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1. Outcome of Patients Transplanted for C3 Glomerulopathy and Primary Immune Complex-Mediated Membranoproliferative Glomerulonephritis

Author

Amico, Patrizia, Aubert, John-David, Banz, Vanessa, Beckmann, Sonia, Beldi, Guido, Berger, Christoph, Berishvili, Ekaterine, Binet, Isabelle, Bochud, Pierre-Yves, Branca, Sanda, Bucher, Heiner, Catana, Emmanuelle, Chalandon, Yves, De Geest, Sabina, De Seigneux Michael Dickenmann, Sophie, Dreifuss, Joëlle Lynn, Duchosal, Michel, Fehr, Thomas, Ferrari-Lacraz, Sylvie, Garzoni, Christian, Gaudet, Christophe, Golshayan, Déla, Goossens, Nicolas, Halter, Jörg, Heim, Dominik, Hess, Christoph, Hillinger, Sven, Hirsch, Hans H., Hirt, Patricia, Hofbauer, Günther, Huynh-Do, Uyen, Immer, Franz, Koller, Michael, Laager, Mirjam, Laesser, Bettina, Lamoth, Frédéric, Lehmann, Roger, Leichtle, Alexander, Manuel, Oriol, Marti, Hans-Peter, Martinelli, Michele, McLin, Valérie, Mellac, Katell, Mercay, Aurelia, Mettler, Karin, Mueller, Nicolas J., Müller, Antonia, Müller-Arndt, Ulrike, Müllhaupt, Beat, Nägeli, Mirjam, Oldani, Graziano, Pascual, Manuel, Passweg, Jakob, Posfay-Barbe, Klara, Rick, Juliane, Rosselet, Anne, Rossi, Simona, Rothlin, Silvia, Ruschitzka, Frank, Schachtner, Thomas, Schanz, Urs, Schaub, Stefan, Schwab, Simon, Schnyder, Aurelia, Schuurmans, Macé, Sengstag, Thierry, Simonetta, Federico, Steiger, Jürg, Stirniman, Guido, Stürzinger, Ueli, Van Delden, Christian, Venetz, Jean-Pierre, Villard, Jean, Vionnet, Julien, Wick, Madeleine, Wilhlem, Markus, Yerly, Patrick, Halfon, Matthieu, Taffé, Patrick, Bucher, Christian, Haidar, Fadi, Huynh-do, Uyen, Mani, Laila-Yasmin, Wehmeier, Caroline, Fakhouri, Fadi, and Golshayan, Dela

Published
2025
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2. The MELD upgrade exception: a successful strategy to optimize access to liver transplantation for patients with high waiting list mortality

Author

Amico, Patrizia, Axel, Andres, Aubert, John-David, Banz, Vanessa, Sonja, Beckmann, Beldi, Guido, Benden, Christian, Berger, Christoph, Binet, Isabelle, Bochud, Pierre-Yves, Branca, Sanda, Bucher, Heiner, Carrel, Thierry, Catana, Emmanuelle, Chalandon, Yves, de Geest, Sabina, de Rougemont, Olivier, Dickenmann, Michael, Dreifuss, Joëlle L., Duchosal, Michel, Fehr, Thomas, Ferrari-Lacraz, Sylvie, Garzoni, Christian, Soccal, Paola G., Gaudet, Christophe, Giostra, Emiliano, Golshayan, Déla, Hadaya, Karine, Halter, Jörg, Hauri, Dimitri, Heim, Dominik, Hess, Christoph, Hillinger, Sven, Hirsch, Hans, Hirt, Patricia, Hofbauer, Günther, Huynh-Do, Uyen, Immer, Franz, Koller, Michael, Laesser, Bettina, Lang, Brian, Lehmann, Roger, Leichtle, Alexander, Lovis, Christian, Manuel, Oriol, Marti, Hans-Peter, Martin, Pierre Y., Martinelli, Michele, Mellac, Katell, Merçay, Aurélia, Mettler, Karin, Meylan, Pascal, Mueller, Nicolas, Müller, Antonia, Müller, Thomas, Müller-Arndt, Ulrike, Müllhaupt, Beat, Nägeli, Mirjam, Pascual, Manuel, Posfay-Barbe, Klara, Rick, Juliane, Rosselet, Anne, Rossi, Simona, Rothlin, Silvia, Ruschitzka, Frank, Schanz, Urs, Schaub, Stefan, Schnyder, Aurelia, Schuurmans, Macé, Simonetta, Federico, Staufer, Katharina, Stampf, Susanne, Steiger, Jürg, Stirniman, Guido, Stürzinger, Ueli, Toso, Christian, Van Delden, Christian, Venetz, Jean-Pierre, Villard, Jean, Vionnet, Julien, Wick, Madeleine, Wilhlem, Markus, Yerly, Patrick, Dirchwolf, Melisa, Becchetti, Chiara, Gschwend, Sarah G., Dutkowski, Philipp, Beyeler, Franziska, Schropp, Jonas, and Dufour, Jean-François

