The Risk Factors for and Effects of Visceral Leishmaniasis in Graft and Renal Transplant Recipients

The Risk Factors for and Effects of Visceral Leishmaniasis in Graft and Renal Transplant Recipients

Autor Silva, Avelar Alves da Autor UNIFESP Google Scholar
Pacheco-Silva, Alvaro Autor UNIFESP Google Scholar
Cintra Sesso, Ricardo de Castro Autor UNIFESP Google Scholar
Esmeraldo, R. M. Google Scholar
Costa de Oliveira, Claudia Maria Google Scholar
Fernandes, P. F. C. B. C. Google Scholar
Oliveira, R. A. Google Scholar
Silva, L. S. V. Google Scholar
Carvalho, Valencio P. Google Scholar
Nery Costa, Carlos Henrique Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Hosp Alianca Casamater
Univ Fed Piaui
Hosp Israelita Albert Einstein
Hosp Geral Fortaleza
Univ Fed Ceara
Resumo Background. the aim of this study was to identify the risk factors for visceral leishmaniasis (VL) in renal transplant recipients and to analyze the impacts of this disease on graft success and patient health.Methods. This retrospective, case-control study examined 120 renal transplant patients in a VL endemic area. the treatment group included patients (n=20) who developed VL after transplantation, and the control group (n=100) was composed of renal transplant recipients without VL. This study evaluated socioeconomic, demographic, clinical, and laboratory variables. Bivariate analysis and multiple logistic regressions were performed to identify potential risk factors.Results. the average time between transplantation and Leishmania infection in the treatment group was 29.4 months. Seventeen (85%) patients were cured and 3 (15%) died. in 95% of the cases, a myelogram was used for initial identification of Leishmania forms. the significant risk factors for VL in renal transplant recipients were cytomegalovirus infection after transplantation (odds ratio [OR], 5.29; 95% confidence interval [CI], 1.27-21.97) and living with cats (OR, 5.74; 95% CI, 1.15-28.76). Bacterial infection after transplantation (OR, 3.00; 95% CI, 0.96-9.37) and unpaved streets in the neighborhood (OR, 2.14; 95% CI, 0.71-6.43) tended to increase the risk of VL, whereas a negative Rh factor tended to protect against VL (OR, 0.26; 95% CI, 0.06-1.02).Conclusion. Cytomegalovirus infection after transplantation and living with cats increased the risk of VL in renal transplant recipients living in VL endemic areas.
Assunto Renal transplant recipients
Risk factors
Visceral leishmaniasis
Idioma Inglês
Financiador Kidney Transplant Units of the Federal University of São Paulo
Federal University of Ceara
General Hospital of Fortaleza
Federal University of Piaui
Data 2013-03-15
Publicado em Transplantation. Philadelphia: Lippincott Williams & Wilkins, v. 95, n. 5, p. 721-727, 2013.
ISSN 0041-1337 (Sherpa/Romeo, fator de impacto)
Editor Lippincott Williams & Wilkins
Extensão 721-727
Fonte http://dx.doi.org/10.1097/TP.0b013e31827c16e2
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000315870900016
URI http://repositorio.unifesp.br/handle/11600/36090

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