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1. European Renal Best Practice Guideline on Kidney Donor and Recipient Evaluation and Perioperative Care

Author

Spasovski, G., Cochat, P., Claas, F. H. J., Heemann, U., Pascual, J., Dudley, C., Harden, P., Hourmant, M., Umberto Maggiore, Salvadori, M., Squifflet, J. -P, Steiger, J., Torres, A., Viklicky, O., Zeier, M., Vanholder, R., Biesen, W., Nagler, E., and Abramowicz, D.

Subjects
medicine.medical_specialty, perioperative care, Best practice, erbp, kidney transplantation, donor evaluation, medicine, Humans, Intensive care medicine, Internal medicine, Transplantation, Kidney, business.industry, Guideline, RC31-1245, Tissue Donors, Transplant Recipients, Europe, medicine.anatomical_structure, Nephrology, Perioperative care, recipient evaluation, Kidney Diseases, Human medicine, business, guideline
Abstract

The European Best Practice Guideline group (EBPG) issued guidelines on the evaluation and selection of kidney donor and kidney transplant candidates, as well as post-transplant recipient care, in the year 2000 and 2002. The new European Renal Best Practice board decided in 2009 that these guidelines needed updating. In order to avoid duplication of efforts with kidney disease improving global outcomes, which published in 2009 clinical practice guidelines on the post-transplant care of kidney transplant recipients, we did not address these issues in the present guidelines.The guideline was developed following a rigorous methodological approach: (i) identification of clinical questions, (ii) prioritization of questions, (iii) systematic literature review and critical appraisal of available evidence and (iv) formulation of recommendations and grading according to Grades of Recommendation Assessment, Development, and Evaluation (GRADE). The strength of each recommendation is rated 1 or 2, with 1 being a 'We recommend' statement, and 2 being a 'We suggest' statement. In addition, each statement is assigned an overall grade for the quality of evidence: A (high), B (moderate), C (low) or D (very low). The guideline makes recommendations for the evaluation of the kidney transplant candidate as well as the potential deceased and living donor, the immunological work-up of kidney donors and recipients and perioperative recipient care.All together, the work group issued 112 statements. There were 51 (45%) recommendations graded '1', 18 (16%) were graded '2' and 43 (38%) statements were not graded. There were 0 (0%) recommendations graded '1A', 15 (13%) were '1B', 19 (17%) '1C' and 17 (15%) '1D'. None (0%) were graded '2A', 1 (0.9%) was '2B', 8 (7%) were '2C' and 9 (8%) '2D'. Limitations of the evidence, especially the lack of definitive clinical outcome trials, are discussed and suggestions are provided for future research.We present here the complete recommendations about the evaluation of the kidney transplant candidate as well as the potential deceased and living donor, the immunological work-up of kidney donors and recipients and the perioperative recipient care. We hope that this document will help caregivers to improve the quality of care they deliver to patients. The full version with methods, rationale and references is published in Nephrol Dial Transplant (2013) 28: i1-i71; doi: 10.1093/ndt/gft218 and can be downloaded freely from http://www.oxfordjournals.org/our_journals/ndt/era_edta.html.

Published
2015

2. Clostridium difficile infection 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, NJ, Hirsch, HH, Weisser, M, Berger, C, van Delden, C, Achermann, R, Amico, P, Aubert, JD, Banz, V, Beldi, G, Benden, C, Binet, I, Bochud, PY, Bucher, H, Bühler, L, Carell, T, Catana, E, Chalandon, Y, de Geest, S, de Rougemont, O, Dickenmann, M, Duchosal, M, Elkrief, L, Fehr, T, Ferrari-Lacraz, S, Gasche Soccal, P, Gaudet, C, Giostra, E, Golshayan, D, Hadaya, K, Halter, J, Heim, D, Hess, C, Hillinger, S, Hofbauer, G, Huynh-Do, U, Immer, F, Klaghofer, R, Laesser, B, Lehmann, R, Lovis, C, Marti, HP, Martin, PY, Mohacsi, P, Morel, P, Mueller, U, Mueller-McKenna, H, Müller, A, Müller, T, Müllhaupt, B, Nadal, D, Pascual, M, Passweg, J, Rick, J, Roosnek, E, Rosselet, A, Rothlin, S, Ruschitzka, F, Schanz, U, Schaub, S, Schnyder, A, Seiler, C, Steiger, J, Stirnimann, G, Toso, C, Venetz, JP, Villard, J, Wick, M, Wilhelm, M, Yerly, P, Gasche-Soccal, Paola Marina Alessandra, University of Zurich, and van Delden, C

Subjects
Graft Rejection, Male, genetic structures, 2747 Transplantation, 10265 Clinic for Endocrinology and Diabetology, 030230 surgery, 10234 Clinic for Infectious Diseases, 0302 clinical medicine, Postoperative Complications, Risk Factors, Medicine, 2736 Pharmacology (medical), Immunology and Allergy, Pharmacology (medical), 030212 general & internal medicine, Prospective Studies, 610 Medicine & health, Prospective cohort study, ddc:616, Incidence, Hazard ratio, Graft Survival, Clostridium difficile, Middle Aged, Prognosis, Anti-Bacterial Agents, Diarrhea, 10209 Clinic for Cardiology, 2723 Immunology and Allergy, Female, medicine.symptom, 10178 Clinic for Pneumology, Switzerland, Cohort study, medicine.medical_specialty, 03 medical and health sciences, Internal medicine, Humans, Transplantation, business.industry, Clostridioides difficile, Case-control study, Organ Transplantation, Confidence interval, Transplant Recipients, 10036 Medical Clinic, Case-Control Studies, Clostridium Infections, business, Follow-Up Studies
Abstract

© 2018 The American Society of Transplantation and the American Society of Transplant Surgeons Clostridium difficile infection (CDI) is a leading cause of infectious diarrhea in solid organ transplant recipients (SOT). We aimed to assess incidence, risk factors, and outcome of CDI within the Swiss Transplant Cohort Study (STCS). We performed a case-control study of SOT recipients in the STCS diagnosed with CDI between 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 SOT recipients, comprising 87 cases of CDI and 174 matched controls were included. The overall CDI rate 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% CI 0.93-2.24). In multivariable analysis, proven infections (hazard ratio [HR] 2.82, 95% CI 1.29-6.19) and antibiotic treatments (HR 4.51, 95% CI 2.03-10.0) during the preceding 3 months were independently associated with the development of CDI. Despite mild clinical presentations, recipients acquiring CDI posttransplantation had an increased risk of graft loss (HR 2.24, 95% CI 1.15-4.37; P =.02). These findings may help to improve the management of SOT recipients. ispartof: American Journal of Transplantation vol:18 issue:7 pages:1745-1754 ispartof: location:United States status: published

Published
2017

3. Donation type and the effect of pre-transplant donor specific antibodies – Data from the Swiss Transplant Cohort Study