Published
2022
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3. BK Polyomavirus‐Specific 9mer CD8 T Cell Responses Correlate With Clearance of BK Viremia in Kidney Transplant Recipients: First Report From the Swiss Transplant Cohort Study

Author

Leboeuf, C., Wilk, S., Achermann, R., Binet, I., Golshayan, D., Hadaya, K., Hirzel, C., Hoffmann, M., Huynh‐Do, U., Koller, M. T., Manuel, O., Mueller, N. J., Mueller, T. F., Schaub, S., van Delden, C., Weissbach, F. H., Hirsch, H. H., Amico, Patrizia, Aubert, John‐David, Banz, Vanessa, Beldi, Guido, Benden, Christian, Berger, Christoph, Bochud, Pierre‐Yves, Bucher, Heiner, Bühler, Leo, Carell, Thierry, Catana, Emmanuelle, Chalandon, Yves, de Geest, Sabina, de Rougemont, Olivier, Dickenmann, Michael, Duchosal, Michel, Elkrief, Laure, Fehr, Thomas, Ferrari‐Lacraz, Sylvie, Garzoni, Christian, Soccal, Paola Gasche, Gaudet, Christophe, Giostra, Emiliano, Halter, Jörg, Heim, Dominik, Hess, Christoph, Hillinger, Sven, Hofbauer, Günther, Immer, Franz, Klaghofer, Richard, Laesser, Bettina, Lehmann, Roger, Lovis, Christian, Marti, Hans‐Peter, Martin, Pierre Yves, Meylan, Pascal, Mohacsi, Paul, Morel, Philippe, Mueller, Ulrike, Mueller‐McKenna, Helen, Müller, Antonia, Müller, Thomas, Müllhaupt, Beat, Nadal, David, Pascual, Manuel, Passweg, Jakob, Rick, Juliane, Roosnek, Eddy, Rosselet, Anne, Rothlin, Silvia, Ruschitzka, Frank, Schanz, Urs, Schnyder, Aurelia, Seiler, Christian, Stampf, Susanne, Steiger, Jürg, Stirnimann, Guido, Toso, Christian, Venetz, Jean‐Pierre, Villard, Jean, Wick, Madeleine, Wilhelm, Markus, and Yerly, Patrick

Published
2017
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4. The MELD upgrade exception: a successful strategy to optimize access to liver transplantation for patients with high waiting list mortality

Author

Dirchwolf, Melisa, primary, Becchetti, Chiara, additional, Gschwend, Sarah G., additional, Toso, Christian, additional, Dutkowski, Philipp, additional, Immer, Franz, additional, Beyeler, Franziska, additional, Rossi, Simona, additional, Schropp, Jonas, additional, Dufour, Jean-François, additional, Banz, Vanessa, additional, Amico, Patrizia, additional, Axel, Andres, additional, Aubert, John-David, additional, Sonja, Beckmann, additional, Beldi, Guido, additional, Benden, Christian, additional, Berger, Christoph, additional, Binet, Isabelle, additional, Bochud, Pierre-Yves, additional, Branca, Sanda, additional, Bucher, Heiner, additional, Carrel, Thierry, additional, Catana, Emmanuelle, additional, Chalandon, Yves, additional, de Geest, Sabina, additional, de Rougemont, Olivier, additional, Dickenmann, Michael, additional, Dreifuss, Joëlle L., additional, Duchosal, Michel, additional, Fehr, Thomas, additional, Ferrari-Lacraz, Sylvie, additional, Garzoni, Christian, additional, Soccal, Paola G., additional, Gaudet, Christophe, additional, Giostra, Emiliano, additional, Golshayan, Déla, additional, Hadaya, Karine, additional, Halter, Jörg, additional, Hauri, Dimitri, additional, Heim, Dominik, additional, Hess, Christoph, additional, Hillinger, Sven, additional, Hirsch, Hans, additional, Hirt, Patricia, additional, Hofbauer, Günther, additional, Huynh-Do, Uyen, additional, Koller, Michael, additional, Laesser, Bettina, additional, Lang, Brian, additional, Lehmann, Roger, additional, Leichtle, Alexander, additional, Lovis, Christian, additional, Manuel, Oriol, additional, Marti, Hans-Peter, additional, Martin, Pierre Y., additional, Martinelli, Michele, additional, Mellac, Katell, additional, Merçay, Aurélia, additional, Mettler, Karin, additional, Meylan, Pascal, additional, Mueller, Nicolas, additional, Müller, Antonia, additional, Müller, Thomas, additional, Müller-Arndt, Ulrike, additional, Müllhaupt, Beat, additional, Nägeli, Mirjam, additional, Pascual, Manuel, additional, Posfay-Barbe, Klara, additional, Rick, Juliane, additional, Rosselet, Anne, additional, Rothlin, Silvia, additional, Ruschitzka, Frank, additional, Schanz, Urs, additional, Schaub, Stefan, additional, Schnyder, Aurelia, additional, Schuurmans, Macé, additional, Simonetta, Federico, additional, Staufer, Katharina, additional, Stampf, Susanne, additional, Steiger, Jürg, additional, Stirniman, Guido, additional, Stürzinger, Ueli, additional, Van Delden, Christian, additional, Venetz, Jean-Pierre, additional, Villard, Jean, additional, Vionnet, Julien, additional, Wick, Madeleine, additional, Wilhlem, Markus, additional, and Yerly, Patrick, additional

