The use of recombinant human activated protein C (drotrecogin alpha) in solid organ transplant recipients: case series and review of the literature.

Septic shock occurs frequently in solid organ transplant (SOT) recipients. Standard therapy includes fluid resuscitation, the administration of antimicrobials, and source control of the infection. Adjunctive therapy with recombinant human activated protein C (rhaPC), also called drotrecogin alpha, is another treatment that is used in patients but has not been studied in SOT patients.

A virtual crossmatch protocol significantly increases access of highly sensitized patients to deceased donor kidney transplantation.

Background: Patients with preexisting antihuman leukocyte antigen (HLA) antibodies (sensitized patients) are more likely to have a positive crossmatch with possible donors and have a lower likelihood of receiving a renal transplant with longer wait times. A virtual crossmatch protocol using solid-phase technology to determine the specificity of anti-HLA antibodies may improve the probability of identifying a crossmatch-negative compatible donor and increase access of sensitized patients to kidney transplantation.

Methods: A virtual crossmatch protocol was implemented on October 1, 2006 with solid-phase HLA antibody characterization for all sensitized patients on the waiting list.

Campath induction for kidney transplantation: report of 297 cases.

Objective: To evaluate 297 adult renal transplantation patients who received Campath-1H-based induction protocol.

Methods: Single center Institutional Review Board approved retrospective chart review of 297 patients who received alemtuzumab induction between November 2003 and December 2005. Maintenance immunosuppression consisted of tacrolimus, mycophenolate mofetil, and rapidly tapered solumedrol with few exceptional cases.

Liver transplantation for sinusoidal obstructive syndrome (veno-occlusive disease): case report with review of the literature and the UNOS database.

Background: Severe sinusoidal obstructive syndrome (SOS) is a life-threatening complication of stem cell transplantation. We report the case of a young man transplanted for SOS.

Method: A single chart review with query of the United Network of Organ Sharing database and review of the medical literature.

Fungal and mycobacterial infections after Campath (alemtuzumab) induction for renal transplantation.

Objectives: To report our experience with fungal and mycobacterial (tuberculosis) infection following induction with Campath (alemtuzumab).

Methods: We reviewed the database of 477 renal transplant patients induced with alemtuzumab. All those who had a fungal or mycobacterial infection were found, and the details of these complications reviewed.