Malakoplakia among kidney transplant recipients: case series and literature review
We report two cases of malakoplakia after kidney transplant, a rare granulomatous condition that occurs primarily in immunocompromised patients and his thought to occur due to incomplete clearance of phagocytized bacterial residue by macrophages. Both patients were at heightened immunological risk d...
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| Format: | Article |
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1605146/full |
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| author | Ali B. Abbasi Gerardo Gamino Alan Zambeli-Ljepović Adrian M. Whelan Garrett R. Roll Peter J. Altshuler |
| author_facet | Ali B. Abbasi Gerardo Gamino Alan Zambeli-Ljepović Adrian M. Whelan Garrett R. Roll Peter J. Altshuler |
| author_sort | Ali B. Abbasi |
| collection | DOAJ |
| description | We report two cases of malakoplakia after kidney transplant, a rare granulomatous condition that occurs primarily in immunocompromised patients and his thought to occur due to incomplete clearance of phagocytized bacterial residue by macrophages. Both patients were at heightened immunological risk due to being highly sensitized or prior episodes of rejection, both experienced E. Coli infections in the first 4 months after transplant, and both presented with granulomatous masses that were biopsied and confirmed to be malakoplakia. Both were treated with suppressive antibiotics and required urinary drainage of the transplant kidney, resulting in improvements in the size of the mass on imaging. Given that both patients were at heightened immunological risk due to sensitization or episodes of rejection, we sought to investigate whether these are common risk factors for malakoplakia in the published literature. We summarized 59 published reports of malakoplakia in kidney transplant recipients. We found that malakoplakia cases predominantly occur in the first two years after transplant and that 47% of patients had either prior rejection or a prior transplant. We also found that many case reports of malakoplakia involve E. Coli infections and that improvement or resolution of malakoplakia was more common in case reports that did not involve surgical resection of the mass. |
| format | Article |
| id | doaj-art-e32e8d2af25a428f875d982a9024e5ee |
| institution | DOAJ |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj-art-e32e8d2af25a428f875d982a9024e5ee2025-08-20T03:13:29ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-05-011610.3389/fimmu.2025.16051461605146Malakoplakia among kidney transplant recipients: case series and literature reviewAli B. Abbasi0Gerardo Gamino1Alan Zambeli-Ljepović2Adrian M. Whelan3Garrett R. Roll4Peter J. Altshuler5Department of Surgery, University of California, San Francisco, San Francisco, CA, United StatesSchool of Medicine, University of California, San Francisco, San Francisco, CA, United StatesDepartment of Surgery, University of California, San Francisco, San Francisco, CA, United StatesDepartment of Medicine, Division of Nephrology, University of California, San Francisco, San Francisco, CA, United StatesDepartment of Surgery, Division of Transplantation, University of California, San Francisco, San Francisco, CA, United StatesDepartment of Surgery, Division of Transplantation, University of California, San Francisco, San Francisco, CA, United StatesWe report two cases of malakoplakia after kidney transplant, a rare granulomatous condition that occurs primarily in immunocompromised patients and his thought to occur due to incomplete clearance of phagocytized bacterial residue by macrophages. Both patients were at heightened immunological risk due to being highly sensitized or prior episodes of rejection, both experienced E. Coli infections in the first 4 months after transplant, and both presented with granulomatous masses that were biopsied and confirmed to be malakoplakia. Both were treated with suppressive antibiotics and required urinary drainage of the transplant kidney, resulting in improvements in the size of the mass on imaging. Given that both patients were at heightened immunological risk due to sensitization or episodes of rejection, we sought to investigate whether these are common risk factors for malakoplakia in the published literature. We summarized 59 published reports of malakoplakia in kidney transplant recipients. We found that malakoplakia cases predominantly occur in the first two years after transplant and that 47% of patients had either prior rejection or a prior transplant. We also found that many case reports of malakoplakia involve E. Coli infections and that improvement or resolution of malakoplakia was more common in case reports that did not involve surgical resection of the mass.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1605146/fullmalakoplakiakidney transplantopportunistic infectionimmunosuppressionposttransplant managementcase report |
| spellingShingle | Ali B. Abbasi Gerardo Gamino Alan Zambeli-Ljepović Adrian M. Whelan Garrett R. Roll Peter J. Altshuler Malakoplakia among kidney transplant recipients: case series and literature review Frontiers in Immunology malakoplakia kidney transplant opportunistic infection immunosuppression posttransplant management case report |
| title | Malakoplakia among kidney transplant recipients: case series and literature review |
| title_full | Malakoplakia among kidney transplant recipients: case series and literature review |
| title_fullStr | Malakoplakia among kidney transplant recipients: case series and literature review |
| title_full_unstemmed | Malakoplakia among kidney transplant recipients: case series and literature review |
| title_short | Malakoplakia among kidney transplant recipients: case series and literature review |
| title_sort | malakoplakia among kidney transplant recipients case series and literature review |
| topic | malakoplakia kidney transplant opportunistic infection immunosuppression posttransplant management case report |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1605146/full |
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