Published
2022
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5. First experience of SARS-CoV-2 infections in solid organ transplant recipients in the Swiss Transplant Cohort Study

Author

Tschopp, Jonathan, LHuillier, Arnaud G., Mombelli, Matteo, Mueller, Nicolas J., Khanna, Nina, Garzoni, Christian, Meloni, Dario, Papadimitriou‐Olivgeris, Matthaios, Neofytos, Dionysios, Hirsch, Hans H., Schuurmans, Macé M., Müller, Thomas, Berney, Thierry, Steiger, Jürg, Pascual, Manuel, Manuel, Oriol, Delden, Christian, Amico, Patrizia, Aubert, John‐David, Banz, Vanessa, Beldi, Guido, Benden, Christian, Berger, Christoph, Binet, Isabelle, Bochud, Pierre‐Yves, Branca, Sanda, Bucher, Heiner, Carell, Thierry, Catana, Emmanuelle, Chalandon, Yves, Geest, Sabina, Rougemont, Olivier, Dickenmann, Michael, Duchosal, Michel, Elkrief, Laure, Fehr, Thomas, Ferrari‐Lacraz, Sylvie, Soccal, Paola Gasche, Gaudet, Christophe, Giostra, Emiliano, Golshayan, Déla, Hadaya, Karine, Halter, Jörg, Hauri, Dimitri, Heim, Dominik, Hess, Christoph, Hillinger, Sven, Hirsch, Hans H, Hofbauer, Günther, Huynh‐Do, Uyen, Immer, Franz, Klaghofer, Richard, Koller, Michael, Laesser, Bettina, Laube, Guido, Lehmann, Roger, Lovis, Christian, Majno, Pietro, Marti, Hans‐Peter, Martin, Pierre Yves, Martinelli, Michele, Meylan, Pascal, Mueller, Nicolas J, Müller, Antonia, Müllhaupt, Beat, Passweg, Jakob, Posfay‐Barbe, Klara, Rick, Juliane, Roosnek, Eddy, Rosselet, Anne, Rothlin, Silvia, Ruschitzka, Frank, Schanz, Urs, Schaub, Stefan, Schnyder, Aurelia, Schuurmans, Macé, Seiler, Christian, Sprachta, Jan, Stampf, Susanne, Steinack, Carolin, Stirnimann, Guido, Toso, Christian, Van Delden, Christian, Venetz, Jean‐Pierre, Villard, Jean, Wick, Madeleine, Wilhelm, Markus, Yerly, Patrick, University of Zurich, Swiss Transplant Cohort Study (STCS), Amico, P., Aubert, J.D., Banz, V., Beldi, G., Benden, C., Berger, C., Binet, I., Bochud, P.Y., Branca, S., Bucher, H., Carell, T., Catana, E., Chalandon, Y., de Geest, S., de Rougemont, O., Dickenmann, M., Duchosal, M., Elkrief, L., Fehr, T., Ferrari-Lacraz, S., Garzoni, C., Soccal, P.G., Gaudet, C., Giostra, E., Golshayan, D., Hadaya, K., Halter, J., Hauri, D., Heim, D., Hess, C., Hillinger, S., Hirsch, H.H., Hofbauer, G., Huynh-Do, U., Immer, F., Klaghofer, R., Koller, M., Laesser, B., Laube, G., Lehmann, R., Lovis, C., Majno, P., Manuel, O., Marti, H.P., Martin, P.Y., Martinelli, M., Meylan, P., Mueller, N.J., Müller, A., Müller, T., Müllhaupt, B., Pascual, M., Passweg, J., Posfay-Barbe, K., Rick, J., Roosnek, E., Rosselet, A., Rothlin, S., Ruschitzka, F., Schanz, U., Schaub, S., Schnyder, A., Schuurmans, M., Seiler, C., Sprachta, J., Stampf, S., Steinack, C., Steiger, J., Stirnimann, G., Toso, C., Van Delden, C., Venetz, J.P., Villard, J., Wick, M., Wilhelm, M., and Yerly, P.