Author

de Rougemont, Olivier, Deng, Yun, Frischknecht, Lukas, Wehmeier, Caroline, Villard, Jean, Ferrari-Lacraz, Sylvie, Golshayan, Déla, Gannagé, Monique, Binet, Isabelle, Wirthmüller, Urs, Sidler, Daniel, Schachtner, Thomas, Schaub, Stefan, Nilsson, Jakob, Swiss Transplant Cohort Study, Amico, P., Axel, A., Aubert, J.D., Banz, V., Sonja, B., Beldi, G., Berger, C., Berishvili, E., Binet, I., Bochud, P.Y., Branca, S., Bucher, H., Carrel, T., Catana, E., Chalandon, Y., De Geest, S., De Rougemont, O., Dickenmann, M., Dreifuss, J.L., Duchosal, M., Fehr, T., Ferrari-Lacraz, S., Franscini, N., Garzoni, C., Soccal, P.G., Gaudet, C., Golshayan, D., Goossens, N., Hadaya, K., Halter, J., Heim, D., Hess, C., Hillinger, S., Hirsch, H., Hirt, P., Hofbauer, G., Huynh-Do, U., Immer, F., Koller, M., Laager, M., Laesser, B., Lehmann, R., Leichtle, A., Lovis, C., Manuel, O., Marti, H.P., Martin, P.Y., Martinelli, M., McLin, V., Mellac, K., Mercay, A., Mettler, K., Mueller, N., Müller, A., Müller, T., Müller-Arndt, U., Müllhaupt, B., Nägeli, M., Oldani, G., Pascual, M., Posfay-Barbe, K., Rick, J., Rosselet, A., Rossi, S., Rothlin, S., Ruschitzka, F., Schanz, U., Schaub, S., Schnyder, A., Schuurmans, M., Sengstag, T., Simonetta, F., Staufer, K., Stampf, S., Steiger, J., Stirniman, G., Stürzinger, U., Van Delden, C., Venetz, J.P., Villard, J., Vionnet, J., Wick, M., Wilhlem, M., and Yerly, P.

Subjects
Humans, Antibodies, Blood Grouping and Crossmatching, Cohort Studies, Living Donors, Switzerland, ABMR, DBD, DCD, donor specific antibodies, graft loss, kidney transplantation, living donation, virtual cross-match, Immunology, Immunology and Allergy, 610 Medicine & health, 610 Medizin und Gesundheit
Abstract

IntroductionThe type of donation may affect how susceptible a donor kidney is to injury from pre-existing alloimmunity. Many centers are, therefore, reluctant to perform donor specific antibody (DSA) positive transplantations in the setting of donation after circulatory death (DCD). There are, however, no large studies comparing the impact of pre-transplant DSA stratified on donation type in a cohort with a complete virtual cross-match and long-term follow-up of transplant outcome.MethodsWe investigated the effect of pre-transplant DSA on the risk of rejection, graft loss, and the rate of eGFR decline in 1282 donation after brain death (DBD) transplants and compared it to 130 (DCD) and 803 living donor (LD) transplants.ResultsThere was a significant worse outcome associated with pre-transplant DSA in all of the studied donation types. DSA directed against Class II HLA antigens as well as a high cumulative mean fluorescent intensity (MFI) of the detected DSA showed the strongest association with worse transplant outcome. We could not detect a significant additive negative effect of DSA in DCD transplantations in our cohort. Conversely, DSA positive DCD transplants appeared to have a slightly better outcome, possibly in part due to the lower mean fluorescent intensity (MFI) of the pre-transplant DSA. Indeed when DCD transplants were compared to DBD transplants with similar MFI (DiscussionOur results suggest that the negative impact of pre-transplant DSA on graft outcome could be similar between all donation types. This suggests that immunological risk assessment could be performed in a similar way regardless of the type of donor kidney transplantation.

Published
2023
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4. Developing and testing a Corona VaccinE tRiAL pLatform (COVERALL) to study Covid-19 vaccine response in immunocompromised patients

Author

Katharina, Kusejko, Frédérique, Chammartin, Daniel, Smith, Marc, Odermatt, Julian, Schuhmacher, Michael, Koller, Huldrych F, Günthard, Matthias, Briel, Heiner C, Bucher, Benjamin, Speich, Patrick, Yerly, Swiss HIV Cohort Study, Swiss Transplant Cohort Study, Abela, I., Aebi-Popp, K., Anagnostopoulos, A., Battegay, M., Bernasconi, E., Braun, D.L., Bucher, H.C., Calmy, A., Cavassini, M., Ciuffi, A., Dollenmaier, G., Egger, M., Elzi, L., Fehr, J., Fellay, J., Furrer, H., Fux, C.A., Günthard, H.F., Hachfeld, A., Haerry, D., Hasse, B., Hirsch, H.H., Hoffmann, M., Hösli, I., Huber, M., Kahlert, C.R., Kaiser, L., Keiser, O., Klimkait, T., Kouyos, R.D., Kovari, H., Kusejko, K., Martinetti, G., Martinez de Tejada, B., Marzolini, C., Metzner, K.J., Müller, N., Nemeth, J., Nicca, D., Paioni, P., Pantaleo, G., Perreau, M., Rauch, A., Schmid, P., Speck, R., Stöckle, M., Tarr, P., Trkola, A., Wandeler, G., Yerly, S., Amico, P., Aubert, J.D., Banz, V., Beckmann, S., Beldi, G., Berger, C., Berishvili, E., Berzigotti, A., Binet, I., Bochud, P.Y., Branca, S., Bucher, H., Catana, E., Cairoli, A., Chalandon, Y., De Geest, S., De Rougemont, O., De Seigneux, S., Dickenmann, M., Dreifuss, J.L., Duchosal, M., Fehr, T., Ferrari-Lacraz, S., Garzoni, C., Golshayan, D., Goossens, N., Halter, FHJ, Heim, D., Hess, C., Hillinger, S., Hirt, P., Hofbauer, G., Huynh-Do, U., Immer, F., Koller, M., Laager, M., Laesser, B., Lamoth, F., Lehmann, R., Leichtle, A., Manuel, O., Marti, H.P., Martinelli, M., McLin, V., Mellac, K., Merçay, A., Mettler, K., Müller, A., Mueller, N.J., Müller-Arndt, U., Müllhaupt, B., Nägeli, M., Oldani, G., Pascual, M., Passweg, J., Pazeller, R., Posfay-Barbe, K., Rick, J., Rosselet, A., Rossi, S., Rothlin, S., Ruschitzka, F., Schachtner, T., Schanz, U., Schaub, S., Scherrer, A., Schnyder, A., Schuurmans, M., Schwab, S., Sengstag, T., Simonetta, F., Stampf, S., Steiger, J., Stirnimann, G., Stürzinger, U., Van Delden, C., Venetz, J.P., Villard, J., Vionnet, J., Wick, M., Wilhelm, M., Yerly, P., University of Zurich, and Kusejko, Katharina

Subjects
10028 Institute of Medical Virology, COVID-19 Vaccines, SARS-CoV-2, COVID-19, 610 Medicine & health, 2725 Infectious Diseases, 10234 Clinic for Infectious Diseases, Cohort Studies, Immunocompromised Host, Treatment Outcome, 10032 Clinic for Oncology and Hematology, 10209 Clinic for Cardiology, Humans, 10178 Clinic for Pneumology, COVID-19/prevention & control, HIV, Immunocompromised, REDCap, Transplant patients, Trial platform
Abstract

BACKGROUND The rapid course of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic calls for fast implementation of clinical trials to assess the effects of new treatment and prophylactic interventions. Building trial platforms embedded in existing data infrastructures is an ideal way to address such questions within well-defined subpopulations. METHODS We developed a trial platform building on the infrastructure of two established national cohort studies: the Swiss human immunodeficiency virus (HIV) Cohort Study (SHCS) and Swiss Transplant Cohort Study (STCS). In a pilot trial, termed Corona VaccinE tRiAL pLatform (COVERALL), we assessed the vaccine efficacy of the first two licensed SARS-CoV-2 vaccines in Switzerland and the functionality of the trial platform. RESULTS Using Research Electronic Data Capture (REDCap), we developed a trial platform integrating the infrastructure of the SHCS and STCS. An algorithm identifying eligible patients, as well as baseline data transfer ensured a fast inclusion procedure for eligible patients. We implemented convenient re-directions between the different data entry systems to ensure intuitive data entry for the participating study personnel. The trial platform, including a randomization algorithm ensuring balance among different subgroups, was continuously adapted to changing guidelines concerning vaccination policies. We were able to randomize and vaccinate the first trial participant the same day we received ethics approval. Time to enroll and randomize our target sample size of 380 patients was 22 days. CONCLUSION Taking the best of each system, we were able to flag eligible patients, transfer patient information automatically, randomize and enroll the patients in an easy workflow, decreasing the administrative burden usually associated with a trial of this size.

