Dataset Information

Cryptococcal Meningitis in Kidney Transplant Recipients: A Two-Decade Cohort Study in France.

ABSTRACT: Cryptococcosis is the third most common cause of invasive fungal infection in solid organ transplant recipients and cryptococcal meningitis (CM) its main clinical presentation. CM outcomes, as well as its clinical features and radiological characteristics, have not yet been considered on a large scale in the context of kidney transplantation (KT). We performed a nationwide retrospective study of adult patients diagnosed with cryptococcosis after KT between 2002 and 2020 across 30 clinical centers in France. We sought to describe overall and graft survival based on whether KT patients with cryptococcosis developed CM or not. Clinical indicators of CNS involvement and brain radiological characteristics were assessed. Eighty-eight cases of cryptococcosis were diagnosed during the study period, with 61 (69.3%) cases of CM. Mortality was high (32.8%) at 12 months (M12) but not significantly different whether or not patients presented with CM. Baseline hyponatremia and at least one neurological symptom were independently associated with CM (p < 0.001). Positive serum cryptococcal antigen at diagnosis was also significantly associated with CM (p < 0.001). On magnetic resonance imaging (MRI), three patterns of brain injury were identified: parenchymal, meningeal, and vascular lesions. Although CM does not affect graft function directly, it entails a grim prognosis.

SUBMITTER: Tardieu L

PROVIDER: S-EPMC9227085 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

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Cryptococcal Meningitis in Kidney Transplant Recipients: A Two-Decade Cohort Study in France.

Tardieu Laurène L Divard Gillian G Lortholary Olivier O Scemla Anne A Rondeau Éric É Accoceberry Isabelle I Agbonon Rémi R Alanio Alexandre A Angoulvant Adela A Albano Laetitia L Attias Philippe P Bellanger Anne Pauline AP Bertrand Dominique D Bonhomme Julie J Botterel Françoise F Bouvier Nicolas N Buchler Matthias M Chouaki Taieb T Crépin Thomas T Durieux Marie-Fleur MF Desoubeaux Guillaume G Doppelt Gary G Favennec Loïc L Fekkar Arnaud A Fourdinier Ophélie O Frimat Marie M Gangneux Jean-Pierre JP Garandeau Claire C Hasseine Lilia L Hennequin Christophe C Iriart Xavier X Kamar Nassim N Kaminski Hannah H Kormann Raphael R Lachaud Laurence L Legendre Christophe C Le Quintrec Donnette Moglie M Leroy Jordan J Levi Charlène C Machouart Marie M Marx David D Menotti Jean J Moal Valérie V Morio Florent F Mrozek Natacha N Nicolas Muriel M Poirier Philippe P Peraldi Marie-Noelle MN Poussot Benjamin B Ranque Stéphane S Rerolle Jean-Philippe JP Sendid Boualem B Snanoudj Renaud R Tourret Jérôme J Vasse Marc M Vigneau Cécile C Villard Odile O Mesnard Laurent L Lanternier Fanny F Rafat Cédric C

Pathogens (Basel, Switzerland) 20220617 6

Cryptococcosis is the third most common cause of invasive fungal infection in solid organ transplant recipients and cryptococcal meningitis (CM) its main clinical presentation. CM outcomes, as well as its clinical features and radiological characteristics, have not yet been considered on a large scale in the context of kidney transplantation (KT). We performed a nationwide retrospective study of adult patients diagnosed with cryptococcosis after KT between 2002 and 2020 across 30 clinical center ...[more]

PMID: 35745553

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Project description:Antibody response to the inactivated influenza vaccine is not well described in kidney transplant recipients administered newer, but commonly used, immunosuppression medications. We hypothesized that kidney transplant recipient participants administered tacrolimus-based regimens would have decreased antibody response compared with healthy controls.Prospective cohort study of 53 kidney transplant recipients and 106 healthy control participants during the 2006-2007 influenza season. All participants received standard inactivated influenza vaccine.Kidney transplant recipients administered tacrolimus-based regimens at a single academic medical center and healthy controls.Presence of kidney transplant.Proportion of participants achieving seroresponse (4-fold increase in antibody titer) and seroprotection (antibody titer > or = 1:32) 1 month after vaccination.Antibody titers before and 1 month after vaccination by means of hemagglutinin inhibition assays for influenza types A/H1N1, A/H3N2, and B.A smaller proportion of the transplantation group compared with the healthy control group developed the primary outcomes of seroresponse or seroprotection for all 3 influenza types at 1 month after vaccination. The response to influenza type A/H3N2 was statistically different; the transplantation group had 69% decreased odds of developing seroresponse (95% confidence interval, 0.16 to 0.62; P = 0.001) and 78% decreased odds of developing seroprotection (95% confidence interval, 0.09 to 0.53; P = 0.001) compared with healthy controls. When participants less than 6 months from the time of transplantation were considered, this group had a significantly decreased response to the vaccine compared with healthy controls.Decreased sample size, potential for confounders, outcome measure used is the standard but does not give information about vaccine efficacy.Kidney transplant recipients, especially within 6 months of transplantation, had diminished antibody response to the 2006-2007 inactivated influenza vaccine.

Dataset Information

Cryptococcal Meningitis in Kidney Transplant Recipients: A Two-Decade Cohort Study in France.

Publications

Cryptococcal Meningitis in Kidney Transplant Recipients: A Two-Decade Cohort Study in France.

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