Allograft loss in renal transplant recipients with Cryptococcus neoformans associated immune reconstitution syndrome

Nina Singh; Olivier Lortholary; Barbara D. Alexander; Krishan L. Gupta; George T. John; Kenneth Pursell; Patricia Munoz; Goran B. Klintmalm; Valentina Stosor; Ramon DelBusto; Ajit P. Limaye; Jyoti Somani; Marshall Lyon; Sally Houston; Andrew A. House; Timothy L. Pruett; Susan Orloff; Atul Humar; Lorraine Dowdy; Julia Garcia-Diaz; Robert A. Fisher; Shahid Husain

doi:10.1097/01.tp.0000180530.17683.02

Allograft loss in renal transplant recipients with Cryptococcus neoformans associated immune reconstitution syndrome

Nina Singh, Olivier Lortholary, Barbara D. Alexander, Krishan L. Gupta, George T. John, Kenneth Pursell, Patricia Munoz, Goran B. Klintmalm, Valentina Stosor, Ramon DelBusto, Ajit P. Limaye, Jyoti Somani, Marshall Lyon, Sally Houston, Andrew A. House, Timothy L. Pruett, Susan Orloff, Atul Humar, Lorraine Dowdy, Julia Garcia-DiazRobert A. Fisher, Shahid Husain

Surgery

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Abstract

This study describes the association of allograft loss and immune reconstitution syndrome (1RS) in the course of Cryptococcosis neoformans infection in renal transplant recipients. Patients comprised 54 renal allograft recipients with cryptococcosis in a prospective, multicenter study. IRS developed in 5.5% (3/54) of the renal transplant recipient with C. neoformans infection. The renal allograft was lost to chronic rejection in 66% (2/3) of the patients with cryptococcosis who developed IRS compared to 5.9% (3/51) of those who did not (P=0.012). Kaplan-Meier survival analysis showed that subsequent to cryptococcal infection the probability of allograft survival was significantly lower in patients who developed 1RS compared to those who did not develop IRS (P=0.0004). Temporal association of graft loss with IRS suggests a common pathophysiologic basis for these entities with implications relevant for the optimal management of renal transplant recipients with cryptococcosis.

Original language	English (US)
Pages (from-to)	1131-1133
Number of pages	3
Journal	Transplantation
Volume	80
Issue number	8
DOIs	https://doi.org/10.1097/01.tp.0000180530.17683.02
State	Published - Oct 27 2005

Keywords

Cryptococcus
Fungal infection
Transplants

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10.1097/01.tp.0000180530.17683.02

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Singh, N., Lortholary, O., Alexander, B. D., Gupta, K. L., John, G. T., Pursell, K., Munoz, P., Klintmalm, G. B., Stosor, V., DelBusto, R., Limaye, A. P., Somani, J., Lyon, M., Houston, S., House, A. A., Pruett, T. L., Orloff, S., Humar, A., Dowdy, L., ... Husain, S. (2005). Allograft loss in renal transplant recipients with Cryptococcus neoformans associated immune reconstitution syndrome. Transplantation, 80(8), 1131-1133. https://doi.org/10.1097/01.tp.0000180530.17683.02

Singh, N, Lortholary, O, Alexander, BD, Gupta, KL, John, GT, Pursell, K, Munoz, P, Klintmalm, GB, Stosor, V, DelBusto, R, Limaye, AP, Somani, J, Lyon, M, Houston, S, House, AA, Pruett, TL, Orloff, S, Humar, A, Dowdy, L, Garcia-Diaz, J, Fisher, RA & Husain, S 2005, 'Allograft loss in renal transplant recipients with Cryptococcus neoformans associated immune reconstitution syndrome', Transplantation, vol. 80, no. 8, pp. 1131-1133. https://doi.org/10.1097/01.tp.0000180530.17683.02

