Oral/oesophageal candidiasis is a risk factor for severe infection after kidney transplantation.

AIM: Bacterial and fungal infections are serious, life-threatening conditions after kidney transplantation. The development of oral/oesophageal candidiasis after kidney transplantation is not a reported risk factor for subsequent severe infection. This study was performed to investigate the relationship between oral/oesophageal candidiasis after kidney transplantation and the development of subsequent infection requiring hospitalization. METHODS: This retrospective study included 522 consecutive patients who underwent kidney transplantation at Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital from 1 January 2010 to 1 February 2019. Ninety-five percentage of patients were living donor transplant recipients. Visual examination was performed to detect oral candidiasis, beginning immediately after kidney transplantation; upper gastrointestinal endoscopy was performed 8-10 months after kidney transplantation. Twenty-five patients developed candidiasis (Candida-onset group) and 497 did not (non-Candida-onset group). The follow-up periods were 67 (37-86) months in the Candida-onset group and 55 (34-89) months in the non-Candida-onset group. Severe infection was defined as bacterial or fungal infection requiring hospitalization; viral infections were excluded. RESULTS: Severe infection developed in 9/25 (36%) patients in the Candida-onset group and in 77/497 (15%) patients in the non-Candida-onset group (p = .006). Binomial logistic analysis revealed that Candida infection (odds ratio [OR] 2.53, 95% confidence interval [CI] 1.06-6.06; p = .037) and use of rituximab (OR 1.81, 95% CI 1.12-2.93; p = .016) were significant predictors of subsequent severe infection. CONCLUSION: Oral/oesophageal candidiasis is a risk factor for severe infection after kidney transplantation and suggests an over-immunosuppressive state, which should prompt evaluation of immunosuppression.

Supercritical carbon dioxide-assisted drug loading and release from biocompatible porous metal-organic frameworks.

Herein we describe the supercritical carbon dioxide (scCO2)-assisted drug loading and release from nontoxic and biocompatible porous iron(iii) polycarboxylate metal-organic frameworks (MOFs), which exhibited very high cargo loadings and gradual release. MIL-53(Fe) and MIL-100(Fe) were investigated as potential carriers for drug molecules, using ibuprofen as a model drug candidate. The loading and release behaviour of ibuprofen were monitored by thermogravimetric analyses (TGA) and high performance liquid chromatography (HPLC) measurements to quantitatively determine the ibuprofen uptake, and have been performed for the first time using scCO2-based technology. After the preparation of the MOFs within a particular solvent, the internal surface area of MIL-53(Fe) and MIL-100(Fe) increased as a result of the scCO2 drying method. Furthermore, ibuprofen could be impregnated into the pores of the MOFs by utilizing a scCO2-hexane solution. ScCO2-assisted impregnation could also be used to deliver ibuprofen to the pores of the MOFs. As a result, a large amount of ibuprofen was able to be loaded into MIL-53(Fe) and MIL-100(Fe).