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2. Surgical site infections after kidney transplantation are independently associated with graft loss

Author

Amico, Patrizia, Aubert, John-David, Banz, Vanessa, Beckmann, Sonja, Beldi, Guido, Berger, Christoph, Berishvili, Ekaterine, Berzigotti, Annalisa, Binet, Isabelle, Bochud, Pierre-Yves, Branca, Sanda, Bucher, Heiner, Catana, Emmanuelle, Cairoli, Anne, Chalandon, Yves, De Geest, Sabina, De Rougemont, Olivier, De Seigneux, Sophie, Dickenmann, Michael, Dreifuss, Joëlle Lynn, Duchosal, Michel, Fehr, Thomas, Ferrari-Lacraz, Sylvie, Garzoni, Christian, Golshayan, Déla, Goossens, Nicolas, Haidar, Fadi, Halter, Jörg, Heim, Dominik, Hess, Christoph, Hillinger, Sven, Hirsch, Hans H., Hirt, Patricia, Hoessly, Linard, Hofbauer, Günther, Huynh-Do, Uyen, Immer, Franz, Koller, Michael, Laesser, Bettina, Lamoth, Frédéric, Lehmann, Roger, Leichtle, Alexander, Manuel, Oriol, Marti, Hans-Peter, Martinelli, Michele, McLin, Valérie, Mellac, Katell, Merçay, Aurélia, Mettler, Karin, Mueller, Nicolas J., Müller-Arndt, Ulrike, Müllhaupt, Beat, Nägeli, Mirjam, Oldani, Graziano, Pascual, Manuel, Passweg, Jakob, Pazeller, Rosemarie, Posfay-Barbe, Klara, Rick, Juliane, Rosselet, Anne, Rossi, Simona, Rothlin, Silvia, Ruschitzka, Frank, Schachtner, Thomas, Schaub, Stefan, Scherrer, Alexandra, Schnyder, Aurelia, Schuurmans, Macé, Schwab, Simon, Sengstag, Thierry, Simonetta, Federico, Stampf, Susanne, Steiger, Jürg, Stirnimann, Guido, Stürzinger, Ueli, Van Delden, Christian, Venetz, Jean-Pierre, Villard, Jean, Vionnet, Julien, Wick, Madeleine, Wilhelm, Markus, Yerly, Patrick, Schreiber, Peter W., Hoessly, Linard D., Boggian, Katia, Neofytos, Dionysios, van Delden, Christian, Egli, Adrian, Hirzel, Cédric, Schmied, Bruno, Guerke, Lorenz, Matter, Maurice, de Rougemont, Olivier, Bonani, Marco, Sidler, Daniel, and Kuster, Stefan P.

Published
2024
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7. 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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9. Immunogenicity of High-Dose Versus MF59-Adjuvanted Versus Standard Influenza Vaccine in Solid Organ Transplant Recipients: The Swiss/Spanish Trial in Solid Organ Transplantation on Prevention of Influenza (STOP-FLU Trial)

Author

Swiss National Science Foundation, Sánchez-Céspedes, Javier [0000-0003-2707-1979], Mombelli, Matteo, Neofytos, Dionysios, Huynh-Do, Uyen, Sánchez-Céspedes, Javier, Stampf, Susanne, Golshayan, Dela, Dahdal, Suzan, Stirnimann, Guido, Schnyder, Aurelia, Garzoni, Christian, Venzin, Reto M., Magenta, Lorenzo, Schönenberger, Melanie, Walti, Laura, Hirzel, Cédric, Munting, Aline, Dickenmann, Michael, Koller, Michael, Aubert, John-David, Steiger, Jürg, Pascual, Manuel, Mueller, Thomas F., Schuurmans, Macé, Berger, Christoph, Binet, Isabelle, Villard, Jean, Mueller, Nicolas J., Egli, Adrian, Cordero, Van Delden, Christian, Manuel, Oriol, Swiss National Science Foundation, Sánchez-Céspedes, Javier [0000-0003-2707-1979], Mombelli, Matteo, Neofytos, Dionysios, Huynh-Do, Uyen, Sánchez-Céspedes, Javier, Stampf, Susanne, Golshayan, Dela, Dahdal, Suzan, Stirnimann, Guido, Schnyder, Aurelia, Garzoni, Christian, Venzin, Reto M., Magenta, Lorenzo, Schönenberger, Melanie, Walti, Laura, Hirzel, Cédric, Munting, Aline, Dickenmann, Michael, Koller, Michael, Aubert, John-David, Steiger, Jürg, Pascual, Manuel, Mueller, Thomas F., Schuurmans, Macé, Berger, Christoph, Binet, Isabelle, Villard, Jean, Mueller, Nicolas J., Egli, Adrian, Cordero, Van Delden, Christian, and Manuel, Oriol

Abstract

[Background] The immunogenicity of the standard influenza vaccine is reduced in solid-organ transplant (SOT) recipients, so new vaccination strategies are needed in this population., [Methods] Adult SOT recipients from 9 transplant clinics in Switzerland and Spain were enrolled if they were >3 months after transplantation. Patients were randomized (1:1:1) to a MF59-adjuvanted or a high-dose vaccine (intervention), or a standard vaccine (control), with stratification by organ and time from transplant. The primary outcome was vaccine response rate, defined as a ≥4-fold increase of hemagglutination-inhibition titers to at least 1 vaccine strain at 28 days postvaccination. Secondary outcomes included polymerase chain reaction–confirmed influenza and vaccine reactogenicity., [Results] A total of 619 patients were randomized, 616 received the assigned vaccines, and 598 had serum available for analysis of the primary endpoint (standard, n = 198; MF59-adjuvanted, n = 205; high-dose, n = 195 patients). Vaccine response rates were 42% (84/198) in the standard vaccine group, 60% (122/205) in the MF59-adjuvanted vaccine group, and 66% (129/195) in the high-dose vaccine group (difference in intervention vaccines vs standard vaccine, 0.20; 97.5% confidence interval [CI], .12–1); P < .001; difference in high-dose vs standard vaccine, 0.24 [95% CI, .16–1]; P < .001; difference in MF59-adjuvanted vs standard vaccine, 0.17 [97.5% CI, .08–1]; P < .001). Influenza occurred in 6% of the standard, 5% in the MF59-adjuvanted, and 7% in the high-dose vaccine groups. Vaccine-related adverse events occurred more frequently in the intervention vaccine groups, but most of the events were mild., [Conclusions] In SOT recipients, use of an MF59-adjuvanted or a high-dose influenza vaccine was safe and resulted in a higher vaccine response rate.

