Advances in Transplant Infectious Diseases

A special issue of Transplantology (ISSN 2673-3943).

Deadline for manuscript submissions: closed (31 May 2022) | Viewed by 21069

Special Issue Editors


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Guest Editor
Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, ul. Dębinki 7, 80-952 Gdańsk, Poland
Interests: kidney transplantation; transplant infectious diseases; immunosuppression; clinical nephrology; novel biomarkers; pancreatic islet transplantation
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, ul. Dębinki 7, 80-952 Gdańsk, Poland
Interests: kidney transplantation; onconephrology; anemia of chronic diseases; clinical nephrology; cystic kidney diseases
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, ul. Borowska 213, 50-529 Wrocław, Poland
Interests: transplant; nephrology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Solid organ transplants (SOTs) are life-saving interventions. New potent immunosuppressive strategies have enabled transplantations in high immunological risk patients, retransplantations, or ABO-incompatible transplantations at the expense of an increased recipients’ susceptibility to various infections. Despite targeted prophylaxis, surveillance, and risk stratification, infectious complications remain a major cause of morbidity and a principal cause of death in this population. SOT recipients experience a high burden of infections with a specific temporal pattern, with rare opportunistic pathogens and a predominance of bacteria. Over the last decade, multidrug resistance has been a rising concern, especially in a vulnerable population of SOT recipients.

In this Special Issue of the journal Transplantology, we will address the whole spectrum of infectious complications in SOT recipients, including bacterial, fungal, and viral infections. Comprehensive reviews, as well as research (be it basic, translational, or clinical research) or interesting case series or case reports are welcome, with the aim of providing readers with an up-to-date view on the screening, prophylaxis, diagnosis, and management of transplant infectious diseases.

Dr. Justyna E. Gołȩbiewska
Prof. Dr. Alicja Dębska-Ślizień
Dr. Dorota Kamińska
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Transplantology is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Bacterial, viral, and fungal infections
  • Multidrug resistance
  • Opportunistic infections
  • Prophylaxis
  • Monitoring of infection
  • Management of infection

Published Papers (5 papers)

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Research

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11 pages, 1291 KiB  
Article
Letermovir for Cytomegalovirus Prophylaxis in Lung Transplant Patients with Valganciclovir-Induced Leukopenia
by Arindam Singha, Pamela K. Burcham, April Logan, Zeinab El Boghdadly, Molly M. Howsare, David R. Nunley, Mark E. Lustberg and Brian C. Keller
Transplantology 2021, 2(2), 129-139; https://doi.org/10.3390/transplantology2020013 - 28 Apr 2021
Cited by 8 | Viewed by 3507
Abstract
Cytomegalovirus (CMV) prophylaxis with valganciclovir is the standard of practice in most transplant centers, but treatment-related leukopenia can limit valganciclovir’s use. Therefore, we evaluated letermovir, a novel antiviral agent recently approved for use in hematopoietic cell transplant patients as CMV prophylaxis, in lung [...] Read more.
Cytomegalovirus (CMV) prophylaxis with valganciclovir is the standard of practice in most transplant centers, but treatment-related leukopenia can limit valganciclovir’s use. Therefore, we evaluated letermovir, a novel antiviral agent recently approved for use in hematopoietic cell transplant patients as CMV prophylaxis, in lung transplant recipients unable to tolerate valganciclovir due to severe leukopenia. We performed a retrospective analysis of all lung transplant patients at our center who received letermovir for CMV prophylaxis between 1 December 2018 and 1 January 2020. A repeated measures mixed model was used to analyze white blood cell (WBC) trends, and descriptive statistics were used to analyze secondary endpoints, including CMV DNAemia, renal function, immunosuppression dosing, and allograft function. Seventeen patients were administered letermovir during the study period due to valganciclovir-induced leukopenia (median WBC nadir 1.1 K/uL, range <0.30–2.19 K/uL). Median WBC improvement was noted in 15 (88.2%) patients after starting letermovir. Breakthrough CMV DNAemia necessitating treatment occurred in two patients, with one of the two cases being due to patient noncompliance. CMV resistance to letermovir was detected in two patients, necessitating a change to an alternative agent in one of these patients. No major side effects were reported in any patient. Letermovir is a generally safe and effective alternative for CMV prophylaxis in lung transplant recipients unable to tolerate valganciclovir due to leukopenia. Full article
(This article belongs to the Special Issue Advances in Transplant Infectious Diseases)
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Review