Published
2022
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5. Surgical site infections after simultaneous pancreas kidney and pancreas transplantation in the Swiss Transplant Cohort Study

Author

P.W. Schreiber, M. Laager, K. Boggian, D. Neofytos, C. van Delden, A. Egli, M. Dickenmann, C. Hirzel, O. Manuel, M. Koller, S. Rossi, B. Schmied, L. Gürke, M. Matter, T. Berney, O. de Rougemont, S.P. Kuster, S. Stampf, N.J. Mueller, P. Amico, J-D. Aubert, V. Banz, S. Beckmann, G. Beldi, C. Berger, E. Berishvili, A. Berzigotti, I. Binet, P-Y. Bochud, S. Branca, H. Bucher, E. Catana, A. Cairoli, Y. Chalandon, S. De Geest, O. De Rougemont, S. De Seigneux, J.L. Dreifuss, M. Duchosal, T. Fehr, S. Ferrari-Lacraz, C. Garzoni, D. Golshayan, N. Goossens, F.H.J. Halter, D. Heim, C. Hess, S. Hillinger, H.H. Hirsch, P. Hirt, G. Hofbauer, U. Huynh-Do, F. Immer, B. Laesser, F. Lamoth, R. Lehmann, A. Leichtle, H.P. Marti, M. Martinelli, V. McLin, K. Mellac, A. Merçay, K. Mettler, A. Müller, U. Müller-Arndt, B. Müllhaupt, M. Nägeli, G. Oldani, M. Pascual, J. Passweg, R. Pazeller, K. Posfay-Barbe, J. Rick, A. Rosselet, S. Rothlin, F. Ruschitzka, T. Schachtner, U. Schanz, S. Schaub, A. Scherrer, A. Schnyder, M. Schuurmans, S. Schwab, T. Sengstag, F. Simonetta, J. Steiger, G. Stirnimann, U. Stürzinger, C. Van Delden, J-P. Venetz, J. Villard, J. Vionnet, M. Wick, M. Wilhelm, P. Yerly, Swiss Transplant Cohort Study, Amico, P., Aubert, J.D., Banz, V., Beckmann, S., Beldi, G., Berger, C., Berishvili, E., Berzigotti, A., Binet, I., Bochud, P.Y., Branca, S., Bucher, H., Catana, E., Cairoli, A., Chalandon, Y., De Geest, S., De Rougemont, O., De Seigneux, S., Dickenmann, M., Dreifuss, J.L., Duchosal, M., Fehr, T., Ferrari-Lacraz, S., Garzoni, C., Golshayan, D., Goossens, N., Halter, FHJ, Heim, D., Hess, C., Hillinger, S., Hirsch, H.H., Hirt, P., Hofbauer, G., Huynh-Do, U., Immer, F., Koller, M., Laager, M., Laesser, B., Lamoth, F., Lehmann, R., Leichtle, A., Manuel, O., Marti, H.P., Martinelli, M., McLin, V., Mellac, K., Merçay, A., Mettler, K., Müller, A., Mueller, N.J., Müller-Arndt, U., Müllhaupt, B., Nägeli, M., Oldani, G., Pascual, M., Passweg, J., Pazeller, R., Posfay-Barbe, K., Rick, J., Rosselet, A., Rossi, S., Rothlin, S., Ruschitzka, F., Schachtner, T., Schanz, U., Schaub, S., Scherrer, A., Schnyder, A., Schuurmans, M., Schwab, S., Sengstag, T., Simonetta, F., Stampf, S., Steiger, J., Stirnimann, G., Stürzinger, U., Van Delden, C., Venetz, J.P., Villard, J., Vionnet, J., Wick, M., Wilhelm, M., and Yerly, P.

Subjects
Microbiology (medical), Adult, 610 Medicine & health, General Medicine, Kidney, Cohort Studies, Humans, Kidney Transplantation/adverse effects, Pancreas, Pancreas Transplantation/adverse effects, Risk Factors, Surgical Wound Infection/epidemiology, Surgical Wound Infection/etiology, Switzerland/epidemiology, Hospital-acquired infection, Pancreas transplantation, Simultaneous kidney–pancreas transplantation, Surgical site infection, Kidney Transplantation, Infectious Diseases, Surgical Wound Infection, Pancreas Transplantation, Switzerland
Abstract

BACKGROUND Among hospital-acquired infections, surgical site infections (SSIs) are frequent. SSI in the early post-transplant course poses a relevant threat to transplant recipients. AIM To determine incidence, risk factors for SSI and its association with post-transplant outcomes and pancreas transplant (P-Tx) recipients. METHODS Adult simultaneous kidney-pancreas transplantation (SPK-T) and P-Tx recipients with a follow-up of at least 90 days were identified in the Swiss Transplant Cohort Study (STCS) dataset. Except for the categorization of SSIs according to Centers for Disease Control and Prevention (CDC) criteria, all other data were prospectively collected. Risk factors for SSI were investigated with logistic regression. A Weibull accelerated failure-time model was applied to address the impact of SSI on length of stay, correcting for transplant-related complications and delayed graft function. FINDINGS Of 130 transplant recipients, 108 SPK-Tx and 22 P-Tx, 18 (14%) individuals developed SSI within the first 90 days after transplantation. Deep incisional (seven, 38.9%) and organ/space infections (eight, 44.4%) predominated. In the majority of SSIs (11, 61.1%; two SSIs with simultaneous identification of fungal pathogens) bacteria were detected with Enterococcus spp. being most frequent. The median duration of hospitalization after transplantation was significantly longer in recipients with SSI (median: 26 days; interquartile range (IQR): 19-44) than in patients without SSI (median: 17 days; IQR: 12-25; P = 0.002). In multivariate analysis, SSI was significantly associated with increased length of stay and prolonged the duration of hospitalization by 36% (95% confidence interval: 4-79). CONCLUSION SSI after SPK-Tx and P-Tx occurred at a frequency of 14%. Among pathogens, Enterococcus spp. predominated. SSI was independently associated with a longer hospitalization after transplantation.

Published
2022
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6. Cohort profile: The Swiss Transplant Cohort Study (STCS): A nationwide longitudinal cohort study of all solid organ recipients in Switzerland

Author

Stampf, Susanne, Mueller, Nicolas J., van Delden, Christian, Pascual, Manuel, Manuel, Oriol, Banz, Vanessa, Binet, Isabelle, De Geest, Sabina, Bochud, Pierre-Yves, Leichtle, Alexander, Schaub, Stefan, Steiger, Jürg, Koller, Michael, Swiss Transplant Cohort Study, members of the Swiss Transplant Cohort Study, Swiss Transplant Cohort Study, members of the Swiss Transplant Cohort Study, Amico, P., Axel, A., Aubert, J.D., Banz, V., Sonja, B., Beldi, G., Berger, C., Berishvili, E., Berzigotti, A., Binet, I., Bochud, P.Y., Branca, S., Bucher, H., Carrel, T., Catana, E., Chalandon, Y., Geest, S., Rougemont, O., Seigneux, S., Dickenmann, M., Dreifuss, J.L., Duchosal, M., Fehr, T., Ferrari-Lacraz, S., Franscini, N., Garzoni, C., Soccal, P.G., Gaudet, C., Golshayan, D., Goossens, N., Hadaya, K., Halter, J., Heim, D., Hess, C., Hillinger, S., Hirsch, H., Hirt, P., Hofbauer, G., Huynh-Do, U., Immer, F., Koller, M., Laager, M., Laesser, B., Lehmann, R., Leichtle, A., Lovis, C., Manuel, O., Marti, H.P., Martin, P.Y., Martinelli, M., McLin, V., Mellac, K., Merçay, A., Mettler, K., Mueller, N., Müller, A., Müller-Arndt, U., Müllhaupt, B., Nägeli, M., Oldani, G., Pascual, M., Posfay-Barbe, K., Rick, J., Rosselet, A., Rossi, S., Rothlin, S., Ruschitzka, F., Schachtner, T., Schanz, U., Schaub, S., Schnyder, A., Schuurmans, M., Sengstag, T., Simonetta, F., Stampf, S., Steiger, J., Stirniman, G., Stürzinger, U., Delden, C.V., Venetz, J.P., Villard, J., Vionnet, J., Wick, M., Wilhlem, M., Yerly, P., University of Zurich, and Stampf, Susanne