Published
2024

10. Immunogenicity of High-Dose vs. MF59-adjuvanted vs. Standard Influenza Vaccine in Solid Organ Transplant Recipients: The STOP-FLU trial

Author

Mombelli, Matteo, Neofytos, Dionysios; https://orcid.org/0000-0001-6970-2869, Huynh-Do, Uyen, Sánchez-Céspedes, Javier, Stampf, Susanne, Golshayan, Dela, Dahdal, Suzan, Stirnimann, Guido, Schnyder, Aurelia, Garzoni, Christian, Venzin, Reto M, Magenta, Lorenzo, Schönenberger, Melanie, Walti, Laura, Hirzel, Cédric, Munting, Aline, Dickenmann, Michael, Koller, Michael, Aubert, John-David, Steiger, Jürg, Pascual, Manuel, Mueller, Thomas F, Schuurmans, Macé, Berger, Christoph, Binet, Isabelle, Villard, Jean, Mueller, Nicolas J, Egli, Adrian; https://orcid.org/0000-0002-3564-8603, Cordero, Elisa, van Delden, Christian, et al, Mombelli, Matteo, Neofytos, Dionysios; https://orcid.org/0000-0001-6970-2869, Huynh-Do, Uyen, Sánchez-Céspedes, Javier, Stampf, Susanne, Golshayan, Dela, Dahdal, Suzan, Stirnimann, Guido, Schnyder, Aurelia, Garzoni, Christian, Venzin, Reto M, Magenta, Lorenzo, Schönenberger, Melanie, Walti, Laura, Hirzel, Cédric, Munting, Aline, Dickenmann, Michael, Koller, Michael, Aubert, John-David, Steiger, Jürg, Pascual, Manuel, Mueller, Thomas F, Schuurmans, Macé, Berger, Christoph, Binet, Isabelle, Villard, Jean, Mueller, Nicolas J, Egli, Adrian; https://orcid.org/0000-0002-3564-8603, Cordero, Elisa, van Delden, Christian, and et al

Abstract

BACKGROUND The immunogenicity of the standard influenza vaccine is reduced in solid-organ transplant (SOT) recipients, so that new vaccination strategies are needed in this population. METHODS Adult SOT recipients from nine transplant clinics in Switzerland and Spain were enrolled if they were >3 months after transplantation. High, with stratification by organ and time from transplant. The primary outcome was vaccine response rate, defined as a ≥4-fold increase of hemagglutination-inhibition titers to at least one vaccine strain at 28 days post-vaccination. Secondary outcomes included PCR-confirmed influenza and vaccine reactogenicity. RESULTS 619 patients were randomized, 616 received the assigned vaccines, and 598 had serum available for analysis of the primary endpoint (standard, n=198; MF59-adjuvanted, n=205; high-dose, n=195 patients). Vaccine response rates were 42% (84/198) in the standard vaccine group, 60% (122/205) in the MF59-adjuvanted vaccine group, and 66% (129/195) in the high-dose vaccine group (difference in intervention vaccines vs. standard vaccine, 0.20 [97.5% CI 0.12-1]; p<0.001; difference in high-dose vs. standard vaccine, 0.24 [95% CI 0.16-1]; p<0.001; difference in MF59-adjuvanted vs. standard vaccine, 0.17 [97.5% CI 0.08-1]; p<0.001). Influenza occurred in 6% the standard, 5% in the MF59-adjuvanted, and 7% in the high-dose vaccine groups. Vaccine-related adverse events occurred more frequently in the intervention vaccine groups, but most of the events were mild. CONCLUSIONS In SOT recipients, use of an MF59-adjuvanted or a high-dose influenza vaccine was safe and resulted in a higher vaccine response rate. TRIAL REGISTRATION Clinicaltrials.gov NCT03699839.

Published
2024

12. Genetic immune and inflammatory markers associated with diabetes in solid organ transplant recipients

Author

Quteineh, Lina, Wójtowicz, Agnieszka, Bochud, Pierre-Yves, Crettol, Severine, Vandenberghe, Frederik, Venetz, Jean-Pierre, Manuel, Oriol, Golshayan, Dela, Lehmann, Roger, Mueller, Nicolas J., Binet, Isabelle, van Delden, Christian, Steiger, Jürg, Mohacsi, Paul, Dufour, Jean-Francois, Soccal, Paola M., Kutalik, Zoltan, Marques-Vidal, Pedro, Vollenweider, Peter, Recher, Mike, Hess, Christoph, Pascual, Manuel, and Eap, Chin B.

Published
2019
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13. Immunogenicity of High-Dose Versus MF59-Adjuvanted Versus Standard Influenza Vaccine in Solid Organ Transplant Recipients: The Swiss/Spanish Trial in Solid Organ Transplantation on Prevention of Influenza (STOP-FLU Trial).

Author

Mombelli, Matteo, Neofytos, Dionysios, Huynh-Do, Uyen, Sánchez-Céspedes, Javier, Stampf, Susanne, Golshayan, Dela, Dahdal, Suzan, Stirnimann, Guido, Schnyder, Aurelia, Garzoni, Christian, Venzin, Reto M, Magenta, Lorenzo, Schönenberger, Melanie, Walti, Laura, Hirzel, Cédric, Munting, Aline, Dickenmann, Michael, Koller, Michael, Aubert, John-David, and Steiger, Jürg

Subjects
INFLUENZA prevention, INFLUENZA vaccines, HEMAGGLUTINATION tests, CONFIDENCE intervals, VACCINE immunogenicity, PATIENTS, VACCINE effectiveness, RANDOMIZED controlled trials, COMPARATIVE studies, DESCRIPTIVE statistics, RESEARCH funding, POLYMERASE chain reaction, STATISTICAL sampling, TRANSPLANTATION of organs, tissues, etc., EVALUATION
Abstract

