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5. Infección por Strongyloides stercoralis en pacientes trasplantados renales

Author

Beltrán Catalán,S., Crespo Albiach,J., Morales García,A.I., Gavela Martínez,E., Górriz Teruel,J., and Pallardó Mateu,L.

Subjects
Parásito, Infección, Paciente trasplantado renal, Strongyloides stercoralis
Abstract

Presentamos dos casos de infección por Strongyloides stercoralis (S. stercoralis) en pacientes trasplantados renales en nuestro centro. Se describen las características de su presentación clínica, el tratamiento y la resolución del mismo.

Published
2009

6. Infección por Strongyloides stercoralis en pacientes trasplantados renales

Author

Beltrán Catalán, S., Crespo Albiach, J., Morales García, A.I., Gavela Martínez, E., Górriz Teruel, J., and Pallardó Mateu, L.

Subjects
Parasitic infection, Parásito, Infección, Paciente trasplantado renal, Strongyloides stercoralis, Renal transplant recipiente
Abstract

Presentamos dos casos de infección por Strongyloides stercoralis (S. stercoralis) en pacientes trasplantados renales en nuestro centro. Se describen las características de su presentación clínica, el tratamiento y la resolución del mismo. We present two cases of Strongyloides stercoralis infection in renal transplant recipients in our centre. We describe clinical presentation characteristics, treatment and resolution.

