[CIS PIDD] [cis-pidd] FW:

[Nicholas, Sarah Kogan]

We had a CVID patient at TCH whom we listed for liver transplant a few months ago.   His underlying diagnosis was a concern at the time.  In my review of the literature, I found 14 case reports of any solid organ transplant in CVID (there may be one or two more older reports I was unable to access online).   Of the 14, at least 6 were deceased, ranging from POD3 to 6 years out.  Two died from overwhelming aspergillus infection, others from other infections, bleeding complications, and graft dysfunction.  We decided that CVID would not be an absolute contraindication, but that we would do additional prophylaxis with voriconazole and that there would likely need to be heightened concern for both rejection and infection.  Unfortunately our patient came to us quite late / ill and had to be deactivated due to clinical decompensation.  I also spoke to Charlotte at the time and we wondered if there was more experience out there.   

Sarah

Sarah K Nicholas, MD
Section of Immunology, Allergy, and Rheumatology
Baylor College of Medicine and Texas Children's Hospital
________________________________________
From: Riedl, Marc [mriedl at ucsd.edu]
Sent: Thursday, March 27, 2014 3:42 PM
To: CIS-PIDD
Cc: nuria.matamoros at ssib.es
Subject: Re: [cis-pidd] FW:

Andy is correct (as usual).  During my 12 years at UCLA, I had a few CVID patients that underwent evaluation by the lung transplant team, but ultimately were not listed or transplanted with their CVID cited as an "unacceptable risk" given the required post-transplant immunosuppression.

Marc

Marc Riedl, MD, MS
Associate Professor of Medicine
Division of Rheumatology, Allergy & Immunology
University of California, San Diego
9500 Gilman Dr, Mail Code 0732
La Jolla, CA  92093
Tel 858.822.6766  Fax 858.642.3791

From: <Saxon>, Andrew Saxon <asaxon at mednet.ucla.edu<mailto:asaxon at mednet.ucla.edu>>
Reply-To: CIS-PIDD <cis-pidd at lists.clinimmsoc.org<mailto:cis-pidd at lists.clinimmsoc.org>>
Date: Thursday, March 27, 2014 12:52 PM
To: CIS-PIDD <cis-pidd at lists.clinimmsoc.org<mailto:cis-pidd at lists.clinimmsoc.org>>
Cc: "nuria.matamoros at ssib.es<mailto:nuria.matamoros at ssib.es>" <nuria.matamoros at ssib.es<mailto:nuria.matamoros at ssib.es>>
Subject: RE: [cis-pidd] FW:

UCLA does a lot of lung transplants but I never heard of one here

Andy Saxon, MD
UCLA Dept of Med.

From: Cunningham-Rundles, Charlotte [mailto:charlotte.cunningham-rundles at mssm.edu]
Sent: Thursday, March 27, 2014 12:34 PM
To: CIS-PIDD
Cc: nuria.matamoros at ssib.es<mailto:nuria.matamoros at ssib.es>
Subject: [cis-pidd] FW:

Dr Matamoros in Mallorca asked me about  lung transplant in CVID.   Does anyone have a case ? Did it go well, or were there problems?
If so, what kinds?

Perhaps we could collect together some data,  so we are somewhat more knowledgeable about this?

We had three in NYC and wrote them up into a review, and I do not have any more information past that experience.

Charlotte

Charlotte Cunningham-Rundles, MD, PhD

Departments of Medicine and Pediatrics

The David S Gottesman Professor

The Immunology Institute

Mount Sinai School of Medicine

1425 Madison Avenue

New York, NY 10029

Phone: 212 659 9268

Fax: 212 987 5593

Email: Charlotte.Cunningham-Rundles at mssm.edu<mailto:Charlotte.Cunningham-Rundles at mssm.edu>

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