Subjects
Male, 10255 Clinic for Thoracic Surgery, Comorbidity, 030230 surgery, Infection and infectious agents/ Viral, Organ transplantation, 10234 Clinic for Infectious Diseases, 0302 clinical medicine, Postoperative Complications, Epidemiology, Immunology and Allergy, Medicine, Pharmacology (medical), Prospective Studies, Prospective cohort study, ddc:616, Infectious disease, education.field_of_study, ddc:618, ddc:617, Incidence, Clinical research/ practice, Middle Aged, 3. Good health, Survival Rate, 10209 Clinic for Cardiology, Female, medicine.symptom, 10178 Clinic for Pneumology, Coronavirus Infections, infectious [Complication], infectious, infection and infectious agents, infection and infectious agents - viral, infectious disease [Aged, Betacoronavirus, Coronavirus Infections/epidemiology, Disease Transmission, Infectious/prevention & control, Follow-Up Studies, Humans, Organ Transplantation/methods, Pandemics, Pneumonia, Viral/epidemiology, Postoperative Complications/epidemiology, Survival Rate/trends, Switzerland/epidemiology, Transplant Recipients, clinical research/ practice, complication], Switzerland, Cohort study, medicine.medical_specialty, Nausea, Population, Pneumonia, Viral, Infection and infectious agents, 610 Medicine & health, Brief Communication, 03 medical and health sciences, Internal medicine, Disease Transmission, Infectious, education, Survival rate, Aged, Transplantation, business.industry, SARS-CoV-2, COVID-19, Organ Transplantation, medicine.disease, 10032 Clinic for Oncology and Hematology, business
Abstract

Immunocompromised patients may be at increased risk for complications of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. However, comprehensive data of SARS‐CoV‐2 infection in solid organ transplant (SOT) recipients are still lacking. We performed a multicenter nationwide observational study within the Swiss Transplant Cohort Study (STCS) to describe the epidemiology, clinical presentation, treatment and outcomes of the first microbiologically documented SARS‐CoV‐2 infection among SOT recipients. Overall, 21 patients were included with a median age of 56 years (10 kidney, 5 liver, 1 pancreas, 1 lung, 1 heart and 3 combined transplantations). The most common presenting symptoms were fever (76%), dry cough (57%), nausea (33%) and diarrhea (33%). Ninety‐five percent and 24% of patients required hospital and ICU admission, respectively, and 19% were intubated. After a median of 33 days of follow‐up, 16 patients were discharged, 3 were still hospitalized and 2 patients died. These data suggest that clinical manifestations of SARS‐CoV‐2 infection in middle‐aged SOT recipients appear to be similar to the general population without an apparent higher rate of complications. These results need to be confirmed in larger cohorts.