Published
2009

8. Transplantation - clinical II

Author

Riegersperger, M., primary, Plischke, M., additional, Steiner-Boker, S., additional, Seidinger, D., additional, Winkelmayer, W., additional, Sunder-Plassmann, G., additional, Vlahovic, P., additional, Cvetkovic, T., additional, Djordjevic, V., additional, Velickovic-Radovanovic, R., additional, Stefanovic, N., additional, Ignjatovic, A., additional, Sladojevic, N., additional, Cademartori, V., additional, Massarino, F., additional, Parodi, E. L., additional, Russo, R., additional, Sofia, A., additional, Fontana, I., additional, Viviani, G. L., additional, Garibotto, G., additional, Mai, M., additional, Mai, W., additional, Taner, B., additional, Wadei, H., additional, Prendergast, M., additional, Gonwa, T., additional, Martin, J., additional, Aurore, S., additional, Aline, C. S., additional, Nicolas, M., additional, Manolie, M., additional, Catherine, S., additional, Eric, A., additional, Christophe, M., additional, Brakemeier, S., additional, Liefeldt, L., additional, Glander, P., additional, Waiser, J., additional, Lachmann, N., additional, Schonemann, C., additional, Zukunft, B., additional, Illigens, P., additional, Schmidt, D., additional, Wu, K., additional, Rudolph, B., additional, Neumayer, H.-H., additional, Budde, K., additional, Pallardo Mateu, L., additional, Gavela Martinez, E., additional, Sancho Calabuig, A., additional, Crespo Albiach, J., additional, Beltran Catalan, S., additional, Kanter Berga, J., additional, Kimura, T., additional, Yagisawa, T., additional, Ishikawa, N., additional, Sakuma, Y., additional, Hujiwara, T., additional, Nukui, A., additional, Yashi, M., additional, Duraes, J., additional, Malheiro, J., additional, Fonseca, I., additional, Rocha, A., additional, Martins, L. S., additional, Almeida, M., additional, Dias, L., additional, Castro-Henriques, A., additional, Cabrita, A., additional, Volpe, A., additional, Quaglia, M., additional, Menegotto, A., additional, Fenoglio, R., additional, Izzo, C., additional, Airoldi, A., additional, Terrone, C., additional, Stratta, P., additional, Ahmed, B., additional, Mireille, K., additional, Nilufer, B., additional, Annick, M., additional, Karl Martin, W., additional, Anh-Dung, H., additional, Dimitri, M., additional, Philippe, M., additional, Judith, R., additional, Daniel, A., additional, Lan, Y., additional, Heine, C., additional, Capone, V., additional, Grace, B., additional, Clayton, P., additional, Cass, A., additional, Mcdonald, S., additional, Fujiwara, T., additional, Iwabuchi, T., additional, Muraishi, O., additional, Torregrosa, V., additional, Barros, X., additional, Martinez de Osaba, M. J., additional, Paschoalin, R., additional, Campistol, J. M., additional, Hassan, R., additional, El-Hefnawy, A., additional, Soliman, S., additional, Shokeir, A., additional, Cobanoglu Kudu, A., additional, Gungor, O., additional, Kircelli, F., additional, Altinel, E., additional, Asci, G., additional, Ozbek, S. S., additional, Toz, H., additional, Ok, E., additional, Sandrini, S., additional, Setti, G., additional, Valerio, F., additional, Possenti, S., additional, Torrisi, I., additional, Polanco, N., additional, Garcia-Puente, L., additional, Gonzalez Monte, E., additional, Morales, E., additional, Gutierrez, E., additional, Bengoa, I., additional, Hernandez, A., additional, Caballero, J., additional, Morales, J. M., additional, Andres, A., additional, Sgarlato, V., additional, Comai, G., additional, La Manna, G., additional, Moretti, I., additional, Grandinetti, V., additional, Martelli, D., additional, Scolari, M. P., additional, Stefoni, S., additional, Valentini, C., additional, Persici, E., additional, Cappuccilli, M. L., additional, Liviano D'arcangelo, G., additional, Fabbrizio, B., additional, Carretta, E., additional, Mosconi, G., additional, Feliciangeli, G., additional, Grigioni, F. W., additional, Apicella, L., additional, Guida, B., additional, Vitale, S., additional, Garofalo, G., additional, Russo, L., additional, Maresca, I., additional, Rossano, R., additional, Memoli, B., additional, Carrano, R., additional, Federico, S., additional, Sabbatini, M., additional, Carta, P., additional, Zanazzi, M., additional, DI Maria, L., additional, Caroti, L., additional, Miejshtri, A., additional, Tsalouchos, A., additional, Bertoni, E., additional, Sezer, S., additional, Erkmen Uyar, M., additional, Colak, T., additional, Bal, Z., additional, Tutal, E., additional, Kalaci, G., additional, Ozdemir Acar, F. N., additional, Jacquelinet, C., additional, Bayat, S., additional, Pernin, V., additional, Portales, P., additional, Szwarc, I., additional, Garrigue, V., additional, Vetromile, F., additional, Delmas, S., additional, Eliaou, J. F., additional, Mourad, G., additional, Huber, L., additional, Slowinski, T., additional, Naik, M., additional, Nakai, K., additional, Fujii, H., additional, Kono, K., additional, Goto, S., additional, Ishimura, T., additional, Takeda, M., additional, Fujisawa, M., additional, Nishi, S., additional, Pereira Paschoalin, R., additional, Torregrosa, J. V., additional, Barros Freiria, X., additional, Duran Rebolledo, C. E., additional, Sanchez Escuredo, A., additional, Sole, M., additional, Youssouf, S., additional, Tabbasm, F., additional, Bell, R., additional, Al-Jayyousi, R., additional, Warwick, G., additional, Grall, A., additional, Treguer, L., additional, Essig, M., additional, Lecaque, C., additional, Noel, N., additional, Buchler, M., additional, Bertrand, D., additional, Rivalan, J., additional, Braun, L., additional, Villemain, F., additional, Hurault de Ligny, B., additional, Totet, A., additional, Pestourie, N., additional, Toubas, D., additional, Nevez, G., additional, Le Meur, Y., additional, Nour el Houda, B., additional, Mustapha, H., additional, Wafaa, F., additional, Inass, L., additional, Rambabova Bushljetikj, I., additional, Masin-Spasovska, J., additional, Spasovski, G., additional, Popov, Z., additional, Sikole, A., additional, Ivanovski, N., additional, Raimundo, M., additional, Guerra, J., additional, Teixeira, C., additional, Santana, A., additional, Silva, S., additional, Mil Homens, C., additional, Gomes Da Costa, A., additional, Loredo, D., additional, Cleres, M., additional, Gondolesi, G., additional, Gutierrez, L. M., additional, Fortunato, R. M., additional, Descalzi, V., additional, and Raffaele, P., additional

Published
2012
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9. Donor-specific HLA antibodies: risk factors and outcomes after kidney transplantation.

