Understanding the causes of mortality post-transplantation - there is more than meets the eye

Riella, Leonardo V.

doi:10.1590/2175-8239-jbn-2018-0002-0003

Cited by 9 publications

(7 citation statements)

References 6 publications

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“…These risks refer to all cancers and not just DOCs and are related to the immunosuppression patients receive after solid organ transplantation, limiting the recipient's immune system to find cancerous cells in their infancy and remove them before tumors develop. [1][2][3][4]5 Studies suggest cancers caused by viral illnesses also occur higher in patients with solid organ transplantation, lending credence to the idea that a dampened immune system plays a significant role in carcinogenesis. 2 Donor selection is a balancing act between risks associated with the transmission of diseases and the risk of delayed transplantation, possibly leading to death.…”

Section: Discussionmentioning

confidence: 98%

“…DTCs are defined as cancers transplanted into the recipient at the time of transplantation, whereas DDCs are felt to be cancers that arise later from donor tissue. 5 The risk of developing cancers in transplant recipients is estimated to be between 2 and 4 times higher in comparable patients without transplantation. These risks refer to all cancers and not just DOCs and are related to the immunosuppression patients receive after solid organ transplantation, limiting the recipient’s immune system to find cancerous cells in their infancy and remove them before tumors develop.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Donor Origin Neuroendocrine Cancer: A Case Report and Literature Review

Brady,

Tamburro,

Joy

et al. 2023

Transplantation Direct

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Donor Origin Neuroendocrine Cancer: A Case Report and Literature Review

Brady,

Tamburro,

Joy

et al. 2023

Transplantation Direct

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“…In conclusion, this meta-analysis revealed that INH prophylaxis could significantly reduce the risk of TB development in KTRs. Nevertheless, the available evidence is not robust and a large multicenter randomized trial is needed to evaluate the efficacy and safety of INH prophylaxis in KTRs ( Bishai and Chaisson, 1997 , Muñoz et al, 2005 , Riella, 2018 , Samavat et al, 2021 , Aguado et al, 2009 ).…”

Section: Discussionmentioning

confidence: 99%

Chemoprophylaxis for the prevention of tuberculosis in kidney transplant recipients: A systematic review and meta-analysis

Yuan

Chao

et al. 2023

Front. Pharmacol.

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Background: A systematic review and meta-analysis was performed to investigate the efficacy and safety of isoniazid (INH) prophylaxis to prevent tuberculosis (TB) infection in kidney transplant recipients (KTRs).Methods: Web of Science, SCOPUS, and PubMed were searched to identify relevant studies that compared the effects among patients who received INH prophylaxis after transplantation.Results: A total of 13 studies (involving 6,547 KTRs) were included in our analysis. We found that the risk of active TB infection (RR: 0.35, 95%CI 0.27–0.45, p < 0.01) for KTRs was lower in the INH treatment group than in those without prophylaxis. However, there was no significant difference between the two groups in mortality (RR: 0.93, 95%CI 0.67–1.28, p = 0.64), acute rejection (RR: 0.82, 95%CI 0.44–1.51, p = 0.52), and hepatotoxicity (RR: 1.25, 95%CI 0.94–1.65, p = 0.12).Conclusion: Isoniazid prophylaxis is a safe and effective for KTRs on reactivation of latent TB infection.

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“…Additionally, lymphopenia in the regeneration phase after HSCT enhances the pathogenassociated morbidity and mortality. Up to 22% and 53% of overall mortality after HSCT and SOT, respectively, are associated with infections resulting from a lack of specific T-cell immunity [2][3][4]. Individuals with congenital primary or secondary immunodeficiencies are even more susceptible to infectious complications, which are among the leading causes of death [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Antiviral T-Cell Frequencies in a Healthy Population: Reference Values for Evaluating Antiviral Immune Cell Profiles in Immunocompromised Patients

et al. 2022

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Viral infections and reactivations are major causes of morbidity and mortality after hematopoietic stem cell (HSCT) and solid organ transplantation (SOT) as well as in patients with immunodeficiencies. Latent herpesviruses (e.g., cytomegalovirus, Epstein-Barr virus, and human herpesvirus 6), lytic viruses (e.g., adenovirus), and polyomaviruses (e.g., BK virus, JC virus) can cause severe complications. Antiviral drugs form the mainstay of treatment for viral infections and reactivations after transplantation, but they have side effects and cannot achieve complete viral clearance without prior reconstitution of functional antiviral T-cell immunity. The aim of this study was to establish normal ranges for virus-specific T-cell (VST) frequencies in healthy donors. Such data are needed for better interpretation of VST frequencies observed in immunocompromised patients. Therefore, we measured the frequencies of VSTs against 23 viral protein-derived peptide pools from 11 clinically relevant human viruses in blood from healthy donors (n = 151). Specifically, we determined the VST frequencies by interferon-gamma enzyme-linked immunospot assay and classified their distribution according to age and gender to allow for a more specific evaluation and prediction of antiviral immune responses. The reference values established here provide an invaluable tool for immune response evaluation, intensity of therapeutic drugs and treatment decision-making in immunosuppressed patients. This data should make an important contribution to improving the assessment of immune responses in immunocompromised patients.

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Understanding the causes of mortality post-transplantation - there is more than meets the eye

Cited by 9 publications

References 6 publications

Donor Origin Neuroendocrine Cancer: A Case Report and Literature Review

Donor Origin Neuroendocrine Cancer: A Case Report and Literature Review

Chemoprophylaxis for the prevention of tuberculosis in kidney transplant recipients: A systematic review and meta-analysis

Antiviral T-Cell Frequencies in a Healthy Population: Reference Values for Evaluating Antiviral Immune Cell Profiles in Immunocompromised Patients

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