Detection of cytomegalovirus disease by real-time quantitative PCR targeting immediate early gene (ppUL83) in different samples among post-renal-transplant recipients

Renal transplantation is a treatment option for end-stage renal disease (ESRD). Cytomegalovirus (CMV) infection was analysed among symptomatic and asymptomatic post-renal-transplant recipients (PRTRs). A total of 30 PRTRs were enrolled. DNA was extracted and quantitative real-time PCR for CMV (CMV R-Gene, France) targeting ppUL83 gene was performed on whole blood, urine and saliva. The detection rate of CMV was found to be 27% (n = 8) in different samples, including whole blood, urine and saliva. Among 30 PRTRs, 53% (n = 16) of the PRTRs did not shed virus in saliva. About 7% of CMV was detected only in saliva among PRTRs who were symptomatic.

An unusual case of invasive aspergillus ulcerative tracheobronchitis without involvement of lung parenchyma in a post-renal transplant patient.

We present the case of a 54-year-old male, who presented with respiratory complaints four months after he underwent renal transplantation. Bronchoscopy showed ulcerated mucosa of the left main bronchus and computed tomography (CT) of the thorax showed foci of air within the bronchial wall. A biopsy from the lesion showed septate fungal hyphae, dichotomously branching at acute angles. A locally invasive Aspergillus ulcerative tracheobronchitis with no parenchymal involvement is an important cause of tracheobronchitis in post-renal transplant patients. An early diagnosis and institution of appropriate treatment can improve the outcome. A combination treatment of caspofungin and voriconazole can be considered if patient is not responding to voriconazole alone.

Post-renal Transplant Diabetes Mellitus-a Retrospective Study / 대한신장학회잡지

To investigate the clinical characteristics and predisposing factors for post-renal transplant diabetes mellitus (PTDM) in Kyung Hee University Medical Center, the records of all renal allograft recipients from 1985 through 1994 were reviewed. One hundred and seventy-nine nondiabetic recipients, whose allografts functioned longer than 6 months, were analyzed for the development of PTDM and the following results were obtained. Twenty two (12.3%) patients developed diabetes mellitus one week to 7 months after transplantation; sixteen of whom were diagnosed within the first 2 months of transplantation. Posttransplant diabetic patients were older (41+/-8.5 vs. 34.8+/-10.8, p<0.05) than those without PTDM. The prevalence of PTDM was significantly higher in patients who received grafts from unrelated donors (p<0.05). Mean fasting blood glucose level of diabetic group was higher than that of nondiabetic group but both of which were within normal range. In HLA phenotypes in 148 renal transplant recipients, the frequencies of HLA-Aw33, -Bw58, -DR7, and -DQw2 were higher in PTDM group, compared with non diabetic group. Family history of diabetes mellitus, the prevalence of posttransplant hypertension, the male to female ratio, and type of immune suppression were similar in both groups. To identify predisposing factors, 44 non diabetic patients matched for age, sex, and time of transplant were used as case controls. There were no differences in cyclosporine or cumulative steroid dose, weight gain after transplant, and graft function at the onset of diabetes between the patients with PTDM and case controls. Our data show that the incidence of PTDM is 12.3% and most of them develop within the first 2 months after transplantation. The risk of PTDM is higher in older patients and those with unrelated donor, higher fasting blood glucose levels, and those with HLA-Aw33, -Bw58, -DR7, DQw2 antigens. It appears to be independent of the amount of prednisone and/or cyclosporine employed.