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Title: The Risk Factors for and Effects of Visceral Leishmaniasis in Graft and Renal Transplant Recipients
Authors: Silva, Avelar Alves da [UNIFESP]
Pacheco-Silva, Alvaro [UNIFESP]
Cintra Sesso, Ricardo de Castro [UNIFESP]
Esmeraldo, R. M.
Costa de Oliveira, Claudia Maria
Fernandes, P. F. C. B. C.
Oliveira, R. A.
Silva, L. S. V.
Carvalho, Valencio P.
Nery Costa, Carlos Henrique
Universidade Federal de São Paulo (UNIFESP)
Hosp Alianca Casamater
Univ Fed Piaui
Hosp Israelita Albert Einstein
Hosp Geral Fortaleza
Univ Fed Ceara
Keywords: Renal transplant recipients
Risk factors
Visceral leishmaniasis
Issue Date: 15-Mar-2013
Publisher: Lippincott Williams & Wilkins
Citation: Transplantation. Philadelphia: Lippincott Williams & Wilkins, v. 95, n. 5, p. 721-727, 2013.
Abstract: 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.
ISSN: 0041-1337
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