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  • 1
  • 2
    Language: German
    Description: Provider: Deutsche Digitale Bibliothek - Institution: Bayerische Staatsbibliothek - Data provided by Europeana Collections- Augsburg, Staats- und Stadtbibliothek -- Th Pr 4984- All metadata published by Europeana are available free of restriction under the Creative Commons CC0 1.0 Universal Public Domain Dedication. However, Europeana requests that you actively acknowledge and give attribution to all metadata sources including Europeana
    Source: Europeana Collections
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  • 3
    Language: English
    In: American journal of transplantation, 2017-10, Vol.17 (10), p.2591-2600
    Description: BK polyomavirus (BKPyV) causes premature kidney transplant (KT) failure in 1–15% of patients. Because antivirals are lacking, most programs screen for BKPyV‐viremia and, if positive, reduce immunosuppression. To evaluate the relationship of viremia and BKPyV‐specific immunity, we examined prospectively cryopreserved plasma and peripheral blood mononuclear cells at the time of transplantation (T0) and at 6 mo (T6) and 12 mo (T12) after transplant from 28 viremic KT patients and 68 nonviremic controls matched for the transplantation period. BKPyV IgG seroprevalence was comparable between cases (89.3%) and controls (91.2%; p = 0.8635), but cases had lower antibody levels (p = 0.022) at T0. Antibody levels increased at T6 and T12 but were not correlated with viremia clearance. BKPyV‐specific T cell responses to pools of overlapping 15mers (15mer peptide pool [15mP]) or immunodominant CD8 9mers (9mer peptide pool [9mP]) from the early viral gene region were not different between cases and controls at T0; however, clearance of viremia was associated with stronger 9mP responses at T6 (p = 0.042) and T12 (p = 0.048), whereas 15mP responses were not informative (T6 p = 0.359; T12 p = 0.856). BKPyV‐specific T cells could be expanded in vitro from all patients after transplant, permitting identification of 78 immunodominant 9mer epitopes including 50 new ones across different HLA class I. Thus, 9mP‐responses may be a novel marker of reconstituting CD8 T cell function that warrants further study as a complement of plasma BKPyV loads for guiding immunosuppression reduction. Interferon‐γ ELISpot responses of CD8 T cells to immunodominant 9mer epitopes from the BK polyomavirus early viral gene region significantly increased in BK viremic patients but not in nonviremic controls, and are associated with viremia clearance posttransplantation, while standard 15mer T cell responses or antibody levels were uninformative.
    Subject(s): Adult ; Aged ; Analysis ; antigen presentation/recognition ; Antigenic determinants ; Antiviral agents ; BK Virus - isolation & purification ; BK Virus - physiology ; Case-Control Studies ; CD8 antigen ; CD8-Positive T-Lymphocytes - immunology ; Cells ; Cohort Studies ; Cryopreservation ; Enzyme-linked immunosorbent assay ; Epitopes ; Female ; Histocompatibility antigen HLA ; Humans ; Immunoglobulin G ; Immunosuppression ; Immunotherapy ; infection and infectious agents ; infectious disease ; Kidney transplantation ; Kidney Transplantation - adverse effects ; kidney transplantation/nephrology ; Kidneys ; Leukocytes (mononuclear) ; Lymphocytes ; Lymphocytes T ; Male ; Medical research ; Medicine, Experimental ; Middle Aged ; Organ transplant recipients ; Peptides ; Peripheral blood mononuclear cells ; Renal failure ; Serology ; Syngeneic grafts ; T cell biology ; T cell receptors ; T cells ; translational research/science ; Transplantation ; Transplants & implants ; viral: BK/JC/polyoma ; Viremia
    ISSN: 1600-6135
    E-ISSN: 1600-6143
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
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  • 4
    Language: English
    In: American journal of transplantation, 2017-07, Vol.17 (7), p.1813-1822
