Infectious complications after simultaneous pancreas-kidney transplantation: a role for the lectin pathway of complement activation

Transplantation
Jeffrey J W VerschurenStefan P Berger

Abstract

Mannose-binding lectin (MBL) is a recognition molecule of the lectin pathway of complement activation, and its serum levels are largely determined by frequently occurring polymorphisms of the MBL gene. We questioned whether MBL deficiency influences infectious complications in patients after simultaneous pancreas-kidney transplantation (SPKT). Infectious complications in the first year after transplantation were scored retrospectively in 152 consecutive SPKT patients who received their transplant at our center between 1990 and 2005. Pretransplant serum MBL levels were determined with enzyme-linked immunosorbent assay. Every 500 ng/mL increase in baseline MBL was associated with an odds ratio of 0.83 (P=0.045) for urinary tract infections and an odds ratio of 0.68 (P=0.029) for urosepsis. Urosepsis was significantly more common in patients with low baseline MBL (<400 ng/mL) compared with those with greater MBL levels (22.7% vs. 8.3%, P=0.015). No significant influence of MBL on the occurrence of wound infections and cytomegalovirus disease could be demonstrated. With the current study, we show that high levels of serum MBL are associated with protection against urinary tract infections and, more specifically, against urosepsis a...Continue Reading

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Citations

Aug 30, 2008·World Journal of Gastroenterology : WJG·Raymund Rabe Razonable
Dec 17, 2014·Clinical & Translational Immunology·Mario Fernández-RuizAtul Humar
Jan 5, 2014·BioMed Research International·Michael Osthoff, Marten Trendelenburg
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Dec 11, 2013·Transplantation Reviews·Meritxell IbernonDaniel Serón
Aug 1, 2011·Kidney International Supplements·Meritxell IbernonDaniel Serón
Jul 14, 2009·The Journal of Hospital Infection·L B PerdizE A S Medeiros
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Jan 15, 2013·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·M Fernández-RuizJ M Aguado
Jun 29, 2011·Clinical and Experimental Immunology·J M Kwakkel-van ErpH G Otten
Apr 10, 2012·Best Practice & Research. Clinical Gastroenterology·Bart van HoekHein W Verspaget
Nov 1, 2018·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Mario Fernández-RuizOriol Manuel
Feb 23, 2020·Expert Review of Anti-infective Therapy·Mario Fernández-RuizJosé María Aguado
Aug 18, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Matthew B Roberts, Jay A Fishman

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