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Quantitative immunoglobulin G (IgG) levels before and after LT were measured, with moderate and severe HGG defined as IgG 350�C500?mg/dL and <350?mg/dL, respectively. Incidence, risk factors, and associated outcomes of moderate or worse HGG were evaluated using Kaplan�CMeier <a href="">Panobinostat supplier estimator and proportional hazards (PH) models. The 1-year cumulative incidence of moderate or worse HGG was 12% (95% confidence interval [CI]: 6�C22%); no new cases were observed between years 1 and 2. In a multivariate PH model, higher pre-transplant model for end-stage liver disease score (P?=?0.04) and treated acute rejection (P?=?0.04) were both identified as significant predictors of moderate or worse HGG. There was a strong association of IgG levels <500?mg/dL with non-opportunistic serious infection (hazard ratio [95% CI]: 3.5 [1.1�C10.6]; P?=?0.03) and mortality (3.2 [1.1�C9.4]; P?=?0.04). These associations held after adjustment for important determinants of infection and survival among the entire cohort. These results suggest that a proportion of HIV-positive LT recipients will develop clinically significant HGG after transplantation. ""M. Geyer, J. Wilpert, T. Wiech, C. Theilacker, M. Stubanus, A. Kramer-Zucker, K.-G. Fischer, O. Drognitz, A. Frydrychowicz, W. Kern, G. Walz, P. Pisarski. Rapidly progressive hepatic alveolar echinococcosis in an ABO-incompatible renal transplant recipient. Transpl Infect Dis 2011: 13: 278�C284. All rights <a href="">Ceritinib reserved Abstract: We report on the case of an ABO-incompatible renal re-transplant recipient maintained on an intensified immunosuppressive regimen for recurrent cellular rejection episodes and transplant glomerulopathy who presented with rapidly growing hepatic tumors, radiologically suggestive of hemangiosarcoma. Upon resection and pathological work-up, the lesions revealed alveolar echinococcosis, a rare but potentially life-threatening parasitosis. Usually infection with Echinococcus multilocularis remains asymptomatic for extended periods of time and can go unrecognized for years. In the case presented, we observed an atypically rapid growth pattern of E. multilocularis that might have been due to the extent of the immunosuppressive regimen, which included repetitive anti-CD20 treatments. Retrospectively performed serological studies with enzyme-linked immunosorbent assays known to provide high sensitivity and specificity for the detection of echinococcosis in the general population, yielded ambiguous results in our immunocompromised host, which could be, in part, explained by B-cell depletion and its effects on antibody production and indirect actions on cellular immunity. In conclusion, this is the first report to our knowledge of hepatic alveolar echinococcosis in a renal transplant recipient.
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