Infections in Renal Transplant Recipients Receiving Mycophenolate Versus Azathioprine-Based Immunosuppression

Bernabéu-Wittel, Máximo; Naranjo, Macarena; Cisneros, José Miguel; Cañas, Elías; Gentil, M.A.; Algarra, G.; Pereira, P.; González-Roncero, F J; Alarcón, Arı́stides de; Pachón, Jerónimo

doi:10.1007/s10096-001-0684-y

Cited by 50 publications

(34 citation statements)

References 21 publications

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“…Other immunosuppressive agents, such as mycophenolate mofetil (MMF), have not been associated with higher overall infection risk, though there was an association of MMF with a higher incidence of CMV infections (16). Our study also did not demonstrate any association between the use of MMF and rate of hospitalizations attributable to infections.…”

Section: Discussionsupporting

confidence: 48%

Post-Transplant Infections Now Exceed Acute Rejection as Cause for Hospitalization: A Report of the NAPRTCS

Dharnidharka

Stablein

Harmon

2004

American Journal of Transplantation

224

133

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Section: Discussionsupporting

confidence: 48%

Post-Transplant Infections Now Exceed Acute Rejection as Cause for Hospitalization: A Report of the NAPRTCS

Dharnidharka

Stablein

Harmon

2004

American Journal of Transplantation

224

133

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“…Such factors as the use of steroids (now often absent in HBV-and HCV-infected recipients), the use of induction T cell-depleting antibodies (monoclonal or polyclonal, which tend to activate herpesviruses and HIV), alemtuzumab, or costimulatory blockade will alter susceptibility to viral infection. Specific immunosuppressive agents have been suggested as increasing risk for specific viral infections, including tacrolimus in BK nephropathy (63)(64)(65), anti-thymocyte globulin in CMV (66), mycophenolate mofetil (MMF) in late CMV (67). The interpretation of these data is complex and a direct association in individual patients is often difficult to assess.…”

Section: Time Course Of Viral Infections After Transplantationmentioning

confidence: 99%

Viral Infection in the Renal Transplant Recipient

Kotton

Fishman²

2005

Journal of the American Society of Nephrology

191

181

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Viruses are among the most common causes of opportunistic infection after transplantation and the most important. The risk for viral infection is a function of the specific virus encountered, the intensity of immune suppression used to prevent graft rejection, and other host factors governing susceptibility. Viral infection, both symptomatic and asymptomatic, causes the "direct effects" of invasive disease and "indirect effects," including immune suppression predisposing to other opportunistic infections and oncogenesis. Rapid and sensitive microbiologic assays for many of the common viruses after transplantation have replaced, for the most part, serologic testing and in vitro cultures for the diagnosis of infection. Furthermore, quantitative molecular tests allow the individualization of antiviral therapies for prevention and treatment of infection. This advance is most prominent in the management of cytomegalovirus, Epstein-Barr, hepatitis B, and hepatitis C viruses. Diagnostic advances have not been accompanied by the development of specific and nontoxic anti-viral agents or effective antiviral vaccines. Vaccines, where available, should be given to patients as early as possible and well in advance of transplantation to optimize the immune response. Studies of viral latency, reactivation, and the cellular effects of viral infection will provide clues for future strategies in prevention and treatment of viral infections.

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“…Another prospective study by Bernabeu-Wittel [13], made in Spain with renal transplant recipients, compared two groups that received cyclosporine and prednisone, combined with either 2g MMF/d (n=76) or azathioprine and antilymphocyte globulin (7-14 days, n=82), analyzed infectious complications during the first six months post-transplantation. Patients at high-risk for CMV infection (D+/R-and use of OKT3) received a course of anti-CMV immunoglobulin.…”

Section: Risk Of Cytomegalovirus Infection In Transplant Recipientsmentioning

confidence: 99%

Does mycophenolate mofetil increase the risk of cytomegalovirus infection in solid organ transplant recipients?: A mini-review

Song¹,

Abdala

Bonazzi

et al. 2006

Braz J Infect Dis

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Mycophenolate mofetil (MMF) is currently used for prophylaxis of acute rejection in solid organ transplantation. There have been diverging reports regarding an association between MMF and the risk of cytomegalovirus (CMV) infection. We reviewed the main published studies in an attempt to clarify the association between the use of MMF and the risk, frequency and severity of CMV infections. In a search of the Medline database with the terms "mycophenolate" and "cytomegalovir*", 42 articles were found to be relevant; among these, 29 articles were thoroughly analyzed. The first studies on MMF in renal transplantation already showed a tendency towards an association between this drug and the occurrence of CMV disease. Further studies were designed specifically to study this association; with the conclusion that an immunosuppressive regimen containing MMF increases the likelihood of CMV disease. Most studies were performed with kidney transplant recipients. We conclude that the use of MMF apparently increases the incidence of CMV disease in renal transplant patients; however, further studies are needed to confirm this association.

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Infections in Renal Transplant Recipients Receiving Mycophenolate Versus Azathioprine-Based Immunosuppression

Cited by 50 publications

References 21 publications

Post-Transplant Infections Now Exceed Acute Rejection as Cause for Hospitalization: A Report of the NAPRTCS

Post-Transplant Infections Now Exceed Acute Rejection as Cause for Hospitalization: A Report of the NAPRTCS

Viral Infection in the Renal Transplant Recipient

Does mycophenolate mofetil increase the risk of cytomegalovirus infection in solid organ transplant recipients?: A mini-review

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