Background The immunogenicity of the standard influenza vaccine is reduced in solid-organ transplant (SOT) recipients, so new vaccination strategies are needed in this population. Methods Adult SOT recipients from 9 transplant clinics in Switzerland and Spain were enrolled if they were >3 months after transplantation. Patients were randomized (1:1:1) to a MF59-adjuvanted or a high-dose vaccine (intervention), or a standard vaccine (control), with stratification by organ and time from transplant. The primary outcome was vaccine response rate, defined as a ≥4-fold increase of hemagglutination-inhibition titers to at least 1 vaccine strain at 28 days postvaccination. Secondary outcomes included polymerase chain reaction–confirmed influenza and vaccine reactogenicity. Results A total of 619 patients were randomized, 616 received the assigned vaccines, and 598 had serum available for analysis of the primary endpoint (standard, n = 198; MF59-adjuvanted, n = 205; high-dose, n = 195 patients). Vaccine response rates were 42% (84/198) in the standard vaccine group, 60% (122/205) in the MF59-adjuvanted vaccine group, and 66% (129/195) in the high-dose vaccine group (difference in intervention vaccines vs standard vaccine, 0.20; 97.5% confidence interval [CI],.12–1); P <.001; difference in high-dose vs standard vaccine, 0.24 [95% CI,.16–1]; P <.001; difference in MF59-adjuvanted vs standard vaccine, 0.17 [97.5% CI,.08–1]; P <.001). Influenza occurred in 6% of the standard, 5% in the MF59-adjuvanted, and 7% in the high-dose vaccine groups. Vaccine-related adverse events occurred more frequently in the intervention vaccine groups, but most of the events were mild. Conclusions In SOT recipients, use of an MF59-adjuvanted or a high-dose influenza vaccine was safe and resulted in a higher vaccine response rate. Clinical Trials Registration Clinicaltrials.gov NCT03699839. [ABSTRACT FROM AUTHOR]

Published
2024
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15. Donation type and the effect of pre-transplant donor specific antibodies – Data from the Swiss Transplant Cohort Study

Author

de Rougemont, Olivier; https://orcid.org/0000-0001-8295-7911, Deng, Yun; https://orcid.org/0000-0002-8204-9021, Frischknecht, Lukas, Wehmeier, Caroline; https://orcid.org/0000-0002-5353-2313, Villard, Jean, Ferrari-Lacraz, Sylvie, Golshayan, Dela, Gannage, Monique, Binet, Isabelle, Wirthmueller, Urs, Sidler, Daniel; https://orcid.org/0000-0002-2435-5936, Schachtner, Thomas; https://orcid.org/0000-0001-5549-4798, Schaub, Stefan; https://orcid.org/0000-0002-9170-1341, Nilsson, Jakob; https://orcid.org/0000-0001-5091-8133, de Rougemont, Olivier; https://orcid.org/0000-0001-8295-7911, Deng, Yun; https://orcid.org/0000-0002-8204-9021, Frischknecht, Lukas, Wehmeier, Caroline; https://orcid.org/0000-0002-5353-2313, Villard, Jean, Ferrari-Lacraz, Sylvie, Golshayan, Dela, Gannage, Monique, Binet, Isabelle, Wirthmueller, Urs, Sidler, Daniel; https://orcid.org/0000-0002-2435-5936, Schachtner, Thomas; https://orcid.org/0000-0001-5549-4798, Schaub, Stefan; https://orcid.org/0000-0002-9170-1341, and Nilsson, Jakob; https://orcid.org/0000-0001-5091-8133

Abstract

Introduction The 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. Methods We 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. Results There 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 (<6.5k), graft survival was not significantly different. Discussion Our 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

16. Immunogenicity, Efficacy, and Safety of High-Dose Trivalent vs. MF59-Adjuvanted Trivalent vs. Standard-Dose Non-Adjuvanted Quadrivalent Influenza Vaccine in Solid Organ Transplant Recipients: A Randomised Clinical Trial.&nbsp;The STOP-FLU Trial

Author

Mombelli, Matteo, primary, Neofytos, Dionysios, additional, Huynh-Do, Uyen, additional, Sánchez-Céspedes, Javier, additional, Stampf, Susanne, additional, Golshayan, Dela, additional, Dahdal, Suzan, additional, Stirnimann, Guido, additional, Schnyder, Aurelia, additional, Garzoni, Christian, additional, Venzin, Reto M., additional, Magenta, Lorenzo, additional, Schönenberger, Melanie, additional, Walti, Laura N., additional, Hirzel, Cédric, additional, Munting, Aline, additional, Dickenmann, Michael, additional, Koller, Michael, additional, Aubert, John-David, additional, Steiger, Jurg, additional, Pascual, Manuel, additional, Müller, Thomas F., additional, Schuurmans, Macé M., additional, Berger, Christoph, additional, Binet, Isabelle, additional, Villard, Jean, additional, Mueller, Nicolas J., additional, Egli, Adrian, additional, Cordero, Elisa, additional, van Delden, Christian, additional, Manuel, Oriol Josep, additional, and Study, Swiss Transplant Cohort, additional

Published
2023
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21. Impact of different urinary tract infection phenotypes within the first year post-transplant on renal allograft outcomes

Author

Brune, Jakob E; https://orcid.org/0000-0002-8894-6444, Dickenmann, Michael, Wehmeier, Caroline; https://orcid.org/0000-0002-5353-2313, Sidler, Daniel, Walti, Laura; https://orcid.org/0000-0002-7048-6590, Golshayan, Dela, Manuel, Oriol, Hadaya, Karine, Neofytos, Dionysios; https://orcid.org/0000-0001-6970-2869, Schnyder, Aurelia, Boggian, Katia, Müller, Thomas, Schachtner, Thomas; https://orcid.org/0000-0001-5549-4798, Khanna, Nina, Schaub, Stefan; https://orcid.org/0000-0002-9170-1341, Swiss Transplant Cohort Study, Brune, Jakob E; https://orcid.org/0000-0002-8894-6444, Dickenmann, Michael, Wehmeier, Caroline; https://orcid.org/0000-0002-5353-2313, Sidler, Daniel, Walti, Laura; https://orcid.org/0000-0002-7048-6590, Golshayan, Dela, Manuel, Oriol, Hadaya, Karine, Neofytos, Dionysios; https://orcid.org/0000-0001-6970-2869, Schnyder, Aurelia, Boggian, Katia, Müller, Thomas, Schachtner, Thomas; https://orcid.org/0000-0001-5549-4798, Khanna, Nina, Schaub, Stefan; https://orcid.org/0000-0002-9170-1341, and Swiss Transplant Cohort Study