Subjects
PREVENTIVE STRATEGIES, 10255 Clinic for Thoracic Surgery, Epidemiology, CYTOMEGALOVIRUS, INVASIVE PULMONARY ASPERGILLOSIS, 610 Medicine & health, 2700 General Medicine, 030230 surgery, infectious diseases, 10234 Clinic for Infectious Diseases, immunology, 03 medical and health sciences, epidemiology, oncology, transplant medicine, Medicine, General & Internal, 0302 clinical medicine, General & Internal Medicine, INFECTION, Humans, Longitudinal Studies, Prospective Studies, PROTECTION, POLYMORPHISMS, OUTCOMES, Science & Technology, General Medicine, Transplant Recipients, 3. Good health, surgical procedures, operative, REJECTION, 10032 Clinic for Oncology and Hematology, 10209 Clinic for Cardiology, RISK-FACTORS, 030211 gastroenterology & hepatology, Life Sciences & Biomedicine, Switzerland
Abstract

PurposeThe Swiss Transplant Cohort Study (STCS) is a prospective multicentre cohort study which started to actively enrol study participants in May 2008. It takes advantage of combining data from all transplant programmes in one unique system to perform comprehensive nationwide reporting and to promote translational and clinical post-transplant outcome research in the framework of Swiss transplantation medicine.ParticipantsOver 5500 solid organ transplant recipients have been enrolled in all six Swiss transplant centres by end of 2019, around three-quarter of them for kidney and liver transplants. Ninety-three per cent of all transplanted recipients have consented to study participation, almost all of them (99%) contributed to bio-sampling. The STCS genomic data set includes around 3000 patients.Findings to dateDetailed clinical and laboratory data in high granularity as well as patient-reported outcomes from transplant recipients and activities in Switzerland are available in the last decade. Interdisciplinary contributions in diverse fields of transplantation medicine such as infectious diseases, genomics, oncology, immunology and psychosocial science have resulted in approximately 70 scientific papers getting published in peer-review journals so far.Future plansThe STCS will deepen its efforts in personalised medicine and digital epidemiology, and will also focus on allocation research and the use of causal inference methods to make complex matters in transplant medicine more understandable and transparent.

Published
2021
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7. Temporal trends, risk factors and outcomes of infections due to extended-spectrum β-lactamase producing Enterobacterales in Swiss solid organ transplant recipients between 2012 and 2018

Author

Kohler, Philipp, Wolfensberger, Aline, Stampf, Susanne, Brönnimann, Andreas, Boggian, Katia, van Delden, Christian, Favre, Melody, Hirzel, Cédric, Khanna, Nina, Kuster, Stefan P, Manuel, Oriol, Neofytos, Dionysios, Ragozzino, Silvio, Schreiber, Peter W, Walti, Laura, Mueller, Nicolas J, Swiss Transplant Cohort Study, Chalandon, Yves, Gasche-Soccal, Paola Marina Alessandra, Gaudet-Blavignac, Christophe, Lovis, Christian, Martin, Pierre-Yves, Posfay Barbe, Klara, Simonetta, Federico, Toso, Christian, Villard, Jean, Swiss Transplant Cohort Study, Amico, P., Axel, A., Aubert, J.D., Banz, V., Sonja, B., Beldi, G., Benden, C., Berger, C., Binet, I., Bochud, P.Y., Branca, S., Bucher, H., Carrel, T., Catana, E., Chalandon, Y., de Geest, S., de Rougemont, O., Dickenmann, M., Dreifuss, J.L., Duchosal, M., 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., Hirt, P., Hofbauer, G., Huynh-Do, U., Immer, F., Koller, M., Laesser, B., Lang, B., Lehmann, R., Leichtle, A., Lovis, C., Manuel, O., Marti, H.P., Martin, P.Y., Martinelli, M., Mellac, K., Merçay, A., Mettler, K., Meylan, P., Mueller, N., Müller, A., Müller, T., Müller-Arndt, U., Müllhaupt, B., Nägeli, M., Pascual, M., Posfay-Barbe, K., Rick, J., Rosselet, A., Rossi, S., Rothlin, S., Ruschitzka, F., Schanz, U., Schaub, S., Schnyder, A., Schuurmans, M., Simonetta, F., Staufer, K., Stampf, S., Steiger, J., Stirniman, G., Toso, C., Van Delden, C., Venetz, J.P., Villard, J., Wick, M., Wilhelm, M., Yerly, P., University of Zurich, and Kohler, Philipp

Subjects
Graft Rejection, Male, 0301 basic medicine, 10255 Clinic for Thoracic Surgery, Antibiotics, Drug resistance, 030230 surgery, 2726 Microbiology (medical), Organ transplantation, 10234 Clinic for Infectious Diseases, Enterobacterales, 0302 clinical medicine, Medical microbiology, Risk Factors, 2736 Pharmacology (medical), Medicine, Pharmacology (medical), Prospective Studies, Prospective cohort study, 610 Medicine & health, Escherichia coli Infections, ddc:616, Enterobacteriaceae Infections, Middle Aged, Anti-Bacterial Agents, Extended-spectrum beta-lactamase, Renal transplant, Infectious Diseases, 10209 Clinic for Cardiology, Female, Switzerland, Cohort study, Adult, Microbiology (medical), medicine.medical_specialty, medicine.drug_class, 030106 microbiology, beta-Lactamases, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, Enterobacteriaceae, Internal medicine, Drug Resistance, Bacterial, Humans, lcsh:RC109-216, Risk factor, Aged, business.industry, Research, Public Health, Environmental and Occupational Health, Organ Transplantation, 2739 Public Health, Environmental and Occupational Health, 2725 Infectious Diseases, Transplant Recipients, Solid organ transplant, Transplantation, Case-Control Studies, 10032 Clinic for Oncology and Hematology, bacteria, business
Abstract

Background The burden of antimicrobial resistance is high in solid organ transplant (SOT) recipients. Among Swiss SOT recipients, we assessed temporal trends of ESBL-producing Enterobacterales (ESBL-E), identified risk factors for ESBL-E, and assessed the impact of resistance on patient outcome. Methods Data from the Swiss Transplant Cohort Study (STCS), a nationwide prospective cohort of SOT-recipients, were analysed. Temporal trends were described for ESBL-detection among Escherichia coli and non-Escherichia coli. In a nested case–control study, cases with ESBL-E infection were 1:1 matched (by time since transplantation, organ transplant, pathogen) to controls infected with non-ESBL-E. Factors associated with resistance and with unfavourable 30-day outcome (death, infection relapse, graft loss) were assessed. Results From 2012 to 2018, we identified 1′212 infection episodes caused by Enterobacterales in 1′074 patients, thereof 11.4% (138/1′212) caused by ESBL-E. The proportion of ESBL-production among Escherichia coli remained stable over time (p = 0.93) but increased for non-E. coli (p = 0.02) Enterobacterales. In the case–control study (n = 102), antibiotic pre-treatment was independently associated with ESBL-production (aOR = 2.6, 95%-CI: 1.0–6.8, p = 0.046). Unfavourable outcome occurred in 24/51 (47%) cases and 9/51 (18%) controls (p = 0.003). Appropriate empiric antibiotic therapy was the only modifiable factor associated with unfavourable outcome. Conclusions In Swiss SOT-recipients, proportion of infections with ESBL-producing non-E. coli Enterobacterales increased in recent years. Antibiotic pre-treatment represents a risk factor for ESBL-E. Improving appropriateness of empiric antibiotic treatment might be an important measure to reduce unfavourable outcome, which was observed in almost half of SOT-recipients with ESBL-E infections.

