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3 results on '"Luigino, B"'

1. Incidence and clinical predictors of primary opportunistic deep cutaneous mycoses in solid organ transplant recipients: A multicenter cohort study

Author

Gianpaolo, T, Luigi, N, Stefano, P, Luigino, B, Francesco, N, Alberto, F, Carlo, R, Giuseppe, F, Elena Dall'Olio, Anna Belloni, F, Mauro, A, Fabrizia, S, Eliana, G, Roberto, F, Fagiuoli, S, Giampiero Girolomoni, Gianpaolo Tessari, Luigi Naldi, Stefano Piaserico, Luigino Boschiero, Francesco Nacchi, Alberto Forni, Carlo Rugiu, Giuseppe Faggian, Anna Belloni Fortina, Mauro Alaibac, Fabrizia Sassi, Eliana Gotti, Roberto Fiocchi, Fagiuoli S, Gianpaolo, T, Luigi, N, Stefano, P, Luigino, B, Francesco, N, Alberto, F, Carlo, R, Giuseppe, F, Elena Dall'Olio, Anna Belloni, F, Mauro, A, Fabrizia, S, Eliana, G, Roberto, F, Fagiuoli, S, Giampiero Girolomoni, Gianpaolo Tessari, Luigi Naldi, Stefano Piaserico, Luigino Boschiero, Francesco Nacchi, Alberto Forni, Carlo Rugiu, Giuseppe Faggian, Anna Belloni Fortina, Mauro Alaibac, Fabrizia Sassi, Eliana Gotti, Roberto Fiocchi, and Fagiuoli S

Abstract

Primary opportunistic deep cutaneous fungal infections may cause significant morbidity and mortality in solid organ transplant recipients (OTR), but no data exist about their incidence, timing, and clinical predictors in a long-term follow-up. Patients and methods: A series of 3293 consecutive OTR including 1991 kidney, 929 heart, and 373 liver transplant recipients were enrolled. Patients were regularly followed up since time at transplantation (mean 5.5 yr ±5.9 SD) and primary opportunistic fungal infections registered. Persons-year at risk (PYs), incidence rates (IR), incidence rate ratios (IRR), and 95% confidence intervals were computed. Results: Twenty-two cases of deep cutaneous mycoses were detected, (IR 1.2 cases per 1000 PYs) after a mean follow-up time since transplantation of 2.5 yr ± 2.0 SD (median 1.8 yr). Six patients had subsequent systemic involvement and three patients died of systemic dissemination. A higher risk for mycoses was observed in the first two yr after transplantation, (IRR 35.9, p < 0.0001), in renal transplant recipients (IRR 5.1 p = 0.030), and in patients transplanted after the age of 50 (IRR 11.5 p = 0.020). Conclusions: Primary deep cutaneous opportunistic mycoses in OTR occur mainly in the first two yr after transplantation, in renal transplant recipients, and in older patients.

Published
2010

2. Incidence and clinical predictors of primary opportunistic deep cutaneous mycoses in solid organ transplant recipients: a multicenter cohort study

Author

Gianpaolo, Tessari, Luigi, Naldi, Stefano, Piaserico, Luigino, Boschiero, Francesco, Nacchia, Alberto, Forni, Carlo, Rugiu, Giuseppe, Faggian, Elena, Dall'olio, Anna Belloni, Fortina, Mauro, Alaibac, Fabrizia, Sassi, Eliana, Gotti, Roberto, Fiocchi, Stefano, Fagioli, Giampiero, Girolomoni, Gianpaolo, T, Luigi, N, Stefano, P, Luigino, B, Francesco, N, Alberto, F, Carlo, R, Giuseppe, F, Elena Dall'Olio, Anna Belloni, F, Mauro, A, Fabrizia, S, Eliana, G, Roberto, F, Fagiuoli, S, and Giampiero Girolomoni

Subjects
Adult, Male, immunosuppression, Middle Aged, Opportunistic Infections, Prognosis, Deep cutaneous mycose, Kidney Transplantation, Liver Transplantation, Cohort Studies, incidence, Dermatomycoses, Heart Transplantation, Humans, risk factors, Female, Risk factor, Deep cutaneous mycoses, transplantation, Follow-Up Studies, Retrospective Studies
Abstract

Primary opportunistic deep cutaneous fungal infections may cause significant morbidity and mortality in solid organ transplant recipients (OTR), but no data exist about their incidence, timing, and clinical predictors in a long-term follow-up. Patients and methods: A series of 3293 consecutive OTR including 1991 kidney, 929 heart, and 373 liver transplant recipients were enrolled. Patients were regularly followed up since time at transplantation (mean 5.5 yr ±5.9 SD) and primary opportunistic fungal infections registered. Persons-year at risk (PYs), incidence rates (IR), incidence rate ratios (IRR), and 95% confidence intervals were computed. Results: Twenty-two cases of deep cutaneous mycoses were detected, (IR 1.2 cases per 1000 PYs) after a mean follow-up time since transplantation of 2.5 yr ± 2.0 SD (median 1.8 yr). Six patients had subsequent systemic involvement and three patients died of systemic dissemination. A higher risk for mycoses was observed in the first two yr after transplantation, (IRR 35.9, p < 0.0001), in renal transplant recipients (IRR 5.1 p = 0.030), and in patients transplanted after the age of 50 (IRR 11.5 p = 0.020). Conclusions: Primary deep cutaneous opportunistic mycoses in OTR occur mainly in the first two yr after transplantation, in renal transplant recipients, and in older patients.

Published
2010

3. Optimizing utilization of kidneys from deceased donors over 60 years: five-year outcomes after implementation of a combined clinical and histological allocation algorithm.

Author

Pierobon ES, Sandrini S, De Fazio N, Rossini G, Fontana I, Boschiero L, Gropuzzo M, Gotti E, Donati D, Minetti E, Gandolfo MT, Brunello A, Libetta C, Secchi A, Chiaramonte S, and Rigotti P

Subjects
Aged, Aged, 80 and over, Algorithms, Biopsy, Cadaver, Delayed Graft Function, Female, Humans, Italy, Male, Middle Aged, Retrospective Studies, Risk Factors, Tissue Donors, Treatment Outcome, Graft Survival, Kidney pathology, Kidney Failure, Chronic surgery, Kidney Transplantation mortality
Abstract

This 5 year observational multicentre study conducted in the Nord Italian Transplant programme area evaluated outcomes in patients receiving kidneys from donors over 60 years allocated according to a combined clinical and histological algorithm. Low-risk donors 60-69 years without risk factors were allocated to single kidney transplant (LR-SKT) based on clinical criteria. Biopsy was performed in donors over 70 years or 60-69 years with risk factors, allocated to Single (HR-SKT) or Dual kidney transplant (HR-DKT) according to the severity of histological damage. Forty HR-DKTs, 41 HR-SKTs and 234 LR-SKTs were evaluated. Baseline differences generally reflected stratification and allocation criteria. Patient and graft (death censored) survival were 90% and 92% for HR-DKT, 85% and 89% for HR-SKT, 88% and 87% for LR-SKT. The algorithm appeared user-friendly in daily practice and was safe and efficient, as demonstrated by satisfactory outcomes in all groups at 5 years. Clinical criteria performed well in low-risk donors. The excellent outcomes observed in DKTs call for fine-tuning of cut-off scores for allocation to DKT or SKT in high-risk patients., (© 2013 Steunstichting ESOT. Published by John Wiley & Sons Ltd.)

Published
2013
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