Abstract

In this study, we investigated the clinical impact of different urinary tract infection (UTI) phenotypes occurring within the first year after renal transplantation. The population included 2368 transplantations having 2363 UTI events. Patients were categorized into four groups based on their compiled UTI events observed within the first year after transplantation: (i) no colonization or UTI (n = 1404; 59%), (ii) colonization only (n = 353; 15%), (iii) occasional UTI with 1-2 episodes (n = 456; 19%), and (iv) recurrent UTI with ≥3 episodes (n = 155; 7%). One-year mortality and graft loss rate were not different among the four groups, but patients with recurrent UTI had a 7-10 ml/min lower eGFR at year one (44 ml/min vs. 54, 53, and 51 ml/min; p < .001). UTI phenotypes had no impact on long-term patient survival (p = .33). However, patients with recurrent UTI demonstrated a 10% lower long-term death-censored allograft survival (p < .001). Furthermore, recurrent UTI was a strong and independent risk factor for reduced death-censored allograft survival in a multivariable analysis (HR 4.41, 95% CI 2.53-7.68, p < .001). We conclude that colonization and occasional UTI have no impact on pertinent outcomes, but recurrent UTI are associated with lower one-year eGFR and lower long-term death-censored allograft survival. Better strategies to prevent and treat recurrent UTI are needed.

Published
2022

22. Impact of Hyponatremia after Renal Transplantation on Decline of Renal Function, Graft Loss and Patient Survival: A Prospective Cohort Study

Author

Berchtold, Lena, Filzer, Anja, Achermann, Rita, Devetzis, Vasileios, Dahdal, Suzan, Bonani, Marco, Schnyder, Aurelia, Golshayan, Dela, Amico, Patrizia, Huynh-Do, Uyen, Seigneux, Sophie de, Arampatzis, Spyridon, Collaborators, on behalf of Swiss Transplant Cohort Study, University of Zurich, and Arampatzis, Spyridon

Subjects
Adult, Graft Rejection, Male, medicine.medical_specialty, hyponatremia, Renal function, kidney transplantation, 610 Medicine & health, Kidney, Gastroenterology, Article, Cohort Studies, Swiss Transplant Cohort Study, Internal medicine, Medicine, Humans, TX341-641, 10035 Clinic for Nephrology, Prospective Studies, Prospective cohort study, Kidney transplantation, 1106 Food Science, Nutrition and Dietetics, business.industry, Nutrition. Foods and food supply, nutritional and metabolic diseases, Middle Aged, medicine.disease, Survival Analysis, Transplant Recipients, Transplantation, Log-rank test, medicine.anatomical_structure, Ambulatory, 2916 Nutrition and Dietetics, Female, business, Hyponatremia, Switzerland, Food Science
Abstract

Background: Hyponatremia is one of the most common electrolyte disorders observed in hospitalized and ambulatory patients. Hyponatremia is associated with increased falls, fractures, prolonged hospitalisation and mortality. The clinical importance of hyponatremia in the renal transplant field is not well established, so the aim of this study was to determine the relationships between hyponatremia and mortality as main outcome and renal function decline and graft loss as secondary outcome among a prospective cohort of renal transplant recipients. Methods: This prospective cohort study included 1315 patients between 1 May 2008 and 31 December 2014. Hyponatremia was defined as sodium concentration below 136 mmol/L at 6 months after transplantation. The main endpoint was mortality. A secondary composite endpoint was also defined as: rapid decline in renal function (≥5 mL/min/1.73 m2 drop of the eGFR/year), graft loss or mortality. Results: Mean sodium was 140 +/− 3.08 mmol/L. 97 patients displayed hyponatremia with a mean of 132.9 +/− 3.05 mmol/L. Hyponatremia at 6 months after transplantation was associated neither with mortality (HR: 1.02, p = 0.97, 95% CI: 0.47–2.19), nor with the composite outcome defined as rapid decline in renal function, graft loss or mortality (logrank test p = 0.9). Conclusions: Hyponatremia 6 months after transplantation is not associated with mortality in kidney allograft patients.

Published
2021

26. Impact of Hyponatremia after Renal Transplantation on Decline of Renal Function, Graft Loss and Patient Survival: A Prospective Cohort Study

Author

Berchtold, Lena; https://orcid.org/0000-0001-8815-4263, Filzer, Anja, Achermann, Rita, Devetzis, Vasileios, Dahdal, Suzan, Bonani, Marco, Schnyder, Aurelia, Golshayan, Dela, Amico, Patrizia, Huynh-Do, Uyen; https://orcid.org/0000-0002-7276-032X, de Seigneux, Sophie, Arampatzis, Spyridon; https://orcid.org/0000-0002-6959-0411, Berchtold, Lena; https://orcid.org/0000-0001-8815-4263, Filzer, Anja, Achermann, Rita, Devetzis, Vasileios, Dahdal, Suzan, Bonani, Marco, Schnyder, Aurelia, Golshayan, Dela, Amico, Patrizia, Huynh-Do, Uyen; https://orcid.org/0000-0002-7276-032X, de Seigneux, Sophie, and Arampatzis, Spyridon; https://orcid.org/0000-0002-6959-0411

Abstract

BACKGROUND Hyponatremia is one of the most common electrolyte disorders observed in hospitalized and ambulatory patients. Hyponatremia is associated with increased falls, fractures, prolonged hospitalisation and mortality. The clinical importance of hyponatremia in the renal transplant field is not well established, so the aim of this study was to determine the relationships between hyponatremia and mortality as main outcome and renal function decline and graft loss as secondary outcome among a prospective cohort of renal transplant recipients. METHODS This prospective cohort study included 1315 patients between 1 May 2008 and 31 December 2014. Hyponatremia was defined as sodium concentration below 136 mmol/L at 6 months after transplantation. The main endpoint was mortality. A secondary composite endpoint was also defined as: rapid decline in renal function (≥5 mL/min/1.73 m$^{2}$ drop of the eGFR/year), graft loss or mortality. RESULTS Mean sodium was 140 ± 3.08 mmol/L. 97 patients displayed hyponatremia with a mean of 132.9 ± 3.05 mmol/L. Hyponatremia at 6 months after transplantation was associated neither with mortality (HR: 1.02; p = 0.97, 95% CI: 0.47-2.19), nor with the composite outcome defined as rapid decline in renal function, graft loss or mortality (logrank test p = 0.9). CONCLUSIONS Hyponatremia 6 months after transplantation is not associated with mortality in kidney allograft patients.