Published
2021
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8. 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

9. 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

10. Pneumocystis jirovecii pneumonia in solid organ transplant recipients: a descriptive analysis for the Swiss Transplant Cohort

Author

Neofytos, Dionysios, Hirzel, Cédric, Boely, Elsa, Lecompte, Thanh, Khanna, Nina, Mueller, Nicolas J, Boggian, Katia, Cusini, Alexia, Manuel, Oriol, Banz Wüthrich, Vanessa, Beldi, Guido, Stirnimann, Guido, van Delden, Christian, Swiss Transplant, Cohort Study, Swiss Transplant Cohort Study, Amico, P., Aubert, J.D., Banz, V., Beldi, G., Benden, C., Berger, C., Binet, I., Bochud, P.Y., Boëly, E., 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., Heim, D., Hess, C., Hillinger, S., Hirsch, H.H., Hofbauer, G., Huynh-Do, U., Immer, F., Klaghofer, R., Koller, M., Laesser, B., Lehmann, R., Lovis, C., Majno, P., Marti, H.P., Martin, P.Y., Meylan, P., Mohacsi, P., Morel, P., Mueller, U., Mueller-McKenna, H., 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., Venetz, J.P., Villard, J., Wick, M., Wilhelm, M., Yerly, P., University of Zurich, and Neofytos, Dionysios

Subjects
0301 basic medicine, Male, Epidemiology, 2747 Transplantation, Pneumocystis carinii, Adult, Aged, Anti-Bacterial Agents/therapeutic use, Antibiotic Prophylaxis/methods, Antibiotic Prophylaxis/standards, Female, Humans, Incidence, Middle Aged, Mortality, Organ Transplantation/adverse effects, Pneumocystis carinii/isolation & purification, Pneumonia, Pneumocystis/drug therapy, Pneumonia, Pneumocystis/epidemiology, Pneumonia, Pneumocystis/microbiology, Pneumonia, Pneumocystis/prevention & control, Practice Guidelines as Topic, Prospective Studies, Switzerland/epidemiology, Treatment Outcome, Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use, Young Adult, Pneumocystis jirovecii pneumonia, Solid organ transplant recipients, 10234 Clinic for Infectious Diseases, 0302 clinical medicine, 030212 general & internal medicine, Prospective cohort study, 610 Medicine & health, education.field_of_study, ddc:617, Incidence (epidemiology), Pneumonia, Pneumocystis, Anti-Bacterial Agents, Infectious Diseases, 10219 Clinic for Gastroenterology and Hepatology, Cohort, 10209 Clinic for Cardiology, 10178 Clinic for Pneumology, Switzerland, medicine.drug, medicine.medical_specialty, 030106 microbiology, Population, 03 medical and health sciences, Internal medicine, parasitic diseases, Trimethoprim, Sulfamethoxazole Drug Combination, medicine, education, Transplantation, business.industry, 2725 Infectious Diseases, Organ Transplantation, Antibiotic Prophylaxis, medicine.disease, Trimethoprim, Pneumonia, Complication, business
Abstract

BACKGROUND Descriptive data on Pneumocystis jirovecii pneumonia (PJP) in solid organ transplant recipients (SOTr) in the era of routine Pneumocystis-prophylaxis are lacking. METHODS All adult SOTr between 2008-2016 were included. PJP was diagnosed based on consensus guidelines. Early-onset PJP was defined as PJP within the 1st-year-post-transplant. RESULTS 41/2842 SOTr (1.4%) developed PJP (incidence rate: 0.01/1000 person-days) at a mean of 493-days post-transplant: 21 (51.2%) early vs 20 (48.8%) late-onset PJP. 2465 (86.7%) SOTr received Pneumocystis-prophylaxis for a mean 316 days. PJP incidence was 0.001% and 0.003% (log-rank

Published
2018
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11. CRTC2 polymorphism as a risk factor for the incidence of metabolic syndrome in patients with solid organ transplantation

Author

Zoltán Kutalik, Pierre-Yves Bochud, Séverine Crettol, Nicolas J. Mueller, Roger Lehmann, Manuel Pascual, Jean-François Dufour, Paola M. Soccal, Isabelle Binet, Andrea Treyer, Jürg Steiger, Dela Golshayan, Lina Quteineh, Chin B. Eap, Jean-Pierre Venetz, C. van Delden, Paul Mohacsi, Oriol Manuel, and The Swiss Transplant Cohort Study, Achermann, R., Aubert, J.D., Baumann, P., Beldi, G., Benden, C., Berger, C., Binet, I., Bochud, P.Y., Boely, E., Bucher, H., Bühler, L., Carell, T., Catana, E., Chalandon, Y., Geest, S., Rougemont, O., Dickenmann, M., Duchosal, M., Fehr, T., Ferrari-Lacraz, S., Garzoni, C., Gasche, Y., Soccal, P.G., Giostra, E., Golshayan, D., Good, D., Hadaya, K., Hess, C., Hillinger, S., Hirsch, H., Hofbauer, G., Huynh-Do, U., Immer, F., Klaghofer, R., Koller, M., Kuntzen, T., Laesser, B., Lehmann, R., Lovis, C., Manuel, O., Marti, H.P., Martin, P.Y., Meylan, P., Mohacsi, P., Morard, I., Morel, P., Mueller, U., Mueller, N., Mueller-McKenna, H., Müller, T., Müllhaupt, B., Nadal, D., Nair, G., Pascual, M., Passweg, J., Ziegler, C.P., Rick, J., Roosnek, E., Rosselet, A., Rothlin, S., Ruschitzka, F., Schanz, U., Schaub, S., Seiler, C., Semmo, N., Stampf, S., Steiger, J., Toso, C., Tsinalis, D., Delden, C.V., Venetz, J.P., Villard, J., Wick, M., Wilhelm, M., Yerly, P., University of Zurich, and Eap, C B

Subjects
0301 basic medicine, Time Factors, Physiology, Pharmacology, Organ transplantation, 10234 Clinic for Infectious Diseases, Diabetes mellitus genetics, Gene Frequency, Risk Factors, Odds Ratio, Prevalence, ddc:616, Metabolic Syndrome, 2. Zero hunger, education.field_of_study, Incidence, Homozygote, 3. Good health, 10219 Clinic for Gastroenterology and Hepatology, 3004 Pharmacology, Phenotype, Treatment Outcome, 10209 Clinic for Cardiology, Molecular Medicine, 10178 Clinic for Pneumology, Switzerland, Heterozygote, medicine.medical_specialty, Population, 610 Medicine & health, Biology, Polymorphism, Single Nucleotide, Risk Assessment, 03 medical and health sciences, Insulin resistance, 1311 Genetics, Diabetes mellitus, Diabetes Mellitus, Genetics, medicine, Humans, Diabetes Mellitus/epidemiology, Diabetes Mellitus/genetics, Dyslipidemias/epidemiology, Dyslipidemias/genetics, Genetic Predisposition to Disease, Linear Models, Logistic Models, Metabolic Syndrome X/diagnosis, Metabolic Syndrome X/epidemiology, Metabolic Syndrome X/genetics, Multivariate Analysis, Obesity/epidemiology, Obesity/genetics, Organ Transplantation/adverse effects, Switzerland/epidemiology, Transcription Factors/genetics, Obesity, education, Dyslipidemias, Organ Transplantation, Odds ratio, medicine.disease, 10020 Clinic for Cardiac Surgery, Transplantation, 030104 developmental biology, 1313 Molecular Medicine, Metabolic syndrome, Transcription Factors
Abstract