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title = "Allograft loss in renal transplant recipients with Cryptococcus neoformans associated immune reconstitution syndrome",

abstract = "This study describes the association of allograft loss and immune reconstitution syndrome (1RS) in the course of Cryptococcosis neoformans infection in renal transplant recipients. Patients comprised 54 renal allograft recipients with cryptococcosis in a prospective, multicenter study. IRS developed in 5.5% (3/54) of the renal transplant recipient with C. neoformans infection. The renal allograft was lost to chronic rejection in 66% (2/3) of the patients with cryptococcosis who developed IRS compared to 5.9% (3/51) of those who did not (P=0.012). Kaplan-Meier survival analysis showed that subsequent to cryptococcal infection the probability of allograft survival was significantly lower in patients who developed 1RS compared to those who did not develop IRS (P=0.0004). Temporal association of graft loss with IRS suggests a common pathophysiologic basis for these entities with implications relevant for the optimal management of renal transplant recipients with cryptococcosis.",

keywords = "Cryptococcus, Fungal infection, Transplants",

author = "Nina Singh and Olivier Lortholary and Alexander, {Barbara D.} and Gupta, {Krishan L.} and John, {George T.} and Kenneth Pursell and Patricia Munoz and Klintmalm, {Goran B.} and Valentina Stosor and Ramon DelBusto and Limaye, {Ajit P.} and Jyoti Somani and Marshall Lyon and Sally Houston and House, {Andrew A.} and Pruett, {Timothy L.} and Susan Orloff and Atul Humar and Lorraine Dowdy and Julia Garcia-Diaz and Fisher, {Robert A.} and Shahid Husain",

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AU - Singh, Nina

AU - Lortholary, Olivier

AU - Alexander, Barbara D.

AU - Gupta, Krishan L.

AU - John, George T.

AU - Pursell, Kenneth

AU - Munoz, Patricia

AU - Klintmalm, Goran B.

AU - Stosor, Valentina

AU - DelBusto, Ramon

AU - Limaye, Ajit P.

AU - Somani, Jyoti

AU - Lyon, Marshall

AU - Houston, Sally

AU - House, Andrew A.

AU - Pruett, Timothy L.

AU - Orloff, Susan

AU - Humar, Atul

AU - Dowdy, Lorraine

AU - Garcia-Diaz, Julia

AU - Fisher, Robert A.

AU - Husain, Shahid

PY - 2005/10/27

Y1 - 2005/10/27

N2 - This study describes the association of allograft loss and immune reconstitution syndrome (1RS) in the course of Cryptococcosis neoformans infection in renal transplant recipients. Patients comprised 54 renal allograft recipients with cryptococcosis in a prospective, multicenter study. IRS developed in 5.5% (3/54) of the renal transplant recipient with C. neoformans infection. The renal allograft was lost to chronic rejection in 66% (2/3) of the patients with cryptococcosis who developed IRS compared to 5.9% (3/51) of those who did not (P=0.012). Kaplan-Meier survival analysis showed that subsequent to cryptococcal infection the probability of allograft survival was significantly lower in patients who developed 1RS compared to those who did not develop IRS (P=0.0004). Temporal association of graft loss with IRS suggests a common pathophysiologic basis for these entities with implications relevant for the optimal management of renal transplant recipients with cryptococcosis.

AB - This study describes the association of allograft loss and immune reconstitution syndrome (1RS) in the course of Cryptococcosis neoformans infection in renal transplant recipients. Patients comprised 54 renal allograft recipients with cryptococcosis in a prospective, multicenter study. IRS developed in 5.5% (3/54) of the renal transplant recipient with C. neoformans infection. The renal allograft was lost to chronic rejection in 66% (2/3) of the patients with cryptococcosis who developed IRS compared to 5.9% (3/51) of those who did not (P=0.012). Kaplan-Meier survival analysis showed that subsequent to cryptococcal infection the probability of allograft survival was significantly lower in patients who developed 1RS compared to those who did not develop IRS (P=0.0004). Temporal association of graft loss with IRS suggests a common pathophysiologic basis for these entities with implications relevant for the optimal management of renal transplant recipients with cryptococcosis.

KW - Cryptococcus

KW - Fungal infection

KW - Transplants

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Allograft loss in renal transplant recipients with Cryptococcus neoformans associated immune reconstitution syndrome

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