Published
2021

27. Infectious complications and graft outcome following treatment of acute antibody-mediated rejection after kidney transplantation: A nationwide cohort study

Author

Perrottet, Nancy, Fernández-Ruiz, Mario, Binet, Isabelle, Dickenmann, Michael, Dahdal, Suzan, Hadaya, Karine, Muller, Thomas, Schaub, Stefan, Koller, Michael, Rotman, Samuel, Moll, Solange, Hopfer, Helmut, Venetz, Jean-Pierre, Aubert, Vincent, Buehler, Leo Hans, Steiger, Jurg, Manuel, Oriol, Pascual, Manuel, Golshayan, Dela, Swiss Transplant Cohort Study (STCS), Chalandon, Yves, Ferrari-Lacraz, Sylvie, Gasche-Soccal, Paola Marina Alessandra, Gaudet-Blavignac, Christophe, Lovis, Christian, Martin, Pierre-Yves, Toso, Christian, Van Delden, Christian, Villard, Jean, and and the Swiss Transplant Cohort Study (STCS)

Subjects
Graft Rejection, Male, Cytomegalovirus Infection, Bacterial Diseases, Viral Diseases, Opportunistic infection, Epidemiology, medicine.medical_treatment, Cancer Treatment, ddc:616.07, Medical Conditions, Medicine and Health Sciences, Renal Transplantation, Public and Occupational Health, Kidney transplantation, Routes of Administration, ddc:616, Multidisciplinary, ddc:617, Hazard ratio, Graft Survival, Immunoglobulins, Intravenous, Plasmapheresis, Middle Aged, Vaccination and Immunization, Transplant rejection, Infectious Diseases, Oncology, Cohort, Medicine, Rituximab, Female, Immunosuppressive Agents, Switzerland, Cohort study, medicine.drug, Research Article, medicine.medical_specialty, Science, Immunology, Surgical and Invasive Medical Procedures, Opportunistic Infections, Infections, Urinary System Procedures, Antibody Therapy, Antiviral Therapy, Internal medicine, Intravenous Injections, medicine, Humans, Immunologic Factors, Antilymphocyte Serum, Retrospective Studies, Pharmacology, Transplantation, business.industry, Biology and Life Sciences, Organ Transplantation, medicine.disease, Kidney Transplantation, Medical Risk Factors, Clinical Immunology, Preventive Medicine, Clinical Medicine, business
Abstract

Acute antibody-mediated rejection (AMR) remains a challenge after kidney transplantation (KT). As there is no clear-cut treatment recommendation, accurate information on current therapeutic strategies in real-life practice is needed. KT recipients from the multicenter Swiss Transplant Cohort Study treated for acute AMR during the first post-transplant year were included retrospectively. We aimed at describing the anti-rejection protocols used routinely, as well as patient and graft outcomes, with focus on infectious complications. Overall, 65/1669 (3.9%) KT recipients were treated for 75 episodes of acute AMR. In addition to corticosteroid boluses, most common therapies included plasmapheresis (56.0%), intravenous immunoglobulins (IVIg) (38.7%), rituximab (25.3%), and antithymocyte globulin (22.7%). At least one infectious complication occurred within 6 months from AMR treatment in 63.6% of patients. Plasmapheresis increased the risk of overall (hazard ratio [HR]: 2.89; P-value = 0.002) and opportunistic infection (HR: 5.32; P-value = 0.033). IVIg exerted a protective effect for bacterial infection (HR: 0.29; P-value = 0.053). The recovery of renal function was complete at 3 months after AMR treatment in 67% of episodes. One-year death-censored graft survival was 90.9%. Four patients (6.2%) died during the first year (two due to severe infection). In this nationwide cohort we found significant heterogeneity in therapeutic approaches for acute AMR. Infectious complications were common, particularly among KT recipients receiving plasmapheresis.

Published
2021

28. Myeloid-derived suppressor cells are implicated in regulating permissiveness for tumor metastasis during mouse gestation

Author

Mauti, Laetitia A., Bitoux, Marie-Aude Le, Baumer, Karine, Stehle, Jean-Christophe, Golshayan, Dela, Provero, Paolo, and Stamenkovic, Ivan

Subjects
Pregnancy -- Physiological aspects -- Research -- Genetic aspects, Gene expression -- Research, Metastasis -- Research -- Genetic aspects, Killer cells -- Physiological aspects -- Research, Health care industry
Abstract

Metastasis depends on the ability of tumor cells to establish a relationship with the newly seeded tissue that is conducive to their survival and proliferation. However, the factors that render [...]

Published
2011
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31. 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

32. Indoleamine 2,3-dioxygenase gene transfer prolongs cardiac allograft survival

Author

Li, Jianping, Meinhardt, Andrea, Roehrich, Marc-Estienne, Golshayan, Dela, Dudler, Jean, Pagnotta, Maria, Trucco, Massimo, and Vassalli, Giuseppe

Subjects
Enzymes -- Health aspects, Enzymes -- Research, Genetic transformation -- Health aspects, Genetic transformation -- Research, Heart -- Transplantation, Heart -- Health aspects, Heart -- Research, Biological sciences
Abstract