Metabolic syndrome after transplantation is a major concern following solid organ transplantation (SOT). The CREB-regulated transcription co-activator 2 (CRTC2) regulates glucose metabolism. The effect of CRTC2 polymorphisms on new-onset diabetes after transplantation (NODAT) was investigated in a discovery sample of SOT recipients (n1=197). Positive results were tested for replication in two samples from the Swiss Transplant Cohort Study (STCS, n2=1294 and n3=759). Obesity and other metabolic traits were also tested. Associations with metabolic traits in population-based samples (n4=46'186, n5=123'865, n6>100,000) were finally analyzed. In the discovery sample, CRTC2 rs8450-AA genotype was associated with NODAT, fasting blood glucose and body mass index (PcorrectedA was significantly associated with several metabolic abnormalities. CRTC2 rs8450G>A appears to have an important role in the high prevalence of metabolic traits observed in patients with SOT. A weak association with metabolic traits was also observed in the population-based samples.The Pharmacogenomics Journal advance online publication, 8 December 2015; doi:10.1038/tpj.2015.82.

Published
2015
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12. PTX3 Polymorphisms and Invasive Mold Infections After Solid Organ Transplant

Author

Wójtowicz, A., Lecompte, T.D., Bibert, S., Manuel, O., Rüeger, S., Berger, C., Boggian, K., Cusini, A., Garzoni, C., Hirsch, H., Khanna, N., Mueller, N.J., Meylan, P.R., Pascual, M., van Delden, C., Bochud, P.Y., University of Zurich, Bochud, Pierre-Yves, Swiss Transplant Cohort Study, Achermann, R., Aubert, JD., Baumann, P., Beldi, G., Benden, C., Berger, C., Binet, I., Bochud, PY., Boely, E., Bucher, H., Bühler, L., Carell, T., Catana, E., Chalandon, Y., de Geest, S., de Rougemont, O., Dickenmann, M., Duchosal, M., Fehr, T., Ferrari-Lacraz, S., Garzoni, C., Gasche, Y., Soccal, PG., Giostra, E., Golshayan, D., Good, D., Hadaya, K., Hess, C., Hillinger, S., Hirsch, HH., Hofbauer, G., Huynh-Do, U., Immer, F., Klaghofer, R., Koller, M., Kuntzen, T., Laesser, B., Lehmann, R., Lovis, C., Manuel, O., Marti, HP., Martin, PY., Meylan, P., Mohacsi, P., Morard, I., Morel, P., Mueller, U., Mueller, NJ., Mueller-McKenna, H., Müller, T., Müllhaupt, B., Nadal, D., Nair, G., Pascual, M., Passweg, J., Ziegler, CP., Rick, J., Roosnek, E., Rosselet, A., Rothlin, S., Ruschitzka, F., Schanz, U., Schaub, S., Seiler, C., Semmo, N., Stampf, S., Steiger, J., Toso, C., Tsinalis, D., Van Delden, C., Venetz, JP., Villard, J., Wick, M., Wilhelm, M., and Yerly, P.

Subjects
10234 Clinic for Infectious Diseases, ddc:616, 10219 Clinic for Gastroenterology and Hepatology, 10036 Medical Clinic, 10209 Clinic for Cardiology, C-Reactive Protein/genetics, Female, Fungi/isolation & purification, Humans, Immunocompromised Host, Male, Mycoses/genetics, Mycoses/immunology, Organ Transplantation/adverse effects, Polymorphism, Genetic, Prospective Studies, Serum Amyloid P-Component/genetics, 610 Medicine & health, 2725 Infectious Diseases, 2726 Microbiology (medical)
Abstract

Donor PTX3 polymorphisms were shown to influence the risk of invasive aspergillosis among hematopoietic stem cell transplant recipients. Here, we show that PTX3 polymorphisms are independent risk factors for invasive mold infections among 1101 solid organ transplant recipients, thereby strengthening their role in mold infection pathogenesis and patients' risk stratification.

Published
2015
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13. Influence of IFNL3/4 polymorphisms on the incidence of cytomegalovirus infection after solid-organ transplantation

Author

Stéphanie Bibert, Alexia Cusini, Christian Garzoni, Nicolas J. Mueller, Juerg Steiger, Adrian Egli, Martin Stern, Isabelle Binet, Christoph Berger, Maja Weisser, Hans H. Hirsch, Pierre-Yves Bochud, Manuel Pascual, Agnieszka Wójtowicz, Pascal Meylan, Oriol Manuel, Christian van Delden, University of Zurich, Manuel, Oriol, Swiss Transplant Cohort Study (STCS), Swiss Transplant Cohort Study STCS, Binet, I., De Geest, S., van Delden, C., Hofbauer, G., Huynh-Do, U., Koller, M., Lovis, C., Manuel, O., Meylan, P., Mueller, Nj., Pascual, M., Schaub, S., and Steiger, J.

Subjects
Adult, Male, medicine.medical_specialty, Hepatitis C virus, Cytomegalovirus, 610 Medicine & health, Disease, Virus Replication, medicine.disease_cause, Antiviral Agents, Polymorphism, Single Nucleotide, Gastroenterology, 10234 Clinic for Infectious Diseases, Interferon, Internal medicine, medicine, Humans, Immunology and Allergy, Genetic Predisposition to Disease, Cumulative incidence, Allele, Genetic Association Studies, Aged, ddc:616, ddc:617, business.industry, Incidence, Interleukins, virus diseases, 2725 Infectious Diseases, Middle Aged, Kidney Transplantation, Confidence interval, 3. Good health, Transplantation, Infectious Diseases, 10036 Medical Clinic, Cytomegalovirus Infections, Immunology, 2723 Immunology and Allergy, Female, Interferons, business, Cohort study, medicine.drug
Abstract

© The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. Background. Polymorphisms in IFNL3 and IFNL4 the genes encoding interferon ?3 and interferon ?4 respectively have been associated with reduced hepatitis C virus clearance. We explored the role of such polymorphisms on the incidence of cytomegalovirus (CMV) infection in solid organ transplant recipients. Methods. White patients participating in the Swiss Transplant Cohort Study in 2008 2011 were included. A novel functional TT/ G polymorphism (rs368234815) in the CpG region upstream of IFNL3 was investigated. Results. A total of 840 solid organ transplant recipients at risk for CMV infection were included among whom 373 (44) received antiviral prophylaxis. The 12 month cumulative incidence of CMV replication and disease were 0.44 and 0.08 cases respectively. Patient homozygous for the minor rs368234815 allele ( G/ G) tended to have a higher cumulative incidence of CMV replication (subdistribution hazard ratio [SHR] 1.30 [95 confidence interval {CI}. 97 1.74]; P =. 07) compared with other patients (TT/TT or TT/ G). The association was significant among patients followed by a preemptive approach (SHR 1.46 [95 CI 1.01 2.12]; P =. 047) especially in patients receiving an organ from a seropositive donor (SHR 1.92 [95 CI 1.30 2.85]; P =. 001) but not among those who received antiviral prophylaxis (SHR 1.13 [95 CI. 70 1.83]; P =. 6). These associations remained significant in multivariate competing risk regression models. Conclusions. Polymorphisms in the IFNL3/4 region influence susceptibility to CMV replication in solid organ transplant recipients particularly in patients not receiving antiviral prophylaxis.