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13 pages, 832 KiB  
Review
Innate Immunity Response to BK Virus Infection in Polyomavirus-Associated Nephropathy in Kidney Transplant Recipients
by Wiwat Chancharoenthana and Asada Leelahavanichkul
Transplantology 2022, 3(1), 20-32; https://doi.org/10.3390/transplantology3010003 - 6 Jan 2022
Cited by 5 | Viewed by 3982
Abstract
BK polyomavirus (BKV) mainly causes infection in uroepithelial and renal tubular epithelial cells of either immunocompetent or immunocompromised hosts. Despite asymptomatic or mild clinical features in immunocompetent hosts with BK infection, serious complications are frequently found in immunocompromised patients, especially patients with kidney [...] Read more.
BK polyomavirus (BKV) mainly causes infection in uroepithelial and renal tubular epithelial cells of either immunocompetent or immunocompromised hosts. Despite asymptomatic or mild clinical features in immunocompetent hosts with BK infection, serious complications are frequently found in immunocompromised patients, especially patients with kidney transplantation. Accordingly, BKV-associated nephropathy (BKVN) demonstrates a wide range of clinical manifestations, including ureteric stenosis and hemorrhagic cystitis. In addition, BKV re-infection in post-kidney transplantation is also a main cause of kidney allograft dysfunction and graft loss. Since the direct anti-BKV is unavailable, immune response against BKV infection is the main mechanism for organism control and might be a novel strategy to treat or suppress BKV. As such, the innate immunity, consisting of immune cells and soluble molecules, does not only suppress BKV but also enhances the subsequent adaptive immunity to eradicate the virus. Furthermore, the re-activation of BKV in BKVN of kidney-transplanted recipients seems to be related to the status of innate immunity. Therefore, this review aims to collate the most recent knowledge of innate immune response against BKV and the association between the innate immunity status of kidney-transplanted recipients and BKV re-activation. Full article
(This article belongs to the Special Issue Advances in Transplant Infectious Diseases)
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12 pages, 979 KiB  
Review
JC Polyomavirus and Transplantation: Implications for Virus Reactivation after Immunosuppression in Transplant Patients and the Occurrence of PML Disease
by James E. K. Hildreth and Donald J. Alcendor
Transplantology 2021, 2(1), 37-48; https://doi.org/10.3390/transplantology2010004 - 2 Feb 2021
Cited by 3 | Viewed by 6435
Abstract
The JC polyomavirus (JCPyV/JCV) is a member of the Polyomaviridae family and is ubiquitious in the general population, infecting 50–80% of individuals globally. A primary infection with JCV usally results in an asymptomatic, persistent infection that establishes latency in the renourinary tract. Reactivation [...] Read more.
The JC polyomavirus (JCPyV/JCV) is a member of the Polyomaviridae family and is ubiquitious in the general population, infecting 50–80% of individuals globally. A primary infection with JCV usally results in an asymptomatic, persistent infection that establishes latency in the renourinary tract. Reactivation from latency via iatrogenic immununosuppression for allograft transplantation may result in organ pathology and a potential life-threatening neuropathological disease in the form of progressive multifocal leukoencephalopathy (PML). Currently, no treatment exists for PML, a rare complication that occurs after transplantation, with an incidence of 1.24 per 1000 persons a year among solid organ transplant patients. PML is also observed in HIV patients who are immununosuppressed and are not receiving antiretroviral therapy, as well as individuals treated with biologics to suppress chronic inflammatory responses due to multiple sclerosis, Crohn’s disease, non-Hodgkin’s lymphoma, rheumatoid arthritis, and other autoimmune-mediated hematological disorders. Here, we describe the proposed mechanisms of JCV reactivation as it relates to iatrogenic immunosuppression for graft survival and the treatment of proinflammatory disease, such as biologics, proposed trafficking of JCV from the renourinary tract, JCV central nervous system dissemination and the pathology of PML in immunosuppressed patients, and potential novel therapeutics for PML disease. Full article
(This article belongs to the Special Issue Advances in Transplant Infectious Diseases)
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Other

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6 pages, 234 KiB  
Case Report
Are CMV and SARS-CoV-2 Infections Mutual Risk Factors in Kidney Transplant Recipients?
by Julia Swist, Mateusz Krotofil, Oktawia Mazanowska, Magdalena Krajewska and Dorota Kamińska
Transplantology 2022, 3(1), 103-108; https://doi.org/10.3390/transplantology3010010 - 16 Mar 2022
Cited by 1 | Viewed by 3667
Abstract
Throughout the years, much progress has been made in the field of renal transplantation; however, along with new developments, new problems have arisen. While transplantation is the optimal choice in patients suffering from end-stage renal disease, it is always connected to certain commonly [...] Read more.
Throughout the years, much progress has been made in the field of renal transplantation; however, along with new developments, new problems have arisen. While transplantation is the optimal choice in patients suffering from end-stage renal disease, it is always connected to certain commonly associated risks, in particular those caused by opportunistic infections. One such risk includes the reactivation of cytomegalovirus (CMV), an issue commonly affecting all kinds of transplant recipients. Similarly, with the rise of the ever-evolving global SARS-CoV-2 pandemic, patients must be constantly monitored for any respiratory symptoms, and observed closely under the care of their attending physician. Treating these patients has become extremely difficult due to limitations caused by COVID-19 protocols (for instance, the reduction of immunosuppression dosages and the avoidance of lymphocyte-depleting induction therapy) and the lack of knowledge surrounding this relatively new and worsening risk factor. In order to give patients optimal care, these arising problems need to be studied and addressed. Full article
(This article belongs to the Special Issue Advances in Transplant Infectious Diseases)
8 pages, 1415 KiB  
Case Report
Co-Infection of COVID-19 and Pneumocystosis Following Rituximab Infusion—A Case Report
by Michelle Dakowitz, Justyna Korus, Oktawia Mazanowska, Magdalena Krajewska and Dorota Kamińska
Transplantology 2022, 3(1), 83-90; https://doi.org/10.3390/transplantology3010008 - 24 Feb 2022
Viewed by 2259
Abstract
Immunocompromised patients with respiratory viral infections are at increased risk of fungal superinfections, including Pneumocystosis. Within the scope of the COVID-19 pandemic, Pneumocystis jirovecii co-infections are being increasingly reported. Differential diagnosis often creates a dilemma, due to multiple overlapping clinical and radiographic features. [...] Read more.
Immunocompromised patients with respiratory viral infections are at increased risk of fungal superinfections, including Pneumocystosis. Within the scope of the COVID-19 pandemic, Pneumocystis jirovecii co-infections are being increasingly reported. Differential diagnosis often creates a dilemma, due to multiple overlapping clinical and radiographic features. Awareness of fungal co-infections in the context of the COVID-19 pandemic is crucial to initiate prophylactic measures, especially in high-risk individuals. We report the second case of Pneumocystis jirovecii pneumonia and COVID-19 co-infection in a renal transplant recipient in Poland. Full article
(This article belongs to the Special Issue Advances in Transplant Infectious Diseases)
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