Cells that express indoleamine 2,3-dioxygenase (IDO), the rate-limiting enzyme in the catabolism of tryptophan, suppress T cell responses and promote immunological tolerance. However, their role in solid organ transplantation is incompletely understood. We analyzed T cell responses to allogeneic dendritic cells (DCs) genetically modified to express the gene encoding IDO in vitro and IDO gene transfer into the donor heart in a cardiac transplant model in vivo. Bone marrow-derived DCs transduced with the gene encoding IDO produced active IDO protein. This was associated with decreased stimulation of allogeneic T cell proliferation in the mixed leukocyte reaction in vitro. In a cardiac transplant model, adenovirus-mediated IDO gene transfer into the donor heart resulted in transgene expression predominantly in cardiomyocytes. Fischer-344 rat donor hearts transduced with the gene encoding IDO survived for longer periods of time when placed in Lewis rat recipients compared with control vector or vehicle alone [median survival times of 17 (range: 12-22) days vs. 10 (range: 8-14) and 9 (range: 8-13) days, respectively, P < 0.0001]. IDO gene transfer combined with low-dose cyclosporin A (CsA) was more effective than CsA alone (P < 0.05). Numbers of monocytes/ macrophages, [CD4.sup.+] cells, and CD8[[alpha].sup.+] cells infiltrating the graft as well as intragraft cytokine transcript levels for IFN-[gamma], IL-1, TNF-[alpha], regulated upon secretion, normal T cell expressed, and secreted/ chemokine (C-C motif) ligand 5 were decreased after IDO gene transfer (P < 0.05). In conclusion, DCs genetically engineered to overexpress IDO modulate T cell alloresponses in vitro. IDO gene transfer into the donor heart attenuates acute cardiac allograft rejection. Regulation of tryptophan catabolism by means of IDO overexpression may be a useful approach in heart transplantation. dendritic cells; transforming growth factor-[beta]; regulated on activation, normal T-cell expressed and secreted/C-C chemokine ligand 5

Published
2007

36. Upfront use of eculizumab to treat early acute antibody‐mediated rejection after kidney allotransplantation and relevance for xenotransplantation

Author

Schwotzer, Nora, primary, Paganetti, Giulia, additional, Barchi, Matteo, additional, Perrottet, Nancy, additional, Aubert, Vincent, additional, Sadallah, Salima, additional, Rotman, Samuel, additional, Venetz, Jean‐Pierre, additional, Matter, Maurice, additional, Golshayan, Dela, additional, and Pascual, Manuel, additional

Published
2020
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37. Dialysis after graft loss: a Swiss experience

Author

Bonani, Marco, primary, Achermann, Rita, additional, Seeger, Harald, additional, Scharfe, Michael, additional, Müller, Thomas, additional, Schaub, Stefan, additional, Binet, Isabelle, additional, Huynh-Do, Uyen, additional, Dahdal, Suzan, additional, Golshayan, Dela, additional, Hadaya, Karine, additional, Wüthrich, Rudolf P, additional, Fehr, Thomas, additional, and Segerer, Stephan, additional

Published
2020
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38. Immunosuppressive effects of streptozotocin-induced diabetes result in absolute lymphopenia and a relative increase of T regulatory cells

Author

Muller, Yannick D., Golshayan, Dela, Ehirchiou, Driss, Wyss, Jean Christophe, Giovannoni, Laurianne, Meier, Raphael, Serre-Beinier, Veronique, Yung, Gisella Puga, Morel, Philippe, Buhler, Leo H., and Seebach, Jorg D.

Subjects
Streptozocin -- Health aspects -- Research, T cells -- Physiological aspects -- Research, Diabetes -- Research -- Analysis -- Complications and side effects -- Drug therapy, Lymphocytopenia -- Research -- Analysis -- Risk factors, Health
Abstract

OBJECTIVE--Streptozotocin (STZ) is the most widely used diabetogenic agent in animal models of islet transplantation. However, the immunomodifying effects of STZ and the ensuing hyperglycemia on lymphocyte subsets, particularly on T regulatory cells (Tregs), remain poorly understood. RESEARCH DESIGN AND METHODS--This study evaluated how STZ-induced diabetes affects adaptive immunity and the consequences thereof on allograft rejection in murine models of islet and skin transplantation. The respective toxicity of STZ and hyperglycemia on lymphocyte subsets was tested in vitro. The effect of hyperglycemia was assessed independently of STZ in vivo by the removal of transplanted syngeneic islets, using an insulin pump, and with rat insulin promoter diphtheria toxin receptor transgenic mice. RESULTS--Early lymphopenia in both blood and spleen was demonstrated after STZ administration. Direct toxicity of STZ on lymphocytes, particularly on [CD8.sup.+] cells and B cells, was shown in vitro. Hyperglycemia also correlated with blood and spleen lymphopenia in vivo but was not lymphotoxic in vitro. Independently of hyperglycemia, STZ led to a relative increase of Tregs in vivo, with the latter retaining their suppressive capacity in vitro. The higher frequency of Tregs was associated with Treg proliferation in the blood, but not in the spleen, and higher blood levels of transforming growth factor-β. Finally, STZ administration delayed islet and skin allograft rejection compared with naive mice. CONCLUSIONS--These data highlight the direct and indirect immunosuppressive effects of STZ and acute hyperglycemia, respectively. Thus, these results have important implications for the future development of tolerance-based protocols and their translation from the laboratory to the clinic. Diabetes 60:2331-2340, 2011, Many animal models of diabetes depend on the administration of diabetogenic drugs such as streptozotocin (STZ) or alloxan. These are toxic glucose analogs that target pancreatic β-cells via GLUT2 transporter [...]

Published
2011
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50. Diagnosis and management of asymptomatic bacteriuria in kidney transplant recipients

