusion, hemodialysis patients waiting for a RT need to be treated with alpha-IFN because when HCV RNA clearance occurred, they experienced no relapse after transplantation despite chronic immunosuppressive treatment...

..In vitro, everolimus inhibited lymphocyte proliferation and IL-10 synthesis dose dependently in anti-CD3 mAb and LPS stimulated peripheral blood mononuclear cell cultures derived from human volunteers...

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..Moreover, we suggest ribavirin daily doses according to various levels of renal function...

..The aim of this study was to assess i) T-cell functions before and after conversion from MMF to leflunomide in kidney-transplant patients with PVAN, and ii) effects of leflunomide on PVAN outcome...

..Conversely, if these HCV(+) KT patients lose their allograft, re-transplantation might be contemplated provided alphaIFN therapy has been attempted...

..e., rituximab). Thus, this provides the rationale to use rituximab for cryoglobulin-related graft dysfunction in RT patients...

..The diversification of the HVR-1 might be used to predict liver fibrosis outcome...

..Finally, when HCV-positive dialysis patients with a sustained virological response undergo successful renal transplantation, very few suffer a virological relapse, thus emphasizing that these patients were cured...

..Severe chronic hemolysis is responsible for iron overload, liver iron deposition, and an acceleration in the progression of liver fibrosis...

..5% (n=12) of patients, of whom two had two or more consecutive HCMV DNAemias. Valganciclovir prophylaxis in HCMV-seropositive kidney-transplant patients is effective for preventing cytomegalovirus disease...

..These data may explain the efficiency of rituximab in these circumstances...

..One-yr results have been published previously. We now report the results of an extension study in which patients were followed up for a period of three yr post-transplant...

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..25%; p = ns) patients. Both induction therapies were clinically and biologically well tolerated. CONCLUSION: RATG induction therapy is as efficient and as safe as induction with anti-CD25 monoclonal antibodies...

..No biochemical or virologic relapse was seen during follow-up. The absence of HCV relapse in formerly HCV-infected immunocompromised patients suggests the complete eradication of HCV after its elimination while on dialysis...

..Overall, there was a significant increase in proteinuria from 0 (0-3.15) to 0.57 (0-4.85) g/day (P=0.002). Finally, the conversion was associated with a significant increase in lipids, and a significant decrease in hemoglobin levels...

..Resistant HCV strains could be distinguished from sensitive viruses as early as a few hours after the beginning of the treatment...

..Further studies are required now to validate the threshold value at which we should begin pre-emptive therapy...

..It can be proposed to all patients, but still needs to be evaluated for repeat transplantation. The main barriers are organ-allocation policies and late referral of patients to transplantation centers...