    Description: We assessed the impact of antiviral preventive strategies on the incidence of herpes simplex virus (HSV) and varicella‐zoster virus (VZV) infections in a nationwide cohort of transplant recipients. Risk factors for the development of HSV or VZV infection were assessed by Cox proportional hazards regression. We included 2781 patients (56% kidney, 20% liver, 10% lung, 7.3% heart, 6.7% others). Overall, 1264 (45%) patients received antiviral prophylaxis (ganciclovir or valganciclovir, n = 1145; acyclovir or valacyclovir, n = 138). Incidence of HSV and VZV infections was 28.9 and 12.1 cases, respectively, per 1000 person‐years. Incidence of HSV and VZV infections at 1 year after transplant was 4.6% (95% confidence interval [CI] 3.5–5.8) in patients receiving antiviral prophylaxis versus 12.3% (95% CI 10.7–14) in patients without prophylaxis; this was observed particularly for HSV infections (3% [95% CI 2.2–4] versus 9.8% [95% CI 8.4–11.4], respectively). A lower rate of HSV and VZV infections was also seen in donor or recipient cytomegalovirus‐positive patients receiving ganciclovir or valganciclovir prophylaxis compared with a preemptive approach. Female sex (hazard ratio [HR] 1.663, p = 0.001), HSV seropositivity (HR 5.198, p 〈 0.001), previous episodes of rejection (HR 1.95, p = 0.004), and use of a preemptive approach (HR 2.841, p = 0.017) were significantly associated with a higher risk of HSV infection. Although HSV and VZV infections were common after transplantation, antiviral prophylaxis significantly reduced symptomatic HSV infections. In this national cohort of solid organ transplant recipients, patients receiving antiviral prophylaxis either with (val)ganciclovir or (val)acyclovir have a lower incidence of herpes simplex virus infections compared to patients managed with a preemptive approach for cytomegalovirus infection or not receiving antiherpes prophylaxis.
    Subject(s): Adult ; antibiotic: antiviral‐ganciclovir/valganciclovir ; Antiviral Agents - therapeutic use ; clinical research/practice ; Cohort Studies ; Cytomegalovirus - drug effects ; Cytomegalovirus Infections - drug therapy ; Cytomegalovirus Infections - epidemiology ; Cytomegalovirus Infections - virology ; Female ; Follow-Up Studies ; Graft Rejection - epidemiology ; Graft Rejection - prevention & control ; Graft Rejection - virology ; Graft Survival ; Herpesviridae Infections - epidemiology ; Herpesviridae Infections - prevention & control ; Herpesviridae Infections - virology ; Herpesvirus 3, Human - drug effects ; Humans ; Incidence ; infection and infectious agents ; infectious disease ; Male ; Middle Aged ; Organ Transplantation - adverse effects ; Prognosis ; Risk Factors ; Switzerland - epidemiology ; Transplant Recipients ; viral ; viral: herpes zoster/Varicella
    ISSN: 1600-6135
    E-ISSN: 1600-6143
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
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  • 5
    Language: English
    In: American journal of transplantation, 2018-07, Vol.18 (7), p.1745-1754
    Description: Clostridium difficile infection (CDI) is a leading cause of infectious diarrhea in solid organ transplant recipients (SOT). We aimed to assess incidence, risk factors, and outcome of CDI within the Swiss Transplant Cohort Study (STCS). We performed a case‐control study of SOT recipients in the STCS diagnosed with CDI between May 2008 and August 2013. We matched 2 control subjects per case by age at transplantation, sex, and transplanted organ. A multivariable analysis was performed using conditional logistic regression to identify risk factors and evaluate outcome of CDI. Two thousand one hundred fifty‐eight SOT recipients, comprising 87 cases of CDI and 174 matched controls were included. The overall CDI rate per 10 000 patient days was 0.47 (95% confidence interval ([CI] 0.38‐0.58), with the highest rate in lung (1.48, 95% CI 0.93‐2.24). In multivariable analysis, proven infections (hazard ratio [HR] 2.82, 95% CI 1.29‐6.19) and antibiotic treatments (HR 4.51, 95% CI 2.03‐10.0) during the preceding 3 months were independently associated with the development of CDI. Despite mild clinical presentations, recipients acquiring CDI posttransplantation had an increased risk of graft loss (HR 2.24, 95% CI 1.15‐4.37; P = .02). These findings may help to improve the management of SOT recipients. The authors demonstrate that despite mild clinical presentations and good clinical responses, Clostridium difficile infections are associated with an increased risk of graft loss in the Swiss Transplant Cohort Study.