Published
2015
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14. Rapid adaptation drives invasion of airway donor microbiota by Pseudomonas after lung transplantation

Author

Beaume, M, Köhler, T, Greub, G, Manuel, O, Aubert, J-D, Baerlocher, L, Farinelli, L, Buckling, A, van Delden, C, Stirnimann, Guido, Beldi, Guido, Huynh-Do, Uyen, Swiss Transplant, Cohort Study, Swiss Transplant Cohort Study, Achermann, R., Amico, P., Baumann, P., Beldi, G., Benden, C., Berger, C., Binet, I., Bochud, P.Y., Boely, E., Bucher, H., Bühler, L., Carell, T., Catana, E., Chalandon, Y., Geest, S., Rougemont, O., Dickenmann, M., Duchosal, M., Fehr, T., Ferrari-Lacraz, S., Garzoni, C., Soccal, P.G., Giostra, E., Golshayan, D., Good, D., Hadaya, K., Halter, J., Heim, D., Hess, C., Hillinger, S., Hirsch, H.H., Hofbauer, G., Huynh-Do, U., Immer, F., Klaghofer, R., Koller, M., Laesser, B., Lehmann, R., Lovis, C., Marti, H.P., Martin, P.Y., Martinolli, L., Meylan, P., Mohacsi, P., Morard, I., Morel, P., Mueller, U., Mueller, N.J., Mueller-McKenna, H., Müller, A., Müller, T., Müllhaupt, B., Nadal, D., Pascual, M., Passweg, J., Ziegler, C.P., Rick, J., Roosnek, E., Rosselet, A., Rothlin, S., Ruschitzka, F., Schanz, U., Schaub, S., Seiler, C., Stampf, S., Steiger, J., Stirnimann, G., Toso, C., Tsinalis, D., Venetz, J.P., Villard, J., Wick, M., Wilhelm, M., and Yerly, P.

Subjects
0301 basic medicine, Adult, Cystic Fibrosis, medicine.medical_treatment, 030106 microbiology, Colony Count, Microbial, Motility, 610 Medicine & health, Cystic fibrosis, Adaptation, Physiological, Allografts, Cystic Fibrosis/microbiology, Female, Genome, Bacterial, Humans, Lung/microbiology, Lung Transplantation, Microbiota, Phenotype, Pseudomonas/isolation & purification, Pseudomonas/physiology, Tissue Donors, Article, Microbiology, 03 medical and health sciences, Pseudomonas, medicine, Lung transplantation, Lung, ddc:616, Multidisciplinary, biology, ddc:617, Biofilm, biology.organism_classification, medicine.disease, respiratory tract diseases, medicine.anatomical_structure, Actinobacillus, Immunology
Abstract

In cystic fibrosis (CF) patients, chronic airway infection by Pseudomonas leads to progressive lung destruction ultimately requiring lung transplantation (LT). Following LT, CF-adapted Pseudomonas strains, potentially originating from the sinuses, may seed the allograft leading to infections and reduced allograft survival. We investigated whether CF-adapted Pseudomonas populations invade the donor microbiota and adapt to the non-CF allograft. We collected sequential Pseudomonas isolates and airway samples from a CF-lung transplant recipient during two years, and followed the dynamics of the microbiota and Pseudomonas populations. We show that Pseudomonas invaded the host microbiota within three days post-LT, in association with a reduction in richness and diversity. A dominant mucoid and hypermutator mutL lineage was replaced after 11 days by non-mucoid strains. Despite antibiotic therapy, Pseudomonas dominated the allograft microbiota until day 95. We observed positive selection of pre-LT variants and the appearance of novel mutations. Phenotypic adaptation resulted in increased biofilm formation and swimming motility capacities. Pseudomonas was replaced after 95 days by a microbiota dominated by Actinobacillus. In conclusion, mucoid Pseudomonas adapted to the CF-lung remained able to invade the allograft. Selection of both pre-existing non-mucoid subpopulations and of novel phenotypic traits suggests rapid adaptation of Pseudomonas to the non-CF allograft.

Published
2017
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15. Ventricular assist devices as bridge to heart transplantation: impact on post-transplant infections

Author

Héquet, Delphine, Kralidis, Georg, Carrel, Thierry, Cusini, Alexia, Garzoni, Christian, Hullin, Roger, Meylan, Pascal R, Mohacsi, Paul, Mueller, Nicolas J, Ruschitzka, Frank, Tozzi, Piergiorgio, van Delden, Christian, Weisser, Maja, Wilhelm, Markus J, Pascual, Manuel, Beldi, Guido, Stirnimann, Guido, Manuel, Oriol, Swiss Transplant Cohort Study, STCS, Swiss Transplant Cohort Study (STCS), Achermann, R., Amico, P., Aubert, JD., Baumann, P., Beldi, G., Benden, C., Berger, C., Binet, I., Bochud, PY., Boely, E., Bucher, H., Bühler, L., 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., Gaudet, C., Giostra, E., Golshayan, D., Hadaya, K., Halter, J., Heim, D., Hess, C., Hillinger, S., Hirsch, H., Hofbauer, G., Huynh-Do, U., Immer, F., Klaghofer, R., Koller, M., Laesser, B., Lehmann, R., Lovis, C., Manuel, O., Marti, HP., Martin, P., Martinolli, L., Meylan, P., Mohacsi, P., Morel, P., Mueller, U., Mueller, N., Mueller-McKenna, H., Müller, A., Müller, T., Müllhaupt, B., Nadal, D., Pascual, M., Passweg, J., Ziegler, C., Rick, J., Roosnek, E., Rosselet, A., Rothlin, S., Ruschitzka, F., Schanz, U., Schaub, S., Schnyder, A., Seiler, C., Stampf, S., Steiger, J., Stirnimann, G., Toso, C., Van Delden, C., Venetz, JP., Villard, J., Wick, M., Wilhelm, M., Yerly, P., University of Zurich, and Manuel, Oriol

Subjects
Male, 10255 Clinic for Thoracic Surgery, medicine.medical_treatment, 030204 cardiovascular system & hematology, 030230 surgery, 10234 Clinic for Infectious Diseases, Cohort Studies, 0302 clinical medicine, Postoperative Complications, Risk Factors, Clinical endpoint, Medicine, Cumulative incidence, 610 Medicine & health, Outcome, Heart transplantation, ddc:616, Mechanical heart support, Incidence (epidemiology), Incidence, Bacterial Infections, Middle Aged, 3. Good health, 10219 Clinic for Gastroenterology and Hepatology, Infectious Diseases, surgical procedures, operative, Virus Diseases, Cohort, 10209 Clinic for Cardiology, Cardiac transplantation, Female, biological phenomena, cell phenomena, and immunity, Cohort study, Research Article, Adult, medicine.medical_specialty, 03 medical and health sciences, Internal medicine, parasitic diseases, Humans, cardiovascular diseases, Aged, Proportional Hazards Models, Retrospective Studies, Heart Failure, business.industry, 2725 Infectious Diseases, medicine.disease, Surgery, Transplantation, Mycoses, 10036 Medical Clinic, Heart failure, Multivariate Analysis, Heart Transplantation, Heart-Assist Devices, business
Abstract