Published
2020

6. Management of allergy transfer upon solid organ transplantation

Author

Muller, Yannick D, Vionnet, Julien, Beyeler, Franziska, Eigenmann, Philippe, Caubet, Jean-Christoph, Villard, Jean, Berney, Thierry, Scherer, Kathrin, Spertini, Francois, Fricker, Michael P, Lang, Claudia, Schmid-Grendelmeier, Peter, Benden, Christian, Lombard, Pascale Roux, Aubert, Vincent, Immer, Franz, Pascual, Manuel, Harr, Thomas, Amico, Patrizia, Aubert, John-David, Banz, Vanessa, Beldi, Guido, Berger, Christoph, Binet, Isabelle, Bochud, Pierre-Yves, Branca, Sanda, Bucher, Heiner, Carell, Thierry, Catana, Emmanuelle, Chalandon, Yves, de Geest, Sabina, de Rougemont, Olivier, Dickenmann, Michael, Duchosal, Michel, Elkrief, Laure, Fehr, Thomas, Ferrari-Lacraz, Sylvie, Garzoni, Christian, Soccal, Paola Gasche, Gaudet, Christophe, Giostra, Emiliano, Golshayan, Dela, Hadaya, Karine, Halter, Joerg, Hauri, Dimitri, Heim, Dominik, Hess, Christoph, Hillinger, Sven, Hirsch, Hans H, Hofbauer, Guenther, Huynh-Do, Uyen, Klaghofer, Richard, Koller, Michael, Laesser, Bettina, Laube, Guido, Lehmann, Roger, Lovis, Christian, Majno, Pietro, Manuel, Oriol, Marti, Hans-Peter, Martin, Pierre Yves, Martinelli, Michele, Meylan, Pascal, Morel, Philippe, Mueller, Nicolas J, Mueller, Antonia, Mueller, Thomas, Muellhaupt, Beat, Yerly, Patrick, Passweg, Jakob, Posfay-Barbe, Klara, Rick, Juliane, Roosnek, Eddy, Rosselet, Anne, Rothlin, Silvia, Ruschitzka, Frank, Schanz, Urs, Schaub, Stefan, Schnyder, Aurelia, Seiler, Christian, Sprachta, Jan, Stampf, Susanne, Steiger, Juerg, Stirnimann, Guido, Toso, Christian, Van Delden, Christian, Venetz, Jean-Pierre, Wick, Madeleine, Wilhelm, Markus, Swiss Transplant Cohort Study, Amico, P., Aubert, J.D., Banz, V., Beldi, G., Benden, C., Berger, C., Binet, I., Bochud, P.Y., Branca, S., Bucher, H., Carell, T., Catana, E., Chalandon, Y., de Geest, S., de Rougemont, O., Dickenmann, M., Duchosal, M., Elkrief, L., Fehr, T., Ferrari-Lacraz, S., Garzoni, C., Gasche Soccal, P., Gaudet, C., Giostra, E., Golshayan, D., Hadaya, K., Halter, J., Hauri, D., Heim, D., Hess, C., Hillinger, S., Hirsch, H.H., Hofbauer, G., Huynh-Do, U., Immer, F., Klaghofer, R., Koller, M., Laesser, B., Laube, G., Lehmann, R., Lovis, C., Majno, P., Manuel, O., Marti, H.P., Yves Martin, P., Martinelli, M., Meylan, P., Morel, P., Mueller, N.J., Müller, A., Müller, T., Müllhaupt, B., Pascual, M., Passweg, J., Posfay-Barbe, K., Rick, J., Roosnek, E., Rosselet, A., Rothlin, S., Ruschitzka, F., Schanz, U., Schaub, S., Schnyder, A., Seiler, C., Sprachta, J., Stampf, S., Steiger, J., Stirnimann, G., Toso, C., Van Delden, C., Venetz, J.P., Villard, J., Wick, M., Wilhelm, M., Yerly, P., University of Zurich, Muller, Yannick D, Gasche-Soccal, Paola Marina Alessandra, Posfay Barbe, Klara, and Lovis, Christian

Subjects
Allergy, diagnostic techniques and imaging, IgE, Immunoglobulin E, allergy transfer, anaphylaxis, immunosuppression, management, solid organ transplantation, allergy, business/management, clinical decision-making, clinical research/practice, guidelines, immunoglobulin E, immunosuppression/immune modulation, organ transplantation in general, patient safety, 10255 Clinic for Thoracic Surgery, 2747 Transplantation, medicine.medical_treatment, 030230 surgery, INCREASE, Cohort Studies, 0302 clinical medicine, Solid organ transplantation, Immunology and Allergy, Medicine, 2736 Pharmacology (medical), Pharmacology (medical), LUNG TRANSPLANTATION, ddc:616, Kidney, ddc:618, biology, ddc:617, PEANUT ALLERGY, 10177 Dermatology Clinic, Immunosuppression, practice, Management, clinical decision‐making, medicine.anatomical_structure, B-CELLS, 10209 Clinic for Cardiology, 2723 Immunology and Allergy, 10178 Clinic for Pneumology, Brief Communications, Life Sciences & Biomedicine, Anaphylaxis, medicine.medical_specialty, 610 Medicine & health, Brief Communication, 03 medical and health sciences, Internal medicine, Humans, Peanut Hypersensitivity, Allergy transfer, business, Retrospective Studies, Transplantation, Lung, Science & Technology, immune modulation, business.industry, Organ Transplantation, medicine.disease, clinical research, 10036 Medical Clinic, 10032 Clinic for Oncology and Hematology, biology.protein, ASTHMA, Surgery, IMMUNOGLOBULIN-E
Abstract

