Allograft loss in renal transplant recipients with Cryptococcus neoformans associated immune reconstitution syndrome

Nina Singh, Olivier Lortholary, Barbara D. Alexander, Krishan L. Gupta, George T. John, Kenneth Pursell, Patricia Munoz, Goran B. Klintmalm, Valentina Stosor, Ramon DelBusto, Ajit P. Limaye, Jyoti Somani, Marshall Lyon, Sally Houston, Andrew A. House, Timothy L. Pruett, Susan Orloff, Atul Humar, Lorraine Dowdy, Julia Garcia-DiazRobert A. Fisher, Shahid Husain

Research output: Contribution to journalArticlepeer-review

79 Scopus citations

Abstract

This study describes the association of allograft loss and immune reconstitution syndrome (1RS) in the course of Cryptococcosis neoformans infection in renal transplant recipients. Patients comprised 54 renal allograft recipients with cryptococcosis in a prospective, multicenter study. IRS developed in 5.5% (3/54) of the renal transplant recipient with C. neoformans infection. The renal allograft was lost to chronic rejection in 66% (2/3) of the patients with cryptococcosis who developed IRS compared to 5.9% (3/51) of those who did not (P=0.012). Kaplan-Meier survival analysis showed that subsequent to cryptococcal infection the probability of allograft survival was significantly lower in patients who developed 1RS compared to those who did not develop IRS (P=0.0004). Temporal association of graft loss with IRS suggests a common pathophysiologic basis for these entities with implications relevant for the optimal management of renal transplant recipients with cryptococcosis.

Original languageEnglish (US)
Pages (from-to)1131-1133
Number of pages3
JournalTransplantation
Volume80
Issue number8
DOIs
StatePublished - Oct 27 2005

Keywords

  • Cryptococcus
  • Fungal infection
  • Transplants

ASJC Scopus subject areas

  • Transplantation

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