Daniele Cappellani, Chiara Terrenzio, Elena Gianetti, Walter Baronti, Valerio Borrelli, Lorella Marselli, Fabio Vistoli, Alessandro Campatelli, Ugo Boggi, Piero Marchetti
{"title":"Subcapsular Renal Hematoma in Simultaneous Pancreas Kidney Transplantation.","authors":"Daniele Cappellani, Chiara Terrenzio, Elena Gianetti, Walter Baronti, Valerio Borrelli, Lorella Marselli, Fabio Vistoli, Alessandro Campatelli, Ugo Boggi, Piero Marchetti","doi":"10.1155/2020/6152035","DOIUrl":"https://doi.org/10.1155/2020/6152035","url":null,"abstract":"<p><p>Subcapsular renal hematoma (SRH) is a challenging condition, which may jeopardize kidney function or constitute a life-threatening event. This is particularly true in single-kidney patients, such as kidney-transplant recipients. SRH may exert an excessive pressure on the surrounding parenchyma, thus resulting in hypoperfusion and ischemia, with high risk of acute kidney failure and graft loss. Moreover, SRH may precede an overt renal rupture with subsequent hemorrhage and hemodynamic instability. The indication to an interventional management for this condition is still a matter of debate, with some authors advocating the high possibilities of spontaneous resolution and others advocating the high-risk of graft loss and even internal bleeding in case of overt renal rupture. Herein, we report the case of a 51-year-old simultaneous pancreas-kidney transplantation recipient who presented a SRH following a mild trauma. The therapeutic choices were carefully balanced on the specific case, and the conservative management proved successful.</p>","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"2020 ","pages":"6152035"},"PeriodicalIF":0.0,"publicationDate":"2020-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/6152035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37974903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jeevan Prakash Gopal, David Taube, John Martin, Simona Deplano, Saral Desai, Vassilios Papalois, Anand Sivaprakash Rathnasamy Muthusamy
{"title":"Transfusion-Dependent Anemia in a Simultaneous Pancreas and Kidney Transplant Recipient.","authors":"Jeevan Prakash Gopal, David Taube, John Martin, Simona Deplano, Saral Desai, Vassilios Papalois, Anand Sivaprakash Rathnasamy Muthusamy","doi":"10.1155/2020/2841456","DOIUrl":"https://doi.org/10.1155/2020/2841456","url":null,"abstract":"A case of transfusion-dependent anemia in a simultaneous pancreas and kidney (SPK) transplant recipient that masqueraded as gastrointestinal bleeding (GIB) is described. The anemia was attributed to bleeding from the donor duodenal cuff based on balloon enteroscopy findings. The patient underwent multiple contrast-enhanced computed tomography scans and multiple endoscopies with confounding features until, eventually, the diagnosis was established. We discuss the diagnostic difficulties and the therapeutic dilemma, along with the pitfalls in ascertaining the final diagnosis.","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"2020 ","pages":"2841456"},"PeriodicalIF":0.0,"publicationDate":"2020-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2841456","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37867418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karen Flores Rosario, Katherine C Michelis, Carol Bjorkman, Faris G Araj
{"title":"Cutaneous Vasculitis and Central Nervous System Infarctions due to Varicella Zoster Virus Vasculopathy in an Immunocompromised Patient.","authors":"Karen Flores Rosario, Katherine C Michelis, Carol Bjorkman, Faris G Araj","doi":"10.1155/2020/5049627","DOIUrl":"https://doi.org/10.1155/2020/5049627","url":null,"abstract":"<p><p>Varicella zoster virus (VZV) infection commonly presents as varicella during childhood, and zoster, later in life. Here, we present a rare and interesting case of VZV infection that manifested with both cerebral and spinal infarctions and cutaneous vasculitis in the absence of a classic vesicular rash in an immunocompromised patient.</p>","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"2020 ","pages":"5049627"},"PeriodicalIF":0.0,"publicationDate":"2020-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/5049627","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37859251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sara Ghaderkhani, Zahra Ahmadinejad, Habibollah Dashti, Masoomeh Safaei, Fereshteh Ghiasvand
