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BKV, CMV, and EBV Interactions and Their Effect on Graft Function One Year Post-renal Transplantation
Abstract: Background BK virus (BKV), Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) reactivations are common after kidney transplantation and associated with increased morbidity and mortality. Although CMV might be a risk factor for BKV and EBV, the effects of combined reactivations remain unknown. The purpose of this study is to ascertain the interaction and effects on graft function of these reactivations. Methods 3715 serum samples from 540 kidney transplant recipients were analysed for viral load by qPCR. Measurements were performed throughout eight visits during the first post-transplantation year. Clinical characteristics, including graft function (GFR), were collected in parallel....
Principles of Metabolic Surgery
For physicians and surgeons entrusted with the care of patients with morbid obesity and related diseases; also for nurses and other professionals on the team. „Principles of Metabolic Surgery“ delivers a succinct account of current knowledge and an excellent overview of modern treatment strategies for morbid obesity. Attractively designed, this user-friendly textbook provides the latest on therapy, monitoring, and management, including: -Completely up-to-date coverage of modern metabolic surgery -Current understanding of the pathophysiology of morbid obesity -Current clinical therapy strategies for conservative and surgical approaches -Recent references In concise, readable chapters, this well-illustrated textbook outlines major concerns and considerations surrounding metabolic surgery. With respect to new insights from basic and clinical research, clear guidelines and practical clinical advice are given to improve the outcome of treatment for morbid obesity.
Insufflation Pressure Above 25 Mm Hg Confers No Additional Benefit Over Lower Pressure Insufflation During Posterior Retroperitoneoscopic Adrenalectomy: a Retrospective Multi-centre Propensity Score-matched Analysis
Abstract: Background Insufflation pressures of or in excess of 25 mm Hg CO2 are routinely used during posterior retroperitoneoscopic adrenalectomy (PRA) in most centres. A critical analysis of the surgical literature provides limited evidence to support this strategy. Objective To determine whether high pressure (≥ 25 mm Hg) compared with lower pressure ( 25 mm Hg) retroperitoneoscopy reduces operating time and complications.brbrMethodsbrA multi-centre retrospective cohort study was performed using data collected over a period of almost one decade (1st November 2008 until 1st February 2018) from surgical centres in Germany. A total of 1032 patients with benign adrenal tumours were identifi...
Sex-associated Differences in Cytomegalovirus Prevention: Prophylactic Strategy is Potentially Associated with a Strong Kidney Function Impairment in Female Renal Transplant Patients
Abstract: Post-transplantation cytomegalovirus (CMV) syndrome can be prevented using the antiviral drug (val)ganciclovir. (Val)ganciclovir is typically administered following a prophylactic or a pre-emptive strategy. The prophylactic strategy entails early universal administration, the pre-emptive strategy, early treatment in case of infection. However, it is not clear which strategy is superior with respect to transplantation outcome; sex-specific effects of these prevention strategies are not known. We have retrospectively analyzed 540 patients from the multi-centre Harmony study along eight pre-defined visits: 308 were treated according to a prophylactic, 232 according to a pre-emptive st...
The Role of Soluble Mediators in the Clinical Course of EBV Infection and B Cell Homeostasis After Kidney Transplantation
Abstract: Epstein-Barr virus (EBV) reactivation can lead to serious complications in kidney transplant patients, including post-transplant lymphoproliferative disorder (PTLD). Here, we have assessed the impact of EBV on B cell homeostasis at cellular and humoral level. In a multicenter study monitoring 540 kidney transplant patients during the first post-transplant year, EBV reactivation was detected in 109 patients. Thirteen soluble factors and B cell counts were analyzed in an EBV+ sub-cohort (N = 54) before, at peak and after EBV clearance and compared to a control group (N = 50). The B cell activating factor (BAFF) was significantly elevated among EBV+ patients. No additional soluble fac...
