Basal-Cell Carcinoma With Matrical Differentiation: Report of a New Case in a Renal-Transplant Recipient and Literature Review.

Basal-cell carcinoma with matrical differentiation (BCC-MD) is one of the rarest pathologic variants of basal-cell carcinoma, of which 41 cases have been so far reported in detail. One of them developed in a heart-transplant recipient. We report a new case of BCC-MD occurring in a renal-transplant recipient and review the relevant literature.

Contrasting effect of new HCMV pUL54 mutations on antiviral drug susceptibility: Benefits and limits of 3D analysis.

Human cytomegalovirus (HCMV) resistance to antiviral drugs is a major drawback of repeated or long-duration treatment in immunocompromised patients. Resistance testing is usually performed by genotypic assays. For accurate interpretation of these assays, the role of new mutations in HCMV resistance has to be assessed.

Profiling sirolimus-induced inflammatory syndrome: a prospective tricentric observational study.

Background: The use of the immunosuppressant sirolimus in kidney transplantation has been made problematic by the frequent occurrence of various side effects, including paradoxical inflammatory manifestations, the pathophysiology of which has remained elusive.

Methods: 30 kidney transplant recipients that required a switch from calcineurin inhibitor to sirolimus-based immunosuppression, were prospectively followed for 3 months. Inflammatory symptoms were quantified by the patients using visual analogue scales and serum samples were collected before, 15, 30, and 90 days after the switch.

Effect of two injections of non-adjuvanted influenza A H1N1pdm2009 vaccine in renal transplant recipients: INSERM C09-32 TRANSFLUVAC trial.

Background: Enhancing vaccine immunogenicity in kidney transplant recipients, particularly against influenza, is required since the immunosuppression used to prevent graft rejection limits vaccine immunogenicity. We therefore investigated the immunogenicity and safety of a double dose non-adjuvanted vaccination regimen against influenza H1N1pdm2009 in kidney transplant adult recipients.

Methods: A prospective single-arm study was conducted including 121 renal transplant recipients under triple immunosuppressive regimen.

Reversible ileitis secondary to high dose intravenous immunoglobulin in adult kidney transplant patient treated for acute humoral rejection.

Use of high dose intravenous immunoglobulin (IVIg) has been associated with necrotizing enterocolitis in late-preterm and term infants treated for severe isoimmune hemolytic jaundice. We present the first adult case of reversible ileitis related to high dose IVIg that occurred during the treatment of acute humoral rejection in a kidney transplant recipient (original nephropathy: lupus). At the third of the 5 days of a 0.

Confounding factors for early death in incident end-stage renal disease patients: Role of emergency dialysis start.

Hemodialysis (HD) has been associated with higher 1-year mortality than peritoneal dialysis (PD) after dialysis start. Confounding effects of late referral, emergency dialysis start, or start with central venous catheter on this association have never been studied concomitantly. Survival was studied among the 495 incident dialysed patients in our department from 1995 to 2006 and followed at least 1 year until December 31, 2007.

Immunogenicity and safety of intradermal influenza vaccination in renal transplant patients who were non-responders to conventional influenza vaccination.

Seasonal influenza epidemics are associated with high morbidity and mortality particularly in high-risk patients. Conventionally administered influenza vaccines show reduced efficacy in populations with weakened immune systems such as solid-organ transplant patients. This study assesses the safety and immunogenicity of an intradermally administered influenza vaccine in renal transplant patients previously identified as non-responders to a licensed trivalent inactivated influenza vaccine (TIV).

[Wegener granulomatosis and aneurysmal subarachnoid hemorrhage: an insignificant association?].

Background: Wegener granulomatosis (WG) is an uncommon systemic necrotizing vasculitis that demonstrates renal and respiratory tropism. While the pathogenesis of WG remains controversial, autoimmune and inflammatory mechanisms are likely to be involved. The nervous system could be affected in up to 54% of cases.

The Impact of type 2 diabetes on mortality in end-stage renal disease patients differs between genders.

Background/aims: In diabetics with end-stage renal disease (ESRD), risk of death has been reported to be non-constant after the first dialysis, and different outcomes have been observed between genders. We assessed the impact of type 2 diabetes (T2DM) on mortality in dialysis regarding its differential effect by gender using time-dependent analyses.