Author

Coussement, Julien, Maggiore, Umberto, Manuel, Oriol, Scemla, Anne, López-Medrano, Francisco, Nagler, Evi, Aguado, José María, Abramowicz, Daniel, Adams, Brigitte, Agnelli, Caroline, Ailioaie, Oana, Akan, Hamdi, Amrouche, Lucile, Andrés, Amado, Anglicheau, Dany, Arnouts, Paul, Baas, Marije, Balgradean, Cristian, Bammens, Bert, Battaglia, Yuri, Baudoux, Thomas, Berto, Bert, Binet, Isabelle, Bistrup, Claus, Bonofiglio, Renzo, Bosmans, Jean-Louis, Bouatou, Yassine, Bouvier, Nicolas, Braconnier, Philippe, Bredewold, Edwin, Broeders, Nilufer, BRUNET, Philippe, Buchler, Matthias, Budde, Klemens, Buron, Fanny, Burtey, Stephane, Buscaroli, Andrea, Büttner, Stefan, Byrne, Catherine, Caldara, Rossana, Cassuto, Elisabeth, Catalano, Concetta, Cavaille, Guilhem, Corbel, Alice, Couzi, Lionel, Crespo, Marta, Daga, Sunil, Debellé, Frederic, Dedinska, Ivana, Devine, Paul, Dickenmann, Michael, Dratwa, Max, Drgona, Lubos, Durlik, Magdalena, Egidi, Maria Francesca, Errasti, Pedro, Etienne, Isabelle, Fariñas, María Carmen, Fehr, Thomas, Fernández-Ruiz, Mario, Founta, Paraskevi, Fourtounas, Konstantinos, Frangou, Eleni, Frimat, Luc, Furian, Luc, Garjau, Maria, Garrigue, Valérie, Gatault, Philippe, Geddes, Colin, Gerlinger, Paul, Gheuens, Eric, Ghisdal, Lidia, Gibbs, Paul, Giral, Magali, Girerd, Sophie, Golshayan, Dela, Gompou, Athina, Grossi, Paolo Antonio, Guglielmetti, Gabriele, Guirado, Luis, Hadaya, Karine, Hazzan, Marc, Helbert, Mark, Hellemans, Rachel, Heller, Katharina, Heemann, Uwe, Henckes, Manu, Hernandez, Domingo, Hertig, Alexandre, Hiesse, Christian, Hilbrands, Luuk, Hilton, Rachel, Hirzel, Cédric, Horcajada, Juan Pablo, Hougardy, Jean-Michel, Huynh-Do, Uyen, Idrizi, Alma, Ismaili, Khalid, Jiménez, Carlos, Jourde-Chiche, Noemie, Kamar, Nassim, Kaminski, Hannah, Kanter, Julia, Karras, Alexandre, Kemlin, Delphine, Kes, Petar, Kianda, Mireille, Klinger, Maria, Knight, Simon, Koneth, Irene, Krrashi, Anita, Kuypers, Dirk, Langlois, Anne, Lang, Philippe, Lauzurica, Ricardo, Le Moine, Alain, Lebeaux, David, Legendre, Christophe, Lemy, Anne, Len, Oscar, Liakopoulos, Vassilios, Lichodziejewska-Niemierko, Monika, Yague, Maria, Lopau, Kai, Madhoun, Philippe, Magott-Procelewska, Maria, Malik, Shafi, Montero, Anna Manonelles, Marchini, Marc, Marega, Alessandra, Mariat, Maria, Mark, Mark, Martin, Pierre-Yves, Martín, Leyre, Martín, Paloma Leticia, Massart, Annick, Matignon, Marie, Maurel, Stéphane, Mazuecos, Auxiliadora, Melexopoulou, Christina, Melilli, Edoardo, Merino, Esperanza, Mesic, Enisa, Messa, Piergiorgio, Michalak, Magdalena, Minetti, Enrico, Miserlis, Grigorios, Montejo, Miguel, Moriconi, Diego, Mottola, Clément, Mourad, Georges, Mueller, Thomas, Muñoz, Patricia, Nabokow, Alexander, Naesens, Maarten, Nikodimopoulou, Maria, Oberbauer, Rainer, Olmedo, María, Olsburgh, Jonathon, Oniscu, Gabriel, Øzbay, Lara Aygen, Palmisano, Alessandra, Papagianni, Aikaterini, Papasotiriou, Mario, Parodi, Angelica, Parry, Rob, Pascual, Julio, Flores, Isabel Pérez, Pérez-Sáez, María, Peruzzi, Licia, Petit-Hoang, Camille, Phelan, Paul, Pillebout, Evangeline, Piotti, Giovanni, Pipeleers, Lissa, Pleros, Christos, Popoola, Joyce, Pretagostini, Renzo, Psimenou, Erasmia, Puig, Josep, Rafat, Cédric, Bloudickova, Silvie Rajnochova, Bushljetikj, Irena Rambabova, Ratkovic, Marina, Redondo, Dolores, Reischig, Tomas, Robert, Thomas, Ferrero, Luis, Rroji, Merita, Rutkowski, Przemyslaw, Rydzewska-Rosolowska, Alicja, Sabé, Núria, Sahali, Dil, Salzberger, Bernd, San-Juan, Rafael, Sobrino, Beatriz Sánchez, Sandrini, Silvio, Santos, Lídia, Sava, Roxana, Schaub, Stefan, Schikowski, Johan, Schvartz, Betoul, Sester, Urban, Silva, Jose Tiago, Snanoudj, Renaud, Somenzi, Danio, Sørensen, Søren, Spanos, Georgios, Steiger, Jürg, Suwelack, Barbara, Theodoropoulou, Eleni, Thervet, Eric, Thorban, Stefan, Tognarelli, Giuliana, Tournay, Yasmina, Tricot, Leïla, Tulissi, Patrizia, Vacher-Coponat, Henri, Valerio, Maricela, Van Der Meijden, W, Van Hamersvelt, Henk, Van Laecke, Steven, Vandivinit, Alain, Vanholder, Raymond, Veroux, Massimiliano, Viklicky, Ondrej, Vigo, Emanuela, Viscoli, Claudio, Watschinger, W, Weekers, W, Welberry Smith, W, Martin, W, Zeneli, Nereida, Zervos, Angelos, Zibar, Lada, Zuber, Julien, Zukunft, Bianca, Nephrology, Department Infections Diseases, Université Libre de Bruxelles [Bruxelles] (ULB), Azienda Ospedaliero-Universitaria di Parma, Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), Réseau CENTAURE, Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Service Néphrologie et transplantation rénale Adultes [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Bases moléculaires de la réponse aux xénobiotiques (U775 (IFR95)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut d’Électronique, de Microélectronique et de Nanotechnologie (IEMN) - UMR 8520 (IEMN), Centre National de la Recherche Scientifique (CNRS)-Université de Lille-Université Polytechnique Hauts-de-France (UPHF)-Ecole Centrale de Lille-Université Polytechnique Hauts-de-France (UPHF)-Institut supérieur de l'électronique et du numérique (ISEN), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Department of Nephrology, Humboldt Universität zu Berlin, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Chirurgie urologique et transplantation rénale [Hôpital de la Conception - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Centre recherche en CardioVasculaire et Nutrition (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de néphrologie, Hôpital Pasteur [Nice] (CHU), Hôpital de Brabois, CHU de Nancy, Vandoeuvre-lès-Nancy, Service de Néphrologie-transplantation-dialyse [Bordeaux], CHU Bordeaux [Bordeaux], Laboratoire des interactions plantes micro-organismes (LIPM), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Recherche Agronomique (INRA), CHU Rouen, Normandie Université (NU), Unit Infectious Diseases, Hospital 12 de Octubre, Service de Néphrologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Pédiatrie spécialisée, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Centre de Recherche en Transplantation et Immunologie (U1064 Inserm - CRTI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Université de Lille, Department of Pulmonary Medicine, Tampere University Hospital, Urgences néphrologiques et transplantation rénale [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Tenon [APHP], Service de néphrologie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Swiss Transplantation Cohort Study, University of Basel (Unibas), Department of Nephrology and Hypertension, and Department of Clinical Research, University of Bern, Centro de Investigación en Ciencias del Mar y Limnología (CIMAR), Universidad Nacional de Costa Rica, Service de Néphrologie - Hypertension Artérielle Dialyse - Transplantation, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Université de Bordeaux (UB), Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Department of Medicine, Division of Hematology-Oncology, University of Pennsylvania [Philadelphia], Department of Nephrology and Renal Transplantation, University Hospitals Leuven [Leuven]-Catholic University Leuven, Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes (UGA), Imagine - Institut des maladies génétiques (IMAGINE - U1163), Service de néphrologie adultes [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP], Centre de Recherches Pétrographiques et Géochimiques (CRPG), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Division of Nephrology, Maggiore Hospital, IRCCS Foundation, Milano, Université de Lorraine (UL), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Clinical Microbiology and Infectious Diseases Department, Universidad Complutense de Madrid [Madrid] (UCM), University Hospitals Leuven [Leuven], Department of Internal Medicine III, Medizinische Universität Wien = Medical University of Vienna, Service de rhumatologie, Kidney and Pancreas Transplantation, Department d'enginyeria quimica agraria i tecnologia agroalimentaria, Universitat de Girona (UdG), Néphrologie Transplantation, Hôpital Henri Mondor, Assistance Publique - Hôpitaux de Paris (AP-HP), Section of Microbiology [Copenhagen], Department of Biology [Copenhagen], Faculty of Science [Copenhagen], University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU)-Faculty of Science [Copenhagen], University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU), University Hospital Basel [Basel], Service Néphrologie Transplantation Rénale, Hôpital Foch [Suresnes], Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION )-Assistance Publique - Hôpitaux de Marseille (APHM), Renal Division, Freiburg University Medical Center, Nephrology Section [Ghent], Ghent University Hospital, Dept. of Nephrology, Institute for Clinical and Experimental Medicine, Division of Infectious Diseases, University of Genoa (UNIGE)-San Martino University Hospital, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université libre de Bruxelles (ULB), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut d’Électronique, de Microélectronique et de Nanotechnologie - UMR 8520 (IEMN), Centrale Lille-Institut supérieur de l'électronique et du numérique (ISEN)-Université de Valenciennes et du Hainaut-Cambrésis (UVHC)-Université de Lille-Centre National de la Recherche Scientifique (CNRS)-Université Polytechnique Hauts-de-France (UPHF), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Humboldt University Of Berlin, Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Université de Mons (UMons), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), University of Pennsylvania, Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Universidad Complutense de Madrid = Complutense University of Madrid [Madrid] (UCM), University of Copenhagen = Københavns Universitet (UCPH)-University of Copenhagen = Københavns Universitet (UCPH)-Faculty of Science [Copenhagen], University of Copenhagen = Københavns Universitet (UCPH)-University of Copenhagen = Københavns Universitet (UCPH), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Universitäts Klinikum Freiburg = University Medical Center Freiburg (Uniklinik), Università degli studi di Genova = University of Genoa (UniGe)-San Martino University Hospital, ERA-EDTA, ESCMID, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Humboldt-Universität zu Berlin, Institut National de la Recherche Agronomique (INRA)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut national des sciences de l'Univers (INSU - CNRS)-Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière], Service d'Urgences néphrologiques et transplantation rénale [CHU Tenon], Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), and San Martino University Hospital-University of Genoa (UNIGE)

