Background: Acceptable post-transplant outcomes were reported in kidney transplant recipients from donors with coronavirus disease 2019 (COVID-19); however, there are no comparative studies with well-matched controls.
Methods: This multicenter, prospective observational study, which included three transplant centers in the United States, enrolled 61 kidney recipients from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected deceased donors. Using optimal matching methods, we matched every recipient to three comparators receiving kidneys from SARS-CoV-2-negative deceased donors with otherwise highly similar characteristics in the same transplant centers to compare 6-month eGFR.
Introduction: Assessing vaccine serologic status presents opportunities to provide live vaccinations to kidney transplant candidates (KTC). This is especially important given the increased risk of infection while taking lifelong immunosuppression following transplant and the inability to routinely provide live vaccines to patients on immunosuppressive medications. In March 2019, the American Society of Transplantation Infectious Disease Community of Practice (AST-IDCOP) released updated guidelines for vaccination of KTC, which emphasize pretransplant viral serology screening and live vaccine administration prior to transplant.
View Article and Find Full Text PDFCheckpoint inhibitors decrease the progression of many cancers. However, the experience in immunosuppressed patients is limited, with reports of possible serious adverse events. We present a heart transplant recipient treated with pembrolizumab for metastatic melanoma who developed fatal rejection.
View Article and Find Full Text PDFMedicare Part D plans make coverage decisions according to FDA-labeled indications and off-label uses endorsed by two CMS-recognized compendia. Patients who rely on Medicare Part D for immunosuppressive drug coverage are at risk for denied coverage when these medications are prescribed off-label. The purpose of this multicenter collaboration was to assemble a case series documenting situations where immunosuppressive therapies prescribed for transplant patients were denied by Medicare Part D prescription drug plans.
View Article and Find Full Text PDFThe purpose of this study was to retrospectively evaluate if a change in practice from January 2013 to August 2015 affected the rate of surgical-site infections following kidney transplantation at the single academic medical center. More patients were found to have a surgical-site infection when surgical antibiotics were only given intra-operatively despite a lower incidence of risk factors identified in the literature when compared to the cohort who received antibiotics intra-op and post-op for 24 hours.
View Article and Find Full Text PDFBackground: The use of prophylactic antifungal therapy is suggested after kidney transplantation. However, efficacy of low-dose (50 mg) oral fluconazole and its effect on tacrolimus trough levels in patients maintained on tacrolimus and mycophenolic acid, with or without corticosteroids, is unknown.
Methods: A retrospective analysis to evaluate efficacy was performed in 305 kidney transplant recipients.
Background: The effect of donor kidney volume on recipient kidney function has not been fully evaluated.
Methods: We performed a prospective analysis of 125 consecutive living kidney donor/recipient pairs. Donor kidney volume was calculated from pretransplantation computed tomography angiograms using a three-dimensional computerized volume method.