Author

Kanter Berga J, Pallardo Mateu LM, Beltran Catalan S, Puig Alcaraz N, Sancho Calabuig A, Gavela Martinez E, Avila Bernabeu A, and Crespo Albiach J

Subjects
Adult, Chi-Square Distribution, Cross-Sectional Studies, Female, Graft Rejection immunology, Graft Survival, Histocompatibility Testing, Humans, Kaplan-Meier Estimate, Logistic Models, Male, Middle Aged, Risk Assessment, Risk Factors, Spain, Time Factors, Treatment Outcome, HLA Antigens immunology, Histocompatibility, Isoantibodies blood, Kidney Transplantation immunology, Kidney Transplantation mortality
Abstract

Background: Anti-human leukocyte antigen antibodies (HLA Abs) have been associated with reduced kidney allograft survival. Our aim was to analyze the prevalence and impact on allograft function of donor-specific HLA antibodies (DSA) among a cohort of kidney transplant recipients., Patients and Methods: The 321 recipients had received deceased-donor kidneys followed for a median of 70 ± 43 months. We performed a cross-sectional analysis of the presence of HLA Abs with the use of Luminex technology., Results: Fifty patients (15.6%) displayed HLA Abs after transplantation including 21 (6.7%) as de novo HLA Abs. Eight patients (2.5%) developed DSA, and 42 (13%) showed no DSA. We compared 3 groups of patients: with DSA, without DSA, and without HLA sensitization. The DSA patients were younger (P = .03) with a higher percentage of men (P = .00), and having received less frequent induction treatment with basiliximab or thymoglobulin (P = .02). Patients without DSA revealed a higher percentage of pretransplantation HLA sensitization (P = .00), more pretransplantation transfusions (P = .08), and more frequent retransplantations (P = .00). The incidence of acute rejections was higher for DSA patients (P = .02) than for the other 2 groups, behaving as an independent risk factor (relative risk, 4.7; 95% confidence interval, 1.1-18.8; P = .03). Graft survival at 5 years was lower among patients with compared to those without HLA Abs (P = .00)., Conclusions: HLA donor-specific sensitization, an uncommon situation in our study, was associated with younger male recipients and less induction treatment. An acute rejection episode was an independent risk factor for the development of DSA; therefore, we think that monitoring of HLA Abs should be included in evaluation of the early postransplantation period., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Published
2011
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10. Very low-grade proteinuria at 3 months posttransplantation is an earlier marker of graft survival.

Author

Sancho Calabuig A, Pallardó Mateu LM, Avila Bernabeu AI, Gavela Martínez E, Beltrán Catalán S, and Crespo Albiach JF

Subjects
Aging physiology, Antilymphocyte Serum therapeutic use, Biomarkers, Brain Death, Humans, Hypertension urine, Immunosuppressive Agents therapeutic use, Kidney Transplantation pathology, Longitudinal Studies, Proteinuria epidemiology, Proteinuria immunology, Proteinuria mortality, Retrospective Studies, Risk Factors, Sensitivity and Specificity, Survival Rate, Survivors, Tacrolimus therapeutic use, Tissue Donors statistics & numerical data, Graft Survival physiology, Kidney Transplantation physiology, Prognosis, Proteinuria physiopathology
Abstract