{"title":"Wound Infection with an Unusual Pathogen after Liver Transplantation.","authors":"Sara Ghaderkhani, Zahra Ahmadinejad, Habibollah Dashti, Masoomeh Safaei, Fereshteh Ghiasvand","doi":"10.1155/2020/8396507","DOIUrl":"https://doi.org/10.1155/2020/8396507","url":null,"abstract":"<p><p>Mucormycosis is a rare and highly invasive fungal infection caused by Mucorales fungi of the class Zygomycetes. Cutaneous mucormycosis typically has a good survival rate when diagnosed early. In this report, we presented a patient with surgical site mucormycosis after liver transplant surgery. Our patient was a 50-year-old man with cirrhosis due to nonalcoholic steatohepatitis who received liver transplant from a deceased donor. On the 8<sup>th</sup> day of transplant, the patient had fever and purulent discharge from the surgical site. The wound became black and necrotic in the next day. A microbiologic study showed mycelium in wound culture. The smear of the discharge was positive for aseptate hyphae, and the report of fungal culture revealed Rhizopus sp. In the histopathologic examination, mucormycosis was confirmed. The combination of antifungal and surgical debridement was a successful treatment in this case. Cutaneous fungal infections should be considered in the differential diagnosis of any nonhealing or black scar-infected wound that does not respond to broad-spectrum antibiotics.</p>","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"2020 ","pages":"8396507"},"PeriodicalIF":0.0,"publicationDate":"2020-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7154978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37852054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jorge M Mallea, Anna Kornafeld, Andras Khoor, David B Erasmus
{"title":"Lung Transplantation in a Patient with COPA Syndrome.","authors":"Jorge M Mallea, Anna Kornafeld, Andras Khoor, David B Erasmus","doi":"10.1155/2020/3624795","DOIUrl":"https://doi.org/10.1155/2020/3624795","url":null,"abstract":"<p><p>COPA syndrome is a newly discovered, rare genetic autoimmune disorder, which can affect the lungs, joints, and kidneys. It is difficult to recognize, and the survival benefit of lung transplantation for these patients is not yet known. We present a case of a 24-year-old woman who received bilateral lung transplant for COPA syndrome. At 15 months posttransplant, her pulmonary function is stable with no episodes of acute cellular- or antibody-mediated rejection and no evidence of disease recurrence.</p>","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"2020 ","pages":"3624795"},"PeriodicalIF":0.0,"publicationDate":"2020-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/3624795","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37852052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Harkiran Sran, Miriam Manook, Pankaj Chandak, Raphael Uwechue, Martin Drage, Ioannis Loukopoulos, Nicos Kessaris
{"title":"Biological Mesh Repair of a Large Incisional Hernia Containing a Kidney Transplant in the Presence of Inflammation.","authors":"Harkiran Sran, Miriam Manook, Pankaj Chandak, Raphael Uwechue, Martin Drage, Ioannis Loukopoulos, Nicos Kessaris","doi":"10.1155/2020/5675613","DOIUrl":"https://doi.org/10.1155/2020/5675613","url":null,"abstract":"<p><p>The incidence of incisional hernia after kidney transplantation varies between 1.1% and 3.8%. These are usually repaired electively using polypropylene mesh. We present here a case where a patient presented as an emergency, with a large painful incisional hernia over his kidney transplant, and evidence of local erythema and systemic inflammation. As this could have represented either infection or rejection, the patient was started on antibiotics and subsequently underwent graft nephrectomy and hernia repair using a biological (porcine-derived) acellular dermal matrix, Strattice™, with a satisfactory outcome. In addition, histology showed evidence of allograft rejection. This is the first reported case of an incisional hernia containing a rejecting kidney allograft, managed with nephrectomy and biological mesh repair.</p>","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"2020 ","pages":"5675613"},"PeriodicalIF":0.0,"publicationDate":"2020-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/5675613","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37852053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jesse E Harris, Jonathan L Balk, Constance M Mobley, Kirk Heyne
{"title":"The Liver That Cured Christmas: Case Report of Orthotopic Liver Transplant in a Patient with Hemophilia B.","authors":"Jesse E Harris, Jonathan L Balk, Constance M Mobley, Kirk Heyne","doi":"10.1155/2020/7873803","DOIUrl":"https://doi.org/10.1155/2020/7873803","url":null,"abstract":"<p><p>Herein, we discuss a case of a 39-year-old male with hemophilia B, who developed end-stage liver disease secondary to nonalcoholic steatohepatitis, that underwent orthotopic liver transplantation (OLT) as a curative means for his liver disease and coagulation disorder. Existing case reports have demonstrated favorable outcomes in patients outside of the United States who received continuous infusions of recombinant factor IX replacement in the perioperative setting after liver transplant. Given limitations in the stability of the recombinant factor IX products in the United States, a dosing strategy was comprised of once daily bolus dosing to achieve satisfactory factor IX levels. Within 48 hours of initial surgery, the patient had sustained factor IX levels above 70% of normal and the patient required no further dosing of factor IX products to date. This strategy helped facilitate less frequent dosing as well as achieved targeted factor levels while synthetic function of the transplanted liver recovered.</p>","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"2020 ","pages":"7873803"},"PeriodicalIF":0.0,"publicationDate":"2020-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/7873803","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37809067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H Charli Karpel, Nicole M Ali, Nikki Lawson, Vasishta S Tatapudi, Rex Friedlander, Mary Carmelle Philogene, Robert A Montgomery, Bonnie E Lonze
