Monitoring of early humoral immunity to identify lung recipients at risk for development of serious infections: A multicenter prospective study

Sarmiento, E.; Cifrián, José; Calahorra, Leticia; Bravo, Carles; López, Sonia; Laporta, Rosalía; Ussetti, Piedad; Solé, Amparó; Morales, C.M. Toledo; Pablos, A. De; Jaramillo, María; Ezzahouri, I.; Garcia, S.; Navarro, J.; López‐Hoyos, Marcos; Carbone, Javier

doi:10.1016/j.healun.2018.04.001

Cited by 18 publications

(16 citation statements)

References 31 publications

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“…49 More recently, early monitoring of specific humoral immunity parameters was proven to be useful for the identification of lung recipients who are at risk of serious infections. 50 All these data together has renewed the interest in studying the role of neutralizing antibodies against CMV infection.…”

Section: Do Neutralizing Antibody Titers Provide Information Regardmentioning

confidence: 99%

“…In addition, in a clinical trial the administration of two monoclonal antibodies in R − kidney recipients at the time of transplant and 1, 4, and 8 post‐transplant weeks reduced the incidence of CMV infection, increased the time interval to CMV viremia and was associated with less CMV disease . More recently, early monitoring of specific humoral immunity parameters was proven to be useful for the identification of lung recipients who are at risk of serious infections . All these data together has renewed the interest in studying the role of neutralizing antibodies against CMV infection.…”

Section: Introductionmentioning

confidence: 99%

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Going beyond serology for stratifying the risk of CMV infection in transplant recipients

Navarro

Fernández‐Ruiz

Aguado

et al. 2018

Reviews in Medical Virology

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Summary Knowledge of donor and recipient (D/R) cytomegalovirus (CMV) serostatus is critical for risk stratification of CMV infection and disease in transplant recipients, particularly in the solid organ transplantation (SOT) setting. Despite its broad availability and the success of it use, the risk stratification based on the D/R serostatus is not free of limitations since there are a nondepreciable number of patients that are not accurately categorized by this approach. In fact, up to 20% of seropositive SOT recipients, classically considered at intermediate risk, develop episodes of CMV infection and disease after transplantation. Here, we provide an overview of additional donor and recipient factors that may have utility in identifying patients at risk for post‐transplant CMV infection. Specifically, we summarize our current understanding regarding the potential use of use CMV‐specific T‐cell‐mediated immunity, neutralizing antibodies and host genetics that may influence the risk of CMV infection and disease. We provide an overview of the benefits and limitations associated with using these immunological factors in risk stratification and propose specific variables that could be analyzed at the pretransplant evaluation to improve the identification of patients with increased individual susceptibility.

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Section: Do Neutralizing Antibody Titers Provide Information Regardmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Going beyond serology for stratifying the risk of CMV infection in transplant recipients

Navarro

Fernández‐Ruiz

Aguado

et al. 2018

Reviews in Medical Virology

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“…Similarly, approaches to the use of replacement IVIG for hypogammaglobulinaemia have not been tested. LTX patients with iatrogenic hypogammaglobulinaemia are eight-fold more likely to develop opportunistic infections such as cytomegalovirus or invasive fungal infection [ 37 ] and two- to three-fold more likely to develop chronic allograft dysfunction (CLAD) [ 38 ].…”

Section: Immunosuppression and Infection Prophylaxismentioning

confidence: 99%

Controversies and emerging topics in lung transplantation

Abelson

Glanville

2018

Breathe

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Lung transplantation provides a realistic hope of improved survival and enhanced quality of life. However, outcomes can be disappointing, meaning many decisions are highly controversial. Practice is largely based on expert opinion and there is a dearth of high-level evidence. Not surprisingly, this leads to centre-specific practices that may vary considerably in controversial areas. The aim of this review, therefore, is to explore some of those domains and present the available evidence. As the science of lung transplantation approaches its fifth decade, we are only now reaching a critical mass of clinicians and scientific researchers to enable adequately powered studies to assist in informing our approach to some of these controversies.Key pointsLung transplantation remains an art, combining experience with evidence.Clinicians need evidence to guide them on a myriad of questions, from candidate selection and listing, to organ donor acceptance, immunosuppression and chronic allograft dysfunction.Chronic lung allograft dysfunction pathogenesis deserves further detailed study.Educational aimsTo illustrate the spectrum of controversial areas in lung transplantation including whom to list, which organs can be used and for whom, immune suppression and infection prophylaxis, and causes and phenotypes of chronic lung allograft dysfunction.To inspire clinicians to always ask questions and help collect the evidence we need to inform decision making.

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“…Secondary antibody deficiency has been associated with risk of invasive fungal infections in solid organ transplantation. Single center and multi-center studies performed in heart and lung recipients have tested this association [1][2][3]. A meta-analysis has demonstrated that severe IgG hypogammaglobulinemia (defined as IgG < 400 mg/dl) during the first year after solid organ transplantation is a risk factor for severe infections including invasive fungal infections and cytomegalovirus disease [4].…”

Section: Introductionmentioning

confidence: 99%

Secondary Antibody Deficiency in a Heart Recipient with Systemic Aspergillosis

Carbone¹,

Fernàndez-Yáñez²,

Sousa³

et al. 2018

obm transplant

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Secondary antibody deficiency has been associated with risk of invasive fungal infections in solid organ transplantation. Single center, multi-center and meta-analysis studies have tested this association. Therapy of these infectious complications in the presence of a secondary antibody deficiency after transplantation remain a challenge for transplant teams. Currently, there are no guidelines for the management of this combined clinical scenario. We report the case of a patient with severe secondary immunodeficiency before and after heart transplantation who developed several infectious complications including, cardiac invasive aspergillosis, and had a long-term survival after combination therapy of antimicrobial drugs and prolonged intravenous immunoglobulin replacement therapy.

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Monitoring of early humoral immunity to identify lung recipients at risk for development of serious infections: A multicenter prospective study

Cited by 18 publications

References 31 publications

Going beyond serology for stratifying the risk of CMV infection in transplant recipients

Going beyond serology for stratifying the risk of CMV infection in transplant recipients

Controversies and emerging topics in lung transplantation

Secondary Antibody Deficiency in a Heart Recipient with Systemic Aspergillosis

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