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Colonic necrosis with kayexalate-sorbitol enemas after renal transplantation

Article Abstract:

Intestinal necrosis, the death of intestinal tissue due to disease or injury, occurs in one percent of kidney transplant patients and can be life-threatening. The mechanism of intestinal tissue injury in these patients is not clear, but it does not appear to be related to a compromised blood supply in the affected area. A 48-year-old kidney transplant recipient developed an increased blood level of potassium, or hyperkalemia. He was given four enemas with Kayexalate-sorbitol (sodium polystyrene sulfonate) to remove excess potassium. The patient subsequently developed severe abdominal pain, fever and chills. X-ray revealed a large portion of necrotic tissue in the colon, which was then surgically removed. The enemas may have lead to the colon injury. Experiments with rats have indicated that sorbitol may cause damage to the colon. Until experimental data suggest otherwise, Kayexalate enemas should not be used to treat hyperkalemia after kidney transplantation. Oral administration of medications for reducing blood potassium levels is preferred. (Consumer Summary produced by Reliance Medical Information, Inc.)

Development and progression, Drug therapy, Colon (Anatomy), Colon, Sorbitol, Necrosis, Hyperkalemia, Kayexalate (Medication)

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Human herpesvirus-6 in transplantation: an emerging pathogen

Article Abstract:

Human herpesvirus-6 may cause severe complications in transplant recipients. Human herpes virus-6 causes roseola, a mild illness, in childhood, but it is also associated with diseases such as mononucleosis, autoimmune disorders, encephalitis, and lymphoma. Almost all healthy adults carry antibodies against it, and the virus can lay dormant within humans. It primarily attacks CD4 T-cells, and like HIV, suppresses their function. Thus it can predispose patients to severe infections from other viruses. This can cause severe problems in transplant patients because their immune systems are suppressed. Herpesvirus-6 infections resulting from reactivation or donor transmission are reported in 40% to 60% of bone marrow transplant recipients and 30% to 55% of kidney and liver transplant recipients. Infection can severely depress bone marrow production of blood cells or cause lung inflammation or encephalitis. It may also cause high fevers. Ganciclovir and foscarnet are the treatment drugs of choice. Monoclonal antibodies for immunohistochemical staining are available for diagnosing the virus.

Herpesviruses

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Serodiagnosis and monitoring of aspergillus infections after lung transplantation

Article Abstract:

Measuring immune proteins that respond to specific fungal infections may be helpful in identifying and monitoring the progress of fungal infections in patients following lung transplantation. Researchers compared the blood levels of the IgG immune proteins specific for the Aspergillus (A.) fumigatus fungus with other routine screening tests performed on four patients with documented A. fumigatus infections following lung transplantation. Increases in fungus-specific IgG levels consistently preceded or paralleled identification of a fungal infection while decreased levels paralleled improvement.

Diagnosis, Lungs, Aspergillosis, Lung transplantation

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