Renal allograft recipients are prone to opportunistic infections due to their need of immunosuppression to prevent rejection. Mucormycosis is a rare opportunistic infection caused by a fungi of the order Mucorales. Risk factors predisposing to this disease include prolonged neutropenia, chelation therapy for iron or aluminum overdose, diabetes, and patients who are immunosuppressed. Life-threatening infections can occur, as this fungi has the propensity to invade blood vessel endothelium, resulting in hematologic dissemination. Early diagnosis and prompt aggressive therapy is imperative to achieve an improved outcome. We present two cases of pulmonary mucormycosis in diabetic renal allograft recipients who were treated successfully with amphotericin B and surgical resection of the lesions with preservation of their allograft function. In this era of intensified immunosuppression, we may see an increased incidence of mucormycosis in our transplant population.
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http://dx.doi.org/10.1016/s0272-6386(97)90211-0 | DOI Listing |
Pediatr Nephrol
January 2025
Department of Pediatrics, University of California, San Diego, 3020 Children's Way MC 5173, San Diego, CA, 92123, USA.
Proliferative Glomerulonephritis with Monoclonal IgG Deposits (PGNMID) is a glomerular disease characterized by membranoproliferative and mesangioproliferative lesions, with granular capillary wall monoclonal IgG positivity and immunoglobulin light chain restriction. Most commonly a disease of older adults, we present the case of an 18-year-old patient who developed de novo PGNMID in a kidney allograft three years after kidney transplantation. There was minimal proteinuria and no serum paraproteinemia was detected, so the patient was managed conservatively.
View Article and Find Full Text PDFTranspl Int
January 2025
Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department for General and Visceral Surgery, Berlin, Germany.
Kidney transplantation is the treatment of choice for end-stage organ failure. To improve transplantation outcomes, particularly of "marginal" organs from extended criteria donors (ECD), attempts have been made to therapeutically modulate donor or graft pre-transplantation. Anti-thymocyte globulin (ATG) has a history as lymphocyte-depleting, immunosuppressive drug for treating rejection episodes post transplantation.
View Article and Find Full Text PDFTransplant Proc
January 2025
Division of Kidney and Pancreas Transplantation, Vanderbilt University Medical Center, Nashville, Tennessee.
Background: Over the last decade, the number of simultaneous heart-kidney transplants (SHKTs) has increased dramatically. There are few reports of renal allograft outcomes in these high acuity patients. The goal of the present study was to identify variables that were related to early adverse outcomes (EAOs), including delayed graft function (DGF), primary non-function (PNF), and renal allograft futility (RAF) after SHKTs.
View Article and Find Full Text PDFJ Clin Invest
January 2025
Division of Nephrology, Duke University, Durham, United States of America.
The role of macrophages remains incompletely understood in kidney injury and repair. Their plasticity offers an opportunity to polarize them towards mediating injury resolution in both native and transplanted kidneys undergoing ischemia and/or rejection. Here, we show that infiltrating kidney macrophages augmented their AIF-1 expression after injury.
View Article and Find Full Text PDFTranspl Int
January 2025
Department of Pathology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands.
Microvascular inflammation (MVI) in kidney transplant biopsies is mainly associated with antibody-mediated rejection (AMR), sparking debate within the Banff Classification of Renal Allograft Pathology regarding its exclusivity. This study reviewed the literature on MVI in T cell-mediated rejection (TCMR) and analyzed MVI in our transplant population. We searched English publications in MEDLINE, Embase, Web of Science, Cochrane, and Google Scholar until June 2024, focusing on glomerulitis (g), peritubular capillaritis (ptc), or MVI in kidney transplant biopsies classified as TCMR.
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