{"title":"Successful A2 to B Deceased Donor Kidney Transplant after Desensitization for High-Strength Non-HLA Antibody Made Possible by Utilizing a Hepatitis C Positive Donor.","authors":"H Charli Karpel, Nicole M Ali, Nikki Lawson, Vasishta S Tatapudi, Rex Friedlander, Mary Carmelle Philogene, Robert A Montgomery, Bonnie E Lonze","doi":"10.1155/2020/3591274","DOIUrl":"https://doi.org/10.1155/2020/3591274","url":null,"abstract":"<p><p>Desensitization using plasma exchange can remove harmful antibodies prior to transplantation and mitigate risks for hyperacute and severe early acute antibody-mediated rejection. Traditionally, the use of plasma exchange requires a living donor so that the timing of treatments relative to transplant can be planned. Non-HLA antibody is increasingly recognized as capable of causing antibody-mediated renal allograft rejection and has been associated with decreased graft longevity. Our patient had high-strength non-HLA antibody deemed prohibitive to transplantation without desensitization, but no living donors. As the patient was eligible to receive an A2 ABO blood group organ and was willing to accept a hepatitis C positive donor kidney, this afforded a high probability of receiving an offer within a short enough time frame to attempt empiric desensitization in anticipation of a deceased donor transplant. Fifteen plasma exchange treatments were performed before the patient received an organ offer, and the patient was successfully transplanted. Hepatitis C infection was treated posttransplant. No episodes of rejection were observed. At one-year posttransplant, the patient maintains good graft function. In this case, willingness to consider nontraditional donor organs enabled us to mimic living donor desensitization using a deceased donor.</p>","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"2020 ","pages":"3591274"},"PeriodicalIF":0.0,"publicationDate":"2020-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/3591274","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37788969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S Gandhi, E Behling, D Behrens, A Ferber, R Schwarting, T Budak-Alpdogan
{"title":"Late-Onset Posttransplant Lymphoproliferative Disorders after Solid Organ Transplantation in Adults: A Case Series and Review of the Literature.","authors":"S Gandhi, E Behling, D Behrens, A Ferber, R Schwarting, T Budak-Alpdogan","doi":"10.1155/2020/8247308","DOIUrl":"https://doi.org/10.1155/2020/8247308","url":null,"abstract":"<p><p>The posttransplant lymphoproliferative disorders (PTLDs) are a heterogeneous group of neoplasms that have wide variety of clinical and histological presentations. The management of PTLDs is challenging due to variety of involvement sites and histological types. The length and type of immunosuppression are correlated with the emergence of PTLDs, and most of the cases appear within the first two years after transplant. This case series describes five late-onset PTLDs with rare histological features and multiorgan involvement.</p>","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"2020 ","pages":"8247308"},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8247308","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37675327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Parvovirus Infection-Related Anemia after Kidney Transplantation.","authors":"Neeraj Sharma, Ranvir Bajwa","doi":"10.1155/2020/6437392","DOIUrl":"https://doi.org/10.1155/2020/6437392","url":null,"abstract":"<p><p>Anemia postkidney transplantation is an important issue which has been correlated with increased hospitalizations and higher mortality. Infections, including those due to parvovirus B19, CMV, and BK virus (polyomavirus), have also been associated with an increased risk of anemia. Here, we present a case of new-onset anemia in a kidney transplant recipient within 3 months of transplant. The patient was found to have multiple viral infections from parvo B19, BK virus, and rhinovirus. The anemia resolved completely after successful reduction in the parvo B19 and BK viral load. Workup for viral infections must be considered in the differential diagnosis of postkidney transplant anemia.</p>","PeriodicalId":30327,"journal":{"name":"Case Reports in Transplantation","volume":"2020 ","pages":"6437392"},"PeriodicalIF":0.0,"publicationDate":"2020-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/6437392","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37665246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}