Alberú J, Gómez-Navarro B, Medeiros M, Monteón F, Ponce-de-León A, Reyes-Acevedo R, Sifuentes-Osornio J, Sierra-Madero J, Villasís-Keever A, Morales-Buenrostro LE

Language: Spanish
References: 26
Page: 56-65
PDF size: 356.66 Kb.

ABSTRACT

Infection in kidney transplant recipients is one of the three leading causes of death. Diagnosis and treatment can be very complex due to the immune suppression to which they are subjected. Measures aimed at prevention are pivotal and are designed to decrease the clinical, economic, and social burden of infections in this patient population. Specialists in kidney transplantation, infectious disease and nephrology, met in February 2013 to discuss and create a document with guidelines aimed to prevent those infections that in the group’s opinion were the most relevant in kidney transplant recipients; these specifically focused on cytomegalovirus, BK virus, Epstein-Barr virus and tuberculosis infections. Additionally, a section on vaccines was included as a table, with specific recommendations for kidney transplant recipients, since this is one of the simplest and most cost-effective interventions. The recommendations provided for each of these infections include diagnostic and management algorithms as well as prevention alternatives that can easily be incorporated into studies and treatment protocols at every hospital with a kidney transplant program. We expect these recommendations will positively impact the care of kidney transplant recipients.

REFERENCES

1. Rubin RH, Tolkoff-Rubin NE. The impact of infection on the outcome of transplantation. Transplant Proc. 1991; 23: 2068-2074.

2. Fishman JA, Rubin RH. Infection in organ-transplant recipients. N Engl J Med. 1998; 338: 1741-1751.

3. McDevitt LM. Etiology and impact of cytomegalovirus disease on solid organ transplant recipients. Am J Health Syst Pharm. 2006; 63: S3-9.

4. Kotton CN, Kumar D, Caliendo AM et al. International consensus guidelines on the management of cytomegalovirus in solid organ transplantation. Transplantation. 2010; 89: 779-795.

5. Kotton CN, Kumar D, Caliendo AM et al. Updated international consensus guidelines on the management of cytomegalovirus in solid-organ transplantation. Transplantation. 2013; 96: 333-360.

6. Humar A, Limaye AP, Blumberg EA et al. Extended valganciclovir prophylaxis in D+/R- kidney transplant recipients is associated with long-term reduction in cytomegalovirus disease: two-year results of the IMPACT study. Transplantation. 2010; 90: 1427-1431.

7. Limaye AP, Bakthavatsalam R, Kim HW et al. Impact of cytomegalovirus in organ transplant recipients in the era of antiviral prophylaxis. Transplantation. 2006; 81: 1645-1652.

8. Razonable RR, Humar A. Cytomegalovirus in solid organ transplantation. Am J Transplant. 2013; 13 (Suppl 4): 93-106.

9. Hirsch HH, Brennan DC, Drachenberg CB et al. Polyomavirus-associated nephropathy in renal transplantation: interdisciplinary analyses and recommendations. Transplantation. 2005; 79: 1277-1286.

10. Babel N, Volk HD, Reinke P. BK polyomavirus infection and nephropathy: the virus-immune system interplay. Nat Rev Nephrol. 2011; 7: 399-406.

11. Ding R, Medeiros M, Dadhania D et al. Noninvasive diagnosis of BK virus nephritis by measurement of messenger RNA for BK virus VP1 in urine. Transplantation. 2002; 74: 987-994.

12. Bechert CJ, Schnadig VJ, Payne DA, Dong J. Monitoring of BK viral load in renal allograft recipients by real-time PCR assays. Am J Clin Pathol. 2010; 133: 242-250.

13. Drake KA, Najera L, Reed RC, Verghese PS. Unusual presentations of BK virus infections in pediatric renal transplant recipients. Pediatr Transplant. 2013; 17: E9-15.

14. Medeiros M, Alberu J, Garcia GR, Fuentes Y, Velasquez L. [Polyoma virus in transplant recipients]. Nefrologia. 2008; 28: 203-211.

15. Kuypers DR. Management of polyomavirus-associated nephropathy in renal transplant recipients. Nat Rev Nephrol. 2012; 8: 390-402.

16. Gross TG, Savoldo B, Punnett A. Posttransplant lymphoproliferative diseases. Pediatr Clin North Am. 2010; 57: 481-503, table of contents.

17. Hatton O, Martinez OM, Esquivel CO. Emerging therapeutic strategies for Epstein-Barr virus+ post-transplant lymphoproliferative disorder. Pediatr Transplant. 2012; 16: 220-229.

18. Allen U, Preiksaitis J. Epstein-Barr virus and posttransplant lymphoproliferative disorder in solid organ transplant recipients. Am J Transplant. 2009; 9 (Suppl 4): S87-96.

19. Kumar D, Blumberg EA, Danziger-Isakov L et al. Influenza vaccination in the organ transplant recipient: review and summary recommendations. Am J Transplant. 2011; 11: 2020-2030.

20. Kumar D, Morris MI, Kotton CN et al. Guidance on novel influenza A/H1N1 in solid organ transplant recipients. Am J Transplant. 2010; 10: 18-25.

21. Cohn J, Blumberg EA. Immunizations for renal transplant candidates and recipients. Nat Clin Pract Nephrol. 2009; 5: 46-53.

22. Kumar D, Humar A, Plevneshi A et al. Invasive pneumococcal disease in solid organ transplant recipients--10-year prospective population surveillance. Am J Transplant. 2007; 7: 1209-1214.

23. Valdez-Ortiz R, Sifuentes-Osornio J, Morales-Buenrostro LE et al. Risk factors for infections requiring hospitalization in renal transplant recipients: a cohort study. Int J Infect Dis. 2011; 15: e188-196.

24. Sollai S, Galli L, de Martino M, Chiappini E. Systematic review and meta-analysis on the utility of Interferon-gamma release assays for the diagnosis of Mycobacterium tuberculosis infection in children: a 2013 update. BMC Infect Dis. 2014; 14 (Suppl 1): S6.

25. Kim CH, Kim JY, Hwang YI et al. Interferon-gamma enzyme-linked immunospot assay in patients with tuberculosis and healthy adults. Tuberc Respir Dis (Seoul). 2014; 76: 23-29.

26. Hernandez-Hernandez E, Alberu J, Gonzalez-Michaca L et al. Screening for tuberculosis in the study of the living renal donor in a developing country. Transplantation. 2006; 81: 290-292.