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Pre-transplant end-stage renal disease-related immune risk profile in kidney transplant recipients predicts post-transplant infections.
Crepin, T; Gaiffe, E; Courivaud, C; Roubiou, C; Laheurte, C; Moulin, B; Frimat, L; Rieu, P; Mousson, C; Durrbach, A; Heng, A-E; Saas, P; Bamoulid, J; Ducloux, D.
Afiliación
  • Crepin T; INSERM, UMR1098, Federation Hospitalo-Universitaire INCREASE, Besançon, France.
  • Gaiffe E; Faculté de Médecine et de Pharmacie, Université de Franche-Comté, Besançon, France.
  • Courivaud C; Structure Fédérative de Recherche, SFR FED4234, Besançon, France.
  • Roubiou C; Department of Nephrology, Dialysis, and Renal Transplantation, CHU Besançon, Besançon, France.
  • Laheurte C; Department of Nephrology, Dialysis, and Renal Transplantation, CHU Besançon, Besançon, France.
  • Moulin B; CIC Biothérapie, INSERM CIC1431, CHU Besançon, Besançon, France.
  • Frimat L; INSERM, UMR1098, Federation Hospitalo-Universitaire INCREASE, Besançon, France.
  • Rieu P; Faculté de Médecine et de Pharmacie, Université de Franche-Comté, Besançon, France.
  • Mousson C; Structure Fédérative de Recherche, SFR FED4234, Besançon, France.
  • Durrbach A; Department of Nephrology, Dialysis, and Renal Transplantation, CHU Besançon, Besançon, France.
  • Heng AE; Faculté de Médecine et de Pharmacie, Université de Franche-Comté, Besançon, France.
  • Saas P; Structure Fédérative de Recherche, SFR FED4234, Besançon, France.
  • Bamoulid J; Department of Nephrology, Dialysis, and Renal Transplantation, CHU Besançon, Besançon, France.
  • Ducloux D; INSERM, UMR1098, Federation Hospitalo-Universitaire INCREASE, Besançon, France.
Transpl Infect Dis ; 18(3): 415-22, 2016 Jun.
Article en En | MEDLINE | ID: mdl-27027787
BACKGROUND: End-stage renal disease (ESRD) is associated with premature aging of the T-cell system. Nevertheless, the clinical significance of pre-transplant ESRD-related immune senescence is unknown. METHODS: We studied whether immune risk phenotype (IRP), a typical feature of immune senescence, may affect post-transplant infectious complications. A total of 486 patients were prospectively studied during the first year post transplant. IRP was defined as positive cytomegalovirus serology with at least 1 of the following criteria: CD4/CD8 ratio <1 and/or CD8 T-cell count >90th percentile. RESULTS: We found that 47 patients (9.7%) had pre-transplant IRP. IRP+ patients did not differ from IRP- patients for any clinical characteristics, but exhibited more pronounced immune senescence. Both opportunistic infections (43% vs. 6%, P < 0.001) and severe bacterial infection (SBI) (40% vs. 25%, P = 0.028) were more frequent in IRP(+) patients. In multivariate analysis, IRP was predictive of both opportunistic infection (hazard ratio [HR] 2.97 [95% confidence interval {CI} 1.53-5.76], P = 0.001), and SBI (HR 2.33 [95% CI 1.34-3.92], P = 0.008). Acute rejection rates were numerically much lower in IRP+ patients. A total of 418 patients (86%) had biological evaluation 1 year post transplant. Among 41 IRP+ patients, 35 (85%) remained IRP+ 1 year post transplant. CONCLUSION: Pre-transplant IRP is associated with an increased risk of post-transplant infection.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Trasplante de Riñón / Infecciones por Citomegalovirus / Citomegalovirus / Fallo Renal Crónico Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Transpl Infect Dis Asunto de la revista: TRANSPLANTE Año: 2016 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Dinamarca
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Trasplante de Riñón / Infecciones por Citomegalovirus / Citomegalovirus / Fallo Renal Crónico Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Transpl Infect Dis Asunto de la revista: TRANSPLANTE Año: 2016 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Dinamarca