    Subject(s): Analysis ; Antibacterial agents ; antibiotic: antibacterial ; clinical research/practice ; Clostridium difficile ; Communicable diseases ; complication: infectious ; Diarrhea ; Health aspects ; Health risk assessment ; infection and infectious agents – bacterial: Clostridium difficile ; infectious disease ; Medical research ; Medicine, Experimental ; Organ transplant recipients ; Risk factors ; Transplantation ; Transplantation of organs, tissues, etc ; Transplants & implants
    ISSN: 1600-6135
    E-ISSN: 1600-6143
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
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  • 6
    Language: English
    In: Transplant infectious disease, 2018-12, Vol.20 (6), p.e12981-n/a
    Description: Contemporary, comprehensive data on epidemiology and outcomes of invasive fungal disease (IFD) including breakthrough IFD among allogeneic hematopoietic stem cell transplantation (HSCT) recipients are scarce. We included 479 allogeneic HSCT recipients with 10 invasive candidiasis (IC) and 31 probable/proven invasive mold disease (IMD) from the Swiss Transplant Cohort Study from 01.2009 to 08.2013. Overall cumulative incidence was 2.3% for IC and 8.5% for probable/proven IMI: 6% for invasive aspergillosis (IA) and 2.5% for non‐AspergillusIMI. Among 41 IFD, 46% IFD were breakthrough, with an overall incidence of 4.6%, more frequently caused by other‐than‐Aspergillus fumigatus molds than primary IFD (47.6% (10/21) vs 13% (3/23), P = 0.04). Twelve‐week mortality among patients with IC was 20% and 58.6% for probable/proven IMD (60% IA and 54.6% non‐Aspergillus). Our results reveal that breakthrough IFD represent a marked burden of probable/proven IFD postallogeneic HSCT and mortality remains above 50% in patients with probable/proven IMD, underscoring the ongoing challenges to prevent and treat IFD in these patients.
    Subject(s): Adult ; Analysis ; Antibiotic Prophylaxis - adverse effects ; Antibiotic Prophylaxis - methods ; Antifungal Agents - adverse effects ; Aspergillosis ; breakthrough infections ; Candida - drug effects ; Candida - isolation & purification ; Candida - physiology ; Candidiasis ; Candidiasis, Invasive - epidemiology ; Candidiasis, Invasive - microbiology ; Candidiasis, Invasive - prevention & control ; Drug Resistance, Fungal ; Epidemiology ; Female ; Fungal diseases ; Fungi ; hematopoietic stem cell transplantation ; Hematopoietic Stem Cell Transplantation - adverse effects ; Hematopoietic stem cells ; Hemopoiesis ; Humans ; Incidence ; invasive fungal diseases ; invasive mold disease ; Male ; Medical research ; Medicine, Experimental ; Middle Aged ; Molds (Fungi) ; Mortality ; Mycoses ; Patients ; Prospective Studies ; Stem cell transplantation ; Stem cells ; Switzerland ; Transplantation ; Transplantation, Homologous - adverse effects ; Transplants & implants
    ISSN: 1398-2273
    E-ISSN: 1399-3062
    Source: Hellenic Academic Libraries Link
    Source: Academic Search Ultimate
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  • 7
    Language: English
    In: Transplant infectious disease, 2020-08, Vol.22 (4), p.e13289-n/a
    Description: Background Infections are an important complication after allogeneic hematopoietic cell transplantation (allo‐HCT). The present study aimed at determining the landscape of infections occurring in a large cohort of allo‐HCT patients, as well as associated risk factors for infections and for one‐year non‐relapse mortality. Methods This is a retrospective cohort study using STCS and EBMT databases to assess the one‐year incidence rate of infection, as well as risk factors for infections and for one‐year non‐relapse mortality among adult allo‐HCT patients transplanted between 2010 and 2014 in Switzerland. Univariable and multivariable quasi‐Poisson and multivariable Cox regression models were used. Results Of 553 patients included, 486 had an infection with a global incidence rate of 3.66 infections per patient‐year. Among a total of 1534 infections analyzed, viral infections were predominant (n = 1138, 74.2%), followed by bacterial (n = 343, 22.4%) and fungal (n = 53, 3.5%) infections. At one year, the cumulative incidence of relapse and non‐relapse mortality was 26% and 16%, respectively. 195 (35.3%) of patients had at least one episode of severe graft‐versus‐host‐disease (GvHD). A center effect was observed, and underlying disease, donor type, cytomegalovirus serological constellation, and GvHD were also associated with the incidence rate of infections. There was an increased risk for one‐year non‐relapse mortality associated with all pathogens, specifically within two months of infection, and this remained true beyond 2 months of a fungal infection. Conclusion Despite advances to limit infections in this population, they still occur in most allo‐HCT patients with a major impact on survival at 1 year.