Allergy transfer upon solid organ transplantation has been reported in the literature, although only few data are available as to the frequency, significance, and management of these cases. Based on a review of 577 consecutive deceased donors from the Swisstransplant Donor‐Registry, 3 cases (0.5%) of fatal anaphylaxis were identified, 2 because of peanut and 1 of wasp allergy. The sera of all 3 donors and their 10 paired recipients, prospectively collected before and after transplantation for the Swiss Transplant Cohort Study, were retrospectively processed using a commercial protein microarray fluorescent test. As early as 5 days posttransplantation, newly acquired peanut‐specific IgE were transiently detected from 1 donor to 3 recipients, of whom 1 liver and lung recipients developed grade III anaphylaxis. Yet, to define how allergy testing should be performed in transplant recipients and to better understand the impact of immunosuppressive therapy on IgE sensitization, we prospectively studied 5 atopic living‐donor kidney recipients. All pollen‐specific IgE and >90% of skin prick tests remained positive 7 days and 3 months after transplantation, indicating that early diagnosis of donor‐derived IgE sensitization is possible. Importantly, we propose recommendations with respect to safety for recipients undergoing solid‐organ transplantation from donors with a history of fatal anaphylaxis., Based on the Swisstransplant donor registry, the Swiss‐Transplant‐Cohort‐Study, and a prospective analysis on allergy maintenance in atopic recipients, this study makes new recommendations for the management of allergy transfer upon solid organ transplantation, emphasizing the poor effect of immunosuppression on IgE sensitization and the need of early allergological investigation in the donor and respective recipients.

Published
2020

7. Clostridium difficileinfection is associated with graft loss in solid organ transplant recipients

Author

Cusini, A., Béguelin, C., Stampf, S., Boggian, K., Garzoni, C., Koller, M., Manuel, O., Meylan, P., Mueller, N. J., Hirsch, H. H., Weisser, M., Berger, C., Delden, C., Achermann, Rita, Amico, Patrizia, Aubert, John‐David, Banz, Vanessa, Beldi, Guido, Benden, Christian, Binet, Isabelle, Bochud, Pierre‐Yves, Bucher, Heiner, Bühler, Leo, Carell, Thierry, Catana, Emmanuelle, Chalandon, Yves, Geest, Sabina, Rougemont, Olivier, Dickenmann, Michael, Duchosal, Michel, Elkrief, Laure, Fehr, Thomas, Ferrari‐Lacraz, Sylvie, Gasche Soccal, Paola, Gaudet, Christophe, Giostra, Emiliano, Golshayan, Déla, Hadaya, Karine, Halter, Jörg, Heim, Dominik, Hess, Christoph, Hillinger, Sven, Hofbauer, Günther, Huynh‐Do, Uyen, Immer, Franz, Klaghofer, Richard, Laesser, Bettina, Lehmann, Roger, Lovis, Christian, Marti, Hans‐Peter, Martin, Pierre Yves, Mohacsi, Paul, Morel, Philippe, Mueller, Ulrike, Mueller‐McKenna, Helen, Müller, Antonia, Müller, Thomas, Müllhaupt, Beat, Nadal, David, Pascual, Manuel, Passweg, Jakob, Rick, Juliane, Roosnek, Eddy, Rosselet, Anne, Rothlin, Silvia, Ruschitzka, Frank, Schanz, Urs, Schaub, Stefan, Schnyder, Aurelia, Seiler, Christian, Steiger, Jürg, Stirnimann, Guido, Toso, Christian, Venetz, Jean‐Pierre, Villard, Jean, Wick, Madeleine, Wilhelm, Markus, and Yerly, Patrick