Methods: All T2DM and non-diabetic (no-DM) patients who started dialysis in two renal units in Lyon, France, between January 1, 1995, and December 31, 2007, were included.

Poor prognosis of heart transplant patients with end-stage renal failure.

Background: Chronic kidney disease (CKD) and end-stage renal failure (ESRF) are major complications after a heart transplant. The aim of this study is to compare survival in heart transplant (HT) vs non-heart transplant (non-HT) patients starting dialysis.

Methods: Survival was studied among the 539 newly dialysed patients between 1 January 1995 and 31 December 2005 in our Department.

Subsequent skin cancers in kidney and heart transplant recipients after the first squamous cell carcinoma.

Background: The increased incidence of skin cancers in transplant patients is well documented; however, few data exist on the risk of subsequent skin tumors in a given patient after the first skin cancer. The aim of this study was to compare the individual rate of subsequent skin cancers in kidney (KTR) and heart transplant recipients (HTR) after the first squamous cell carcinoma (SCC) and to assess risk factors for tumor multiplicity.

Methods: In all, 188 patients (121 KTR/67 HTR) were studied for up to 5 years.

[Granulomatous arteritis through sarcoidosis].

Introduction: Digestive localisation of sarcoidosis is rare.

Observation: A 35 year-old man presented with sarcoidosis revealed by a mediastinal hilum lymphadenopathy 13 years earlier. Epigastric pain led to oeso-gastroduodenal fibroscopy and biopsies, showing inflammatory mucosa and numerous giant-cell epithelioid granulomas, without concomitant necrosis or fibrosis.

Induction versus noninduction in renal transplant recipients with tacrolimus-based immunosuppression.

Background: The aim of this study was to compare the efficacy and safety of induction treatment with antithymocyte globulins (ATG) followed by tacrolimus therapy with immediate tacrolimus therapy in renal transplant recipients.

Methods: This 12-month, open, prospective study was conducted in 15 centers in France and 1 center in Belgium; 309 patients were randomized to receive either induction therapy with ATG (n=151) followed by initiation of tacrolimus on day 9 or immediate tacrolimus-based triple therapy (n=158). In both study arms, the initial daily tacrolimus dose was 0.

Transplanted renal artery: detection of stenosis with color Doppler US.

Purpose: To evaluate the influence of various parameters on peak systolic velocity in the transplanted renal artery and to define the normal range of peak systolic velocity.

Material And Methods: Color Doppler ultrasonographic (US) findings in 105 patients were reviewed. There were no clinical or biologic findings suggestive of a stenosis in the transplanted renal artery in these patients.

Transplant renal artery stenosis. Evaluation of diagnosis with magnetic resonance angiography compared with color duplex sonography and arteriography.

The goal of this study was to assess the value of a three-dimensional phase contrast magnetic resonance angiography (3D PC MRA) for diagnosing transplant renal artery stenosis (TRAS). Twelve consecutive patients clinically suspected of having TRAS were prospectively enrolled during a period of 18 months. Delays from transplantation varied from 3 months to 4 years (mean: 18.

MR angiography of renal artery stenosis: value of the combination of three-dimensional time-of-flight and three-dimensional phase-contrast MR angiography sequences.

Objective: It has been reported and also has been our preliminary experience that many false ostial stenoses are attributable to a loss of signal intensity at the origin of the renal arteries when three-dimensional (3D) phase-contrast MR angiography is used. Our objective was to add a 3D time-of-flight MR angiography sequence to the 3D phase-contrast MR angiography sequence to better analyze the origin of the main renal arteries. We assessed the value of the combination of these two MR angiography sequences for the depiction of renal artery stenosis.

Hodgkin's disease after transplantation.

Hodgkin's disease (HD) has seldom been reported after transplantation. Epstein-Barr virus (EBV) is present in about 50% of Reed-Sternberg cells in HD developing in immunocompetent individuals, but is more frequently found in HD of acquired immune deficiency syndrome patients. We report 7 cases of HD that occurred in transplant recipients.