Proteinuria is an early finding that appears in the first 3 months after transplantation in half of patients. Frequently, it is very low grade (VLP; <0.5 g/24 h). The aim of this study was to analyze the risk factors and prognostic significance of VLP at 3 months posttransplantation, which was maintained for the first year among our renal recipients. We compared 141 patients (39.7%) who showed VLP with 214 patients (60.3%) without proteinuria. VLP was associated with older recipients (P = .002), HLA incompatibilities (P = .001), older donors (P = .000), nontraumatic cause of brain death (P = .033) and previous hypertension (P = .030), tacrolimus (P = .000) and induction treatment with Thymoglobulin (P = .018) or anti-CD25 monoclonal antibodies (P = .000), as well as delayed graft function (DGF; P = .000). VLP patients showed worse renal function (P < .05) and greater requirement for antihypertensive drugs (P = .001). Multivariate analysis confirmed the impact of donor age, HLA incompatibilities, DGF, and tacrolimus treatment to predict the presence of VLP. Graft (P = .0019) and patient (P = .0146) survivals were lower among the VLP group. Cox analysis showed that VLP (RR: 2.047; P = .018) and DGF (RR: 2.062; P = .0017) were independently associated with reduced graft survival. The positive predictive value of VLP on graft survival was low. In conclusion, VLP was related to increasing acceptance of marginal donors, DGF, and worse renal function. Proteinuria was a noninvasive, readily determined parameter which was related to reduced graft and patient survivals, so renoprotective measures are mandatory from the early stages after transplantation.

Published
2009
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11. [Strongyloides stercoralis infection in renal transplant recipients].

Author

Beltrán Catalán S, Crespo Albiach JF, Morales García AI, Gavela Martínez E, Górriz Teruel JL, and Pallardó Mateu LM

Subjects
Animals, Humans, Male, Middle Aged, Kidney Transplantation adverse effects, Strongyloides stercoralis, Strongyloidiasis etiology
Abstract

We present two cases of strongyloides stercoralis infection in renal transplant recipients in our centre. We describe clinical presentation characteristics, treatment and resolution.

Published
2009
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12. Induction treatment with low-dose thymoglobulin or basiliximab in renal transplants from older donors.

Author

Gavela Martínez E, Sancho Calabuig A, Escudero Quesada V, Avila Bernabeu AI, Beltrán Catalán S, Morales García AI, Crespo Albiach JF, and Pallardó Mateu LM

Subjects
Adult, Aged, Antilymphocyte Serum therapeutic use, Basiliximab, Creatinine blood, Female, Humans, Length of Stay, Male, Middle Aged, Postoperative Complications epidemiology, Postoperative Complications prevention & control, Retrospective Studies, Tissue Donors statistics & numerical data, Antibodies, Monoclonal therapeutic use, Immunosuppressive Agents therapeutic use, Kidney Transplantation immunology, Recombinant Fusion Proteins therapeutic use
Abstract

Transplantation of kidneys from older donors is followed by an increase in delayed graft function (DGF) and acute rejection episodes (ARE). In these circumstances, induction treatment, whether with antithymocyte globulin or with interleukin-2 receptor blockers, may delay the introduction of calcineurin inhibitors (CNI) with effective prevention of ARE. We examined the efficacy and safety of induction treatment with 2 low doses of thymoglobulin compared with 2 doses of basiliximab. A group of 27 patients were treated with thymoglobulin and another 36 with basiliximab. CNI introduction was delayed until day 3 posttransplantation. The thymoglobulin group received 2 doses of 1.25 mg/kg on alternate days and the basiliximab group 2 doses of 20 mg. A trend to a lower incidence of DGF was observed in the thymoglobulin group (33% vs 55.6%; P = .08), with lower levels of serum creatinine on days 7 (P = .02) and 14 (P = .02) posttransplantation. No patient in the thymoglobulin group experienced ARE, but 11 patients (30.6%) in the basiliximab group did (P < .001), and 5 needed rescue treatment with thymoglobulin. We found no differences in the incidence of cytomegalovirus (CMV) disease (P = .945), admission due to infections (P = .274), or neoplasia (P = .340), or differences in graft (P = .69) and patient (P = .21) survivals at 1 and 3 years. Low-dose thymoglobulin was more effective at preventing DGF and ARE in renal transplant recipients of organs from older donors, with no differences in infectious complications or graft and patient survivals.

Published
2008
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