Abstract

Clostridium difficileinfection (CDI) is a leading cause of infectious diarrhea in solid organ transplant recipients (SOT). We aimed to assess incidence, risk factors, and outcome of CDIwithin the Swiss Transplant Cohort Study (STCS). We performed a case‐control study of SOTrecipients in the STCSdiagnosed with CDIbetween May 2008 and August 2013. We matched 2 control subjects per case by age at transplantation, sex, and transplanted organ. A multivariable analysis was performed using conditional logistic regression to identify risk factors and evaluate outcome of CDI. Two thousand one hundred fifty‐eight SOTrecipients, comprising 87 cases of CDIand 174 matched controls were included. The overall CDIrate per 10 000 patient days was 0.47 (95% confidence interval ([CI] 0.38‐0.58), with the highest rate in lung (1.48, 95% CI0.93‐2.24). In multivariable analysis, proven infections (hazard ratio [HR] 2.82, 95% CI1.29‐6.19) and antibiotic treatments (HR 4.51, 95% CI2.03‐10.0) during the preceding 3 months were independently associated with the development of CDI. Despite mild clinical presentations, recipients acquiring CDIposttransplantation had an increased risk of graft loss (HR2.24, 95% CI1.15‐4.37; P= .02). These findings may help to improve the management of SOTrecipients. The authors demonstrate that despite mild clinical presentations and good clinical responses, Clostridium difficileinfections are associated with an increased risk of graft loss in the Swiss Transplant Cohort Study.

Published
2018
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8. BKPolyomavirus‐Specific 9mer CD8 T Cell Responses Correlate With Clearance of BKViremia in Kidney Transplant Recipients: First Report From the Swiss Transplant Cohort Study

Author

Leboeuf, C., Wilk, S., Achermann, R., Binet, I., Golshayan, D., Hadaya, K., Hirzel, C., Hoffmann, M., Huynh‐Do, U., Koller, M. T., Manuel, O., Mueller, N. J., Mueller, T. F., Schaub, S., Delden, C., Weissbach, F. H., Hirsch, H. H., Amico, Patrizia, Aubert, John‐David, Banz, Vanessa, Beldi, Guido, Benden, Christian, Berger, Christoph, Bochud, Pierre‐Yves, Bucher, Heiner, Bühler, Leo, Carell, Thierry, Catana, Emmanuelle, Chalandon, Yves, Geest, Sabina, Rougemont, Olivier, Dickenmann, Michael, Duchosal, Michel, Elkrief, Laure, Fehr, Thomas, Ferrari‐Lacraz, Sylvie, Garzoni, Christian, Soccal, Paola Gasche, Gaudet, Christophe, Giostra, Emiliano, Halter, Jörg, Heim, Dominik, Hess, Christoph, Hillinger, Sven, Hofbauer, Günther, Immer, Franz, Klaghofer, Richard, Laesser, Bettina, Lehmann, Roger, Lovis, Christian, Marti, Hans‐Peter, Martin, Pierre Yves, Meylan, Pascal, Mohacsi, Paul, Morel, Philippe, Mueller, Ulrike, Mueller‐McKenna, Helen, Müller, Antonia, Müller, Thomas, Müllhaupt, Beat, Nadal, David, Pascual, Manuel, Passweg, Jakob, Rick, Juliane, Roosnek, Eddy, Rosselet, Anne, Rothlin, Silvia, Ruschitzka, Frank, Schanz, Urs, Schnyder, Aurelia, Seiler, Christian, Stampf, Susanne, Steiger, Jürg, Stirnimann, Guido, Toso, Christian, Venetz, Jean‐Pierre, Villard, Jean, Wick, Madeleine, Wilhelm, Markus, and Yerly, Patrick

Abstract

BKpolyomavirus (BKPyV) causes premature kidney transplant (KT) failure in 1–15% of patients. Because antivirals are lacking, most programs screen for BKPyV‐viremia and, if positive, reduce immunosuppression. To evaluate the relationship of viremia and BKPyV‐specific immunity, we examined prospectively cryopreserved plasma and peripheral blood mononuclear cells at the time of transplantation (T0) and at 6 mo (T6) and 12 mo (T12) after transplant from 28 viremic KTpatients and 68 nonviremic controls matched for the transplantation period. BKPyVIgG seroprevalence was comparable between cases (89.3%) and controls (91.2%; p = 0.8635), but cases had lower antibody levels (p = 0.022) at T0. Antibody levels increased at T6 and T12 but were not correlated with viremia clearance. BKPyV‐specific T cell responses to pools of overlapping 15mers (15mer peptide pool [15mP]) or immunodominant CD8 9mers (9mer peptide pool [9mP]) from the early viral gene region were not different between cases and controls at T0; however, clearance of viremia was associated with stronger 9mP responses at T6 (p = 0.042) and T12 (p = 0.048), whereas 15mP responses were not informative (T6 p = 0.359; T12 p = 0.856). BKPyV‐specific T cells could be expanded in vitrofrom all patients after transplant, permitting identification of 78 immunodominant 9mer epitopes including 50 new ones across different HLAclass I. Thus, 9mP‐responses may be a novel marker of reconstituting CD8 T cell function that warrants further study as a complement of plasma BKPyVloads for guiding immunosuppression reduction. Interferon‐γ ELISpot responses of CD8 T cells to immunodominant 9mer epitopes from the BK polyomavirus early viral gene region significantly increased in BK viremic patients but not in nonviremic controls, and are associated with viremia clearance posttransplantation, while standard 15mer T cell responses or antibody levels were uninformative.