Subjects
Nephrology, Male, Cross-sectional study, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, Practice Patterns, 030230 surgery, Antimicrobial stewardship, urologic and male genital diseases, 0302 clinical medicine, Surveys and Questionnaires, Bacteriuria/diagnosis, Medicine, Practice Patterns, Physicians'/statistics & numerical data, Practice Patterns, Physicians', Asymptomatic Infections, Kidney transplantation, ComputingMilieux_MISCELLANEOUS, Asymptomatic bacteriuria, Questionnaire, Transplantation, Urinary tract infection, Adult, Anti-Bacterial Agents, Bacteriuria, Cross-Sectional Studies, Europe, Female, Humans, Kidney Transplantation, Transplant Recipients, Response rate (survey), Kidney Transplantation/adverse effects, 16. Peace & justice, 3. Good health, medicine.medical_specialty, Asymptomatic Infections/epidemiology, Europe/epidemiology, 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, Internal medicine, Dialysis, Physicians', business.industry, medicine.disease, Anti-Bacterial Agents/therapeutic use, Human medicine, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business
Abstract

Background Asymptomatic bacteriuria is frequent in kidney transplant recipients (KTRs). However, there is no consensus on diagnosis or management. We conducted a European survey to explore current practice related to the diagnosis and management of asymptomatic bacteriuria in adult KTRs. Methods A panel of experts from the European Renal Association-European Dialysis Transplant Association/Developing Education Science and Care for Renal Transplantation in European States working group and the European Study Group for Infections in Compromised Hosts of the European Society of Clinical Microbiology and Infectious Diseases designed this cross-sectional, questionnaire-based, self-administered survey. Invitations to participate were e-mailed to European physicians involved in the care of KTRs. Results Two hundred and forty-four participants from 138 institutions in 25 countries answered the survey (response rate 30%). Most participants [72% (176/244)] said they always screen for asymptomatic bacteriuria in KTRs. Six per cent (15/240) reported never treating asymptomatic bacteriuria with antibiotics. When antimicrobial treatment was used, 24% of the participants (53/224) said they would start with empirical antibiotics. For an episode of asymptomatic bacteriuria caused by a fully susceptible microorganism and despite no contraindications, a majority of participants (121/223) said they would use a fluoroquinolone (n = 56), amoxicillin/clavulanic acid (n = 38) or oral cephalosporins (n = 27). Conclusions Screening for and treating asymptomatic bacteriuria are common in KTRs despite uncertainties around the benefits and harms. In an era of antimicrobial resistance, further studies are needed to address the diagnosis and management of asymptomatic bacteriuria in these patients.

Published
2018

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