Background Ventricular assist devices (VAD) are valuable options for patients with heart failure awaiting cardiac transplantation. We assessed the impact of pre-transplant VAD implantation on the incidence of post-transplant infections in a nationwide cohort of heart transplant recipients. Methods Heart transplant recipients included in the Swiss Transplant Cohort Study between May 2008 and December 2012 were analyzed. Cumulative incidence curves were used to calculate the incidence of bacterial or Candida infections (primary endpoint) and of other infections (secondary endpoint) after transplant. Cox regression models treating death as a competing risk were used to identify risk factors for the development of infection after transplant. Results Overall, 119 patients were included in the study, 35 with a VAD and 84 without VAD. Cumulative incidences of post-transplant bacterial or Candida infections were 37.7 % in VAD patients and 40.4 % in non-VAD patients. In multivariate analysis, the use of cotrimoxazole prophylaxis was the only variable associated with bacterial/Candida infections after transplant (HR 0.29 [95 % CI 0.15-0.57], p

Published
2016
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16. IL1B and DEFB1 Polymorphisms Increase Susceptibility to Invasive Mold Infection After Solid-Organ Transplantation

Author

S. De Geest, Christian van Delden, Sina Rüeger, Christoph Berger, Isabelle Binet, Frank L. van de Veerdonk, Michael T. Koller, C. van Delden, Manuel Pascual, Uyen Huynh-Do, Zoltán Kutalik, P. Meylan, Pierre-Yves Bochud, Juerg Steiger, Stéphanie Bibert, S. Schaub, Katia Boggian, Nicolas J. Mueller, G. F. K. Hofbauer, Alexia Cusini, Jürg Steiger, T. Lecompte, O. Manuel, Agnieszka Wójtowicz, Leo A. B. Joosten, Pascal Meylan, Christian Lovis, Christian Garzoni, Oriol Manuel, Maja Weisser, Mark S. Gresnigt, Hans H. Hirsch, Swiss Transplant Cohort Study (STCS), Swiss Transplant Cohort Study STCS, Binet, I., De Geest, S., van Delden, C., Hofbauer, GF., Huynh-Do, U., Koller, MT., Lovis, C., Manuel, O., Meylan, P., Mueller, NJ., Pascual, M., Schaub, S., Steiger, J., University of Zurich, and Wójtowicz, Agnieszka

Subjects
Adult, Male, beta-Defensins, Genotype, medicine.medical_treatment, Interleukin-1beta, lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], Single-nucleotide polymorphism, 610 Medicine & health, Biology, Peripheral blood mononuclear cell, Polymorphism, Single Nucleotide, 10234 Clinic for Infectious Diseases, Cohort Studies, medicine, Genetic predisposition, Immunology and Allergy, Humans, Genetic Predisposition to Disease, Genetic Association Studies, Aged, ddc:616, ddc:617, Fungi, Interleukin, 2725 Infectious Diseases, Organ Transplantation, Middle Aged, Transplant Recipients, 3. Good health, Transplantation, Infectious Diseases, Cytokine, Interleukin 1 receptor antagonist, Mycoses, 10036 Medical Clinic, Immunology, 2723 Immunology and Allergy, Female
Abstract

Contains fulltext : 153038.pdf (Publisher’s version ) (Closed access) BACKGROUND: Single-nucleotide polymorphisms (SNPs) in immune genes have been associated with susceptibility to invasive mold infection (IMI) among hematopoietic stem cell but not solid-organ transplant (SOT) recipients. METHODS: Twenty-four SNPs from systematically selected genes were genotyped among 1101 SOT recipients (715 kidney transplant recipients, 190 liver transplant recipients, 102 lung transplant recipients, 79 heart transplant recipients, and 15 recipients of other transplants) from the Swiss Transplant Cohort Study. Association between SNPs and the end point were assessed by log-rank test and Cox regression models. Cytokine production upon Aspergillus stimulation was measured by enzyme-linked immunosorbent assay in peripheral blood mononuclear cells (PBMCs) from healthy volunteers and correlated with relevant genotypes. RESULTS: Mold colonization (n = 45) and proven/probable IMI (n = 26) were associated with polymorphisms in the genes encoding interleukin 1beta (IL1B; rs16944; recessive mode, P = .001 for colonization and P = .00005 for IMI, by the log-rank test), interleukin 1 receptor antagonist (IL1RN; rs419598; P = .01 and P = .02, respectively), and beta-defensin 1 (DEFB1; rs1800972; P = .001 and P = .0002, respectively). The associations with IL1B and DEFB1 remained significant in a multivariate regression model (P = .002 for IL1B rs16944; P = .01 for DEFB1 rs1800972). The presence of 2 copies of the rare allele of rs16944 or rs419598 was associated with reduced Aspergillus-induced interleukin 1beta and tumor necrosis factor alpha secretion by PBMCs. CONCLUSIONS: Functional polymorphisms in IL1B and DEFB1 influence susceptibility to mold infection in SOT recipients. This observation may contribute to individual risk stratification.

Published
2015
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17. Reply to Cunha et al

Author

Wójtowicz, Agnieszka, Lecompte, Thanh Doco, Bibert, Stéphanie, Manuel, Oriol, Rüeger, Sina, Berger, Christoph, Boggian, Katia, Cusini, Alexia, Garzoni, Christian, Khanna, Nina, Mueller, Nicolas J, Meylan, Pascal R, Pascual, Manuel, Van Delden, Christian, Semmo, Nasser, Beldi, Guido, Bochud, Pierre-Yves, Swiss Transplant, Cohort Study, Swiss Transplant Cohort Study, Achermann, R., Aubert, JD., Baumann, P., Beldi, G., Benden, C., Berger, C., Binet, I., Bochud, PY., Boely, E., Bucher, H., Bühler, L., Carell, T., Catana, E., Chalandon, Y., de Geest, S., de Rougemont, O., Dickenmann, M., Duchosal, M., Fehr, T., Ferrari-Lacraz, S., Garzoni, C., Gasche, Y., Soccal, PG., Giostra, E., Golshayan, D., Good, D., Hadaya, K., Hess, C., Hillinger, S., Hirsch, HH., Hofbauer, G., Huynh-Do, U., Immer, F., Klaghofer, R., Koller, M., Kuntzen, T., Laesser, B., Lehmann, R., Lovis, C., Manuel, O., Marti, HP., Martin, PY., Meylan, P., Mohacsi, P., Morard, I., Morel, P., Mueller, U., Mueller, NJ., Mueller-McKenna, H., Müller, T., Müllhaupt, B., Nadal, D., Nair, G., Pascual, M., Passweg, J., Ziegler, CP., Rick, J., Roosnek, E., Rosselet, A., Rothlin, S., Ruschitzka, F., Schanz, U., Schaub, S., Seiler, C., Semmo, N., Stampf, S., Steiger, J., Toso, C., Tsinalis, D., Van Delden, C., Venetz, JP., Villard, J., Wick, M., Wilhelm, M., Yerly, P., University of Zurich, Bochud, Pierre-Yves, and Chalandon, Yves

Subjects
Male, Microbiology (medical), medicine.medical_specialty, Organ Transplantation / adverse effects, Serum Amyloid P-Component / genetics, 610 Medicine & health, 2726 Microbiology (medical), Organ transplantation, 10234 Clinic for Infectious Diseases, Immunocompromised Host, Internal medicine, medicine, Humans, Serum amyloid P component, ddc:616, Mycoses / immunology, Polymorphism, Genetic, Fungi / isolation & purification, biology, business.industry, C-reactive protein, Fungi, Organ Transplantation, 2725 Infectious Diseases, Mycoses / genetics, Serum Amyloid P-Component, C-Reactive Protein, Infectious Diseases, Endocrinology, Mycoses, 10209 Clinic for Cardiology, biology.protein, C-Reactive Protein / genetics, Female, business, C-Reactive Protein/genetics, Fungi/isolation & purification, Mycoses/genetics, Mycoses/immunology, Organ Transplantation/adverse effects, Serum Amyloid P-Component/genetics
Published
2015
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