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Data are scarce on cytomegalovirus (CMV) replication in patients receiving CD19-directed chimeric antigen receptor (CAR) T cell treatment. Here we describe the incidence, severity, and management of CMV infection in patients with aggressive B cell lymphoma treated with CAR T cell therapy. In this retrospective observational study, we analyzed CMV viral load and its clinical impact in patients with aggressive B cell lymphoma receiving CAR T cell therapy between July 2018 and December 2021 at...
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Information regarding COVID-19 continues to change rapidly. This document will be updated with new information whenever possible. Please contact your transplant center with specific questions or concerns. Human coronaviruses are common viruses that cause the common cold, and do not usually cause serious symptoms. A novel coronavirus named SARS-CoV-2 causes the disease called Coronavirus disease 2019 (COVID-19). This coronavirus appeared in December 2019 and quickly spread all over the...
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The COVID-19 pandemic has had a significant impact on donor evaluation and organ procurement.1 As the virus entrenches itself, the risk of donor-derived infection must be balanced with the risk of morbidity and mortality while remaining on the transplant waitlist. Decisions to proceed with organ transplant locally must balance the existing capacity of the center, availability of testing for donors and candidates, and sufficient capacity to provide adequate occupational protection to recovery...
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Vaccination can prevent influenza in solid organ transplant (SOT) recipients. Using a modified season‐specific approach over nine consecutive influenza seasons, we investigated influenza vaccination coverage and effectiveness in a population‐based nationwide cohort study that included all SOT recipients aged ≥18 years who were living in Denmark from December 1, 2007 to April 1, 2016. The primary outcome was the season‐specific risk of all‐cause pneumonia admission. Secondary outcomes were...
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Hepatitis D is caused by the hepatitis D virus (HDV); it is the most severe form of viral hepatitis in humans, running an accelerated course to cirrhosis. There is no efficacious therapy, and liver transplantation provides the only therapeutic option for terminal HDV disease. However, HDV infection is prevalent in poor countries of the world with no access to liver transplant programs; liver grafting has been performed in high-income countries, where the prevalence of the infection has much...
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Background. BK polyomavirus (BKPyV) infection and BK polyomavirus nephropathy (BKPyVAN) are important causes of allograft dysfunction and premature allograft loss in renal transplant recipients. Results and Discussion. Controlled clinical trials to evaluate new agents for prevention and treatment are needed but are hampered by the lack of outcome measures that accurately assess the effect of the intervention, are clinically relevant, and are acceptable from a regulatory...
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BACKGROUND: Cytomegalovirus (CMV) donor-positive/recipient-negative (D+R-) serostatus is independently associated with worse allograft and patient survival across solid organ transplant (SOT) types. We characterized trends in CMV D+R- serostatus among adult SOT recipients performed in the United States. METHODS: Donor (D) and recipient (R) CMV serostatus and demographic factors were obtained from the Scientific Registry of Transplant Recipients for persons ≥18 y undergoing a first SOT...
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Many US deceased organ donors carry hepatitis C virus (HCV) infection, which can infect recipients during transplant. Historically, recipients of HCV-infected organ transplants only had access to ineffective interferon-based antiviral regimens and have experienced elevated rates of allograft failure and death. Most HCV-infected donor organs were discarded. However, starting in 2016, the availability of direct-acting antiviral therapy enabled transplant trials of HCV-infected kidneys into...
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Background. Therapies for refractory cytomegalovirus infections (with or without resistance [R/R]) in transplant recipients are limited by toxicities. Maribavir has multimodal anti-cytomegalovirus activity through the inhibition of UL97 protein kinase. Methods. In this phase 3, open-label study, hematopoietic-cell and solid-organ transplant recipients with R/R cytomegalovirus were randomized 2:1 to maribavir 400 mg twice daily or investigator-assigned therapy (IAT;...
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This document provides guidance for transplant practitioners on monkeypox (MPX) and organ transplants. We acknowledge that our current understanding of the disease is incomplete. This guidance will require revision as new evidence emerges. In these guidelines, we adopt a conservative approach to organ donation with regards to MPX transmission. We err on the side of safety. We recognize that many institutions already have experience with MPX. This document makes suggestions, but its aim is...
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Hepatitis E virus (HEV) infection in immunocompetent patients can lead to chronic hepatitis and liver failure. However, the burden of HEV infection in cancer patients is largely unknown. We studied the characteristics of HEV infection in patients at a tertiary care cancer center in the United States. This retrospective study included adult cancer patients with HEV infection diagnosed between September 2011 to September 2021. A total of 405 patients were tested for HEV, and 63 (16%) had...
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Solid organ transplantation is a life-saving treatment for people with end-stage organ disease. Immune-mediated transplant rejection is a common complication that decreases allograft survival. Although immunosuppression is required to prevent rejection, it also increases the risk of infection. Some infections, such as cytomegalovirus and BK virus, can promote inflammatory gene expression that can further tip the balance toward rejection. BK virus and other infections can induce damage that...
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