Incidence and timing of infections after liver transplant in Italy

Background. Infections are one of the main complications that cause high morbidity and mortality in transplant recipients. This study sought to estimate the incidence of infections and their main determinants in liver transplant recipients in the first year after transplantation. Patients and methods. A prospective study was conducted on 103 consecutive patients (72% men) who underwent liver transplantation in three centers in Northern (Bologna) and Central (Rome) Italy in 2005. Person-years (PY) at risk, incidence rates (IR), IR ratios and 95% confidence intervals were computed for viral, fungal, and bacterial infections. Results. The 103 patients (median age 55 years) contributed a total of 78.2 PYs, with a median follow-up of 286 days (interquartile range: 194 to 365 days). Fifty-eight patients (56.3%) experienced one or more infections, namely, 151 events (IR 193.2 infections/100 PYs). IR for bacterial, fungal, and viral infections were 110.0, 56.3, and 26.9 infections/100 Pys, respectively. Within the first 30 days after transplantation, 37.9% patients (39/103) developed one or more events. Bacterial infections represented the most frequent event (86/151, 57.0%). Risk factors significantly associated with increased IR were gender (female), age (50 years), prolonged intensive care stay, volume of blood transfused during surgery and posttransplant, and need for retransplantation. Conclusions. These preliminary results showed the relevance of infectious events after liver transplantation especially those of bacterial etiology, and identified factors mainly associated with their occurrence

Deficiency of 6B11+invariant NK T-cells in celiac disease

The definitive version can be found at www.springerlink.comImmunoregulatory NK T-cells are deficient in certain autoimmune diseases. The purpose of this study was to investigate any deficiency of immunoregulatory NK T-cells in celiac disease. NK T-cells were identified by flow cytometry with 6B11 and Vα24 markers in blood from 18 normal and 12 celiac subjects. Blood mononuclear cells were stimulated with anti-CD3/CD28 antibodies and intracellular cytokines assessed at 4 h in seven normal and eight celiac subjects. Vα24/GAPDH mRNA was quantitated in duodenal biopsies by real time PCR in 17 control and 13 celiac subjects. NK T-cells in celiac subjects were reduced to 30% of those in normal subjects. Intracellular IL-4, IL-10 and IL-13 increased significantly by 33–41% in normal subjects, but did not change in celiac subjects. Vα24/GAPDH mRNA from celiac subjects was reduced to 5% of levels in control subjects. We conclude that immunoregulatory NK T-cells are deficient in celiac disease.Randall H. Grose, Fiona M. Thompson and Adrian G. Cummin