Area under the viraemia curve versus absolute viral load: utility for predicting symptomatic cytomegalovirus infections in kidney transplant patients.

A novel approach to predicting symptomatic cytomegalovirus (CMV) infections combines the level and the duration of viraemia in a single parameter. Sixty-four kidney transplant recipients were monitored by quantitative shell vial culture, pp65 antigenaemia, and polymerase chain reaction (PCR) of leucocytes. The area under the curve (AUC) of each parameter was determined from the onset of viraemia to the beginning of antiviral treatment.

Do serum C-reactive protein measurements help to discriminate episodes of renal dysfunction in patients after renal transplantation?

Introduction: This study investigated whether serial daily measurements of serum C-reactive protein (sCRP) could help differentiate episodes of transplant dysfunction due to rejection, infection, cyclosporine A (CsA) nephrotoxicity, or acute tubular necrosis (ATN) in renal-allograft recipients.

Materials And Methods: Morning serum was obtained daily from 134 patients during the first 30 days after renal transplantation. All episodes of graft dysfunction were recorded and differentiated with transplant biopsies.

False-positive results of plasma PCR for cytomegalovirus DNA due to delayed sample preparation.

Positive results by cytomegalovirus (CMV) PCR of plasma are considered predictive of active CMV infection in kidney allograft recipients. To assess whether contamination with leukocyte-derived CMV DNA can distort the results, aliquots of whole-blood samples from 60 CMV immunoglobulin G-positive patients with leukocyte CMV DNAemia were stored for up to 24 h at room temperature (RT) and at 4 degrees C before plasma preparation. Native and ultrafiltered plasma samples were tested by CMV and beta-globin PCRs.

Cytomegalovirus cultured from different major leukocyte subpopulations: association with clinical features in CMV immunoglobulin G-positive renal allograft recipients.

Cytomegalovirus (CMV) cultured from peripheral blood mononuclear cells (PBMCs) was shown to be associated more closely with clinical manifestations than infectious CMV in polymorphonuclear leukocytes (PMNLs) of renal allograft recipients with secondary CMV infection. Shell vial culture was carried out with ficoll-purified PBMCs and PMNLs of 71 CMV IgG-positive patients after kidney transplantation. Thirty-six patients experienced active CMV infections.

Pulsed-field gel electrophoresis for the analysis of Listeria monocytogenes infection clusters after kidney transplantation.

Listeria monocytogenes causes a rare, life-threatening infection in recipients of transplanted organs. We used cultures of blood and cerebrospinal fluid to characterize isolates and to distinguish cases in clusters from what might have been sporadic cases. From December 1994 to November 1995, six systemic L.

[Perioperative incidence of transfusions after allogenic kidney transplantation].

The requirement of blood transfusions was evaluated in a two compartment (retrospective/prospective) study in our renal transplantation program. Between July 1st, 1993 and December 31st, 1994 (observation period 1) we retrospectively investigated 110 patients with end stage renal disease and anemia undergoing kidney transplantation. Between January 1st, 1995 and December 31st, 1996 (observation period II) the requirement of blood transfusions was followed prospectively in 134 patients after allogenic renal transplantation.

Utility of major leukocyte subpopulations for monitoring secondary cytomegalovirus infections in renal-allograft recipients by PCR.

The feasibility of the major peripheral blood leukocyte (PBL) subsets for use in qualitative and quantitative PCR to monitor secondary cytomegalovirus (CMV) infection and ganciclovir therapy was assessed with 188 blood samples derived from 40 CMV immunoglobulin G-positive renal-allograft recipients. In pp65 antigen-positive patients all leukocyte fractions, but only 79.5% of plasma preparations, were PCR positive.

[Occurrence of lymphoceles after allogeneic kidney transplantation and their therapy].

We conducted a prospective evaluation of 301 consecutive renal transplants to define the prevalence and therapy of lymphoceles following renal transplantation. Using a management scheme, we identified in 52 patients (17.3%) perirenal fluid collections.

Nosocomial infections by Listeria monocytogenes: analysis of a cluster of septicemias in immunocompromised patients.

From December 1994 to November 1995 an unusual accumulation of Listeria infections occurred at the University Hospital Hamburg-Eppendorf, Germany. Eleven immunosuppressed patients from different departments developed septicemia due to Listeria monocytogenes during hospitalization. In a retrospective study, serotyping and pulsed-field gel electrophoresis revealed that six isolates were identical or genetically related.

Minimal effect of delayed sample processing on results of quantitative PCR for cytomegalovirus DNA in leukocytes compared to results of an antigenemia assay.

Quantitative cytomegalovirus antigenemia and DNAemia were determined in peripheral leukocytes of 25 patients stored for up to 72 h at room temperature (RT) and 4 degrees C before processing. Numbers of antigen-positive cells significantly decreased with time. The decline was greater at RT than at 4 degrees C.

[Femoral arteriovenous fistula and transplant malfunction after allogeneic kidney transplantation. A case report].

This case report deals with the clinical history of a 52-year-old woman who suffered from delayed graft function and ischaemic pain after a technically successful renal transplantation. The past history of the patient revealed that coronary catheters had repeatedly been used for investigation and treatment of myocardial infarctions. The clinical investigation reported here revealed a typical auscultatory result with an arteriovenous (AV) fistula in the right upper limb.

Endo-urological cold-knife incision for ureteral stenosis after renal transplantation.

Cold-knife incision of stenoses in the transplant ureter was performed in 11 patients with upper urinary tract obstruction in renal transplants. The operations were complicated by bleeding in 2 patients and the graft had to be removed in 1 of them. The stenoses could be treated successfully in 10 of the 11 patients (91%) and the mean serum creatinine concentration decreased significantly from 3.

[Urologic complications after kidney transplantation. Experiences in a center with 539 recipients].

A total of 539 renal transplantations were performed at the Department of Urology of the University Hospital of Hamburg between 1984 and 1991. 132 (24.5%) patients developed urological complications (by definition, complications occurring as a result of the operative procedure).

[Diagnosis of graft rejection].

The topic of renal transplant rejection diagnosis is reviewed. The immunological and morphological findings and the clinical presentation of hyperacute, acute and chronic rejection are described. The indications for, and the value and limitations of diagnostic techniques such as core biopsy, fine-needle aspiration cytology, duplex Doppler sonography and immunological findings are analyzed.

[Cytomegalovirus diseases following allogenic kidney transplantation].

Lymphotrophic virus infections, especially when they are caused by the cytomegalovirus, are severe complications after allogenic organ transplantation. First infections are mainly caused by donation of CMV-positive organs to CMV negative recipients. The regular incubation time of 30 to 40 days can be significantly shorter after therapeutic application with high dose prednisone or mono/polyclonal antibodies for treatment of rejection.

Hemofiltration in myoglobinuric acute renal failure.

The frequency of myoglobinuric renal failure is estimated between 8 and 20%. Despite early onset of therapy often the use of renal substitution by hemodialysis or hemofiltration is required. This study of the clinical course of nine patients with myoglobinuric acute renal failure reveals continuous arterio-venous hemofiltration (CAVH) to have an effective clearance for myoglobin.

Results of a long-term administration of omega-3 fatty acids in haemodialysis patients with dyslipoproteinaemia.

In this study we evaluated the effect of a daily administration of 1 g salmon-oil concentrate containing 0.2 g eicosapentaenoic acid (EPA) on the blood pressure, serum cholesterol, HDL and LDL cholesterol, triglycerides and magnesium of ten patients on chronic haemodialysis. Systolic and diastolic blood pressure values decreased significantly from 156 +/- 27.