    Subject(s): allogeneic cell transplantation ; Constellations ; Cytomegalovirus ; Fungi ; Graft-versus-host reaction ; Health risks ; Hemopoiesis ; infection ; Infections ; Mortality ; Regression analysis ; Regression models ; Risk analysis ; Risk factors ; Transplantation ; Transplants & implants ; Viral infections
    ISSN: 1398-2273
    E-ISSN: 1399-3062
    Source: Hellenic Academic Libraries Link
    Source: Academic Search Ultimate
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  • 8
    Language: English
    In: Transplant international, 2019-01, Vol.32 (1), p.49-58
    Description: Summary Increasing evidence indicates a role of vitamin D in the immune system affecting response to infections. We aimed to characterize the role of vitamin D status, i.e. deficiency [25‐OH vitamin D (25‐OHD) 〈50 nmol/l] and no deficiency (25‐OHD ≥50 nmol/l) in incident infections after liver transplantation. In 135 liver transplant recipients, blood samples drawn at time of liver transplantation and 6 months afterwards were used to determine 25‐OHD levels. Incident infections episodes were prospectively collected within the Swiss Transplant Cohort Study database. Poisson regression was applied to address associations between vitamin D status and incident infections. Vitamin D deficiency was common at time of transplantation and 6 months afterwards without a significant change in median 25‐OHD levels. In univariable analyses, vitamin D deficiency was a risk factor for incident infections in the first 6 months post‐transplant incidence rate ratio (IRR 1.52, 95% CI 1.08–2.15, P = 0.018) and for bacterial infections occurring after 6 up to 30 months post‐transplant (IRR 2.29, 95% CI 1.06–4.94, P = 0.034). These associations were not detectable in multivariable analysis with adjustment for multiple confounders. Efforts to optimize vitamin D supplementation in liver transplant recipients are needed. Our data question the role of vitamin D deficiency in incident infections.
    Subject(s): Adult ; Aged ; Allografts ; Bacterial Infections - epidemiology ; Female ; Health risk assessment ; Health risks ; Humans ; Immune system ; Infections ; Life Sciences & Biomedicine ; Liver ; Liver Failure - blood ; Liver Failure - surgery ; Liver transplantation ; Liver Transplantation - adverse effects ; Male ; Middle Aged ; Multivariate Analysis ; Nutrient deficiency ; Poisson density functions ; Poisson Distribution ; Postoperative Complications ; post‐transplant care ; Prospective Studies ; Regression Analysis ; Risk analysis ; Risk Factors ; Science & Technology ; Statistical analysis ; Supplementation ; Surgery ; Switzerland ; Syngeneic grafts ; Transplantation ; Transplants & implants ; Vitamin D ; Vitamin D - blood ; Vitamin D Deficiency - complications ; Vitamin deficiency
    ISSN: 0934-0874
    E-ISSN: 1432-2277
    Source: Web of Science - Science Citation Index Expanded - 2019〈img src="http://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /〉
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
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  • 9
    Language: German
    Description: Provider: Deutsche Digitale Bibliothek - Institution: Bayerische Staatsbibliothek - Data provided by Europeana Collections- München, Bayerische Staatsbibliothek -- 2 J.publ.g. 164- All metadata published by Europeana are available free of restriction under the Creative Commons CC0 1.0 Universal Public Domain Dedication. However, Europeana requests that you actively acknowledge and give attribution to all metadata sources including Europeana
    Subject(s): Vertrag
    Source: Europeana Collections
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