Get in touch

Post-transplant Long-term Complications

4. A 41-year-old man had a successful second renal transplant 13 months ago, 212 mismatch, no DSA and negative FAXM. His remains stable at 143 µmol/L. He is currently on Tacrolimus (trough 8.8 ng/ml), MMF 750 bd and prednisolone 5 mg od. Routine urine cytology for BK-infected cells demonstrated decoy cells (see below).
11
Feb
145

What is a decoy cell? What are the sensitivity and specificity of this test? What are the positive and negative predictive values of this test? Describe this technique. Does it correlate well with BK nephropathy? What is the difference between decoy cells and CMV inclusion bodies? How do you manage this case?

Posted in: Post-transplant Long-term Complications , Week 4 ,
3. A 47-year-old man had a successful second renal transplant 15 months ago, 022 mismatch, no DSA and negative FAXM. His creatinine has risen from 143 µmol/L to 215 µmol/L. USS is shown below (left). Antegrade nephrostogram was performed (right). He is currently on Tacrolimus (trough 8.8 ng/ml), MMF 750 bd and prednisolone 5 mg od. There is BK viraemia (plasma PCR 5.5 log 10).
11
Feb
147

How do you manage this case?

Posted in: Post-transplant Long-term Complications , Week 4 ,
2. A 37-year-old man was admitted after one episode of haematuria. He had a successful third renal transplant 15 months ago, 212 mismatch, no DSA and negative FAXM. His creatinine has risen from 151 µmol/L to 223 µmol/L. USS showed mild dilatation of the pelvicalyceal system, not different from the previous scan. He is currently on Tacrolimus (trough 8 ng/ml), MMF 750 bd and prednisolone 5 mg od. There is BK viraemia (plasma PCR 4 log 10). The biopsy is shown below, and SV40 staining (left).
11
Feb
208

What is your differential diagnosis? How do you manage this case? Elaborate on SV40 staining the specificity, the sensitivity and where it comes from.

Posted in: Post-transplant Long-term Complications , Week 4 ,
1. What are the diseases caused by polyomaviruses in renal transplant recipients?
11
Feb
180
Posted in: Post-transplant Long-term Complications , Week 4 ,
BKV in Kidney Transplantation Discussion
11
Feb
34
Posted in: Post-transplant Long-term Complications , Week 4 ,
IV. Is It Feasible to Use CMV-Specific T-Cell Adoptive Transfer as Treatment Against Infection in SOT Recipients?
04
Feb
111

Please summarise this article. Please address the role of Adoptive immunotherapy in managing different conditions related to transplantation. View / Download

Posted in: Post-transplant Long-term Complications , Week 3 ,
III. Protocol for prophylaxis, surveillance, and treatment of CMV after renal transplantation
04
Feb
129

Please summarise this protocol Please reflect on your practice View / Download

Posted in: Post-transplant Long-term Complications , Week 3 ,
II. Treatment of Ganciclovir Resistant Cytomegalovirus Infection
04
Feb
136

Please summarise this article Please reflect on your practice View / Download

Posted in: Post-transplant Long-term Complications , Week 3 ,
I. UK GUIDELINE ON PREVENTION AND MANAGEMENT OF CYTOMEGALOVIRUS (CMV) INFECTION AND DISEASE FOLLOWING SOLID ORGAN TRANSPLANTATION
04
Feb
141

Please summarise these guidelines Please reflect on your practice View / Download

Posted in: Post-transplant Long-term Complications , Week 3 ,
5. A 68-year-old woman was admitted with diarrhoea and normal kidney function. She had a cadaveric renal transplant 3 months ago for ESRD secondary to APKD. She received a kidney from CMV positive donor (she was also CMV-positive at the time of transplantation). She received ATG for steroid-resistant CMR 3 weeks after transplantation. A routine infection screen and USS of her kidney were normal. Quantitative CMV PCR reported negative for CMV. Colonoscopy and biopsy are shown below:
04
Feb
154

What is your differential diagnosis? How do you manage this case?

Posted in: Post-transplant Long-term Complications , Week 3 ,