Published
2017
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9. Preventive Strategies Against Cytomegalovirus and Incidence of α‐Herpesvirus Infections in Solid Organ Transplant Recipients: A Nationwide Cohort Study

Author

Martin‐Gandul, C., Stampf, S., Héquet, D., Mueller, N. J., Cusini, A., Delden, C., Khanna, N., Boggian, K., Hirzel, C., Soccal, P., Hirsch, H. H., Pascual, M., Meylan, P., Manuel, O., Achermann, Rita, Amico, Patrizia, Aubert, John‐David, Baumann, Philippe, Beldi, Guido, Benden, Christian, Berger, Christoph, Binet, Isabelle, Bochud, Pierre‐Yves, Boely, Elsa, Bucher, Heiner, Bühler, Leo, Carell, Thierry, Catana, Emmanuelle, Chalandon, Yves, Geest, Sabina, Rougemont, Olivier, Dickenmann, Michael, Duchosal, Michel, Elkrief, Laure, Fehr, Thomas, Ferrari‐Lacraz, Sylvie, Garzoni, Christian, Gaudet, Christophe, Giostra, Emiliano, Golshayan, Déla, Hadaya, Karine, Halter, Jörg, Heim, Dominik, Hess, Christoph, Hillinger, Sven, Hofbauer, Günther, Huynh‐Do, Uyen, Immer, Franz, Klaghofer, Richard, Koller, Michael, Laesser, Bettina, Lehmann, Roger, Lovis, Christian, Marti, Hans‐Peter, Yves Martin, Pierre, Martinolli, Luca, Mohacsi, Paul, Morel, Philippe, Mueller, Ulrike, Mueller‐McKenna, Helen, Müller, Antonia, Müller, Thomas, Müllhaupt, Beat, Nadal, David, Passweg, Jakob, Piot Ziegler, Chantal, Rick, Juliane, Roosnek, Eddy, Rosselet, Anne, Rothlin, Silvia, Ruschitzka, Frank, Schanz, Urs, Schaub, Stefan, Schnyder, Aurelia, Seiler, Christian, Steiger, Jürg, Stirnimann, Guido, Toso, Christian, Venetz, Jean‐Pierre, Villard, Jean, Wick, Madeleine, Wilhelm, Markus, and Yerly, Patrick

Abstract

We assessed the impact of antiviral preventive strategies on the incidence of herpes simplex virus (HSV) and varicella‐zoster virus (VZV) infections in a nationwide cohort of transplant recipients. Risk factors for the development of HSVor VZVinfection were assessed by Cox proportional hazards regression. We included 2781 patients (56% kidney, 20% liver, 10% lung, 7.3% heart, 6.7% others). Overall, 1264 (45%) patients received antiviral prophylaxis (ganciclovir or valganciclovir, n = 1145; acyclovir or valacyclovir, n = 138). Incidence of HSVand VZVinfections was 28.9 and 12.1 cases, respectively, per 1000 person‐years. Incidence of HSVand VZVinfections at 1 year after transplant was 4.6% (95% confidence interval [CI]3.5–5.8) in patients receiving antiviral prophylaxis versus 12.3% (95% CI10.7–14) in patients without prophylaxis; this was observed particularly for HSVinfections (3% [95% CI2.2–4] versus 9.8% [95% CI8.4–11.4], respectively). A lower rate of HSVand VZVinfections was also seen in donor or recipient cytomegalovirus‐positive patients receiving ganciclovir or valganciclovir prophylaxis compared with a preemptive approach. Female sex (hazard ratio [HR]1.663, p = 0.001), HSVseropositivity (HR5.198, p < 0.001), previous episodes of rejection (HR1.95, p = 0.004), and use of a preemptive approach (HR2.841, p = 0.017) were significantly associated with a higher risk of HSVinfection. Although HSVand VZVinfections were common after transplantation, antiviral prophylaxis significantly reduced symptomatic HSVinfections. In this national cohort of solid organ transplant recipients, patients receiving antiviral prophylaxis either with (val)ganciclovir or (val)acyclovir have a lower incidence of herpes simplex virus infections compared to patients managed with a preemptive approach for cytomegalovirus infection or not receiving antiherpes prophylaxis.

Published
2017
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