Pathogenicity of Fumonisin-producing and Nonproducing Strains of Aspergillus Species in Section Nigri to Maize Ears and Seedlings.

Species of Aspergillus section Nigri are commonly associated with maize kernels, and some strains can produce fumonisin mycotoxins. However, there is little information about the extent to which these fungi contribute to fumonisin contamination in grain, the damage they cause to maize ears, or their effects on maize seed germination and seedling health. We compared fumonisin-producing and nonproducing strains of A. niger, A. welwitschiae, A. phoenicis, A. tubingensis, and A. carbonarius from the United States and Italy in laboratory and field studies to assess their ability to contribute to fumonisin contamination, to cause maize ear rot, and to affect seed germination and seedling growth. In laboratory experiments, some strains of each Aspergillus species reduced germination or seedling growth, but there was high variability among strains within species. There were no consistent differences between fumonisin-producing and nonproducing strains. In field studies in Iowa and Illinois, strains were variable in their ability to cause ear rot symptoms, but this was independent of the ability of the Aspergillus strains to produce fumonisins. Contamination of grain with fumonisins was not consistently increased by inoculation with Aspergillus strains compared with the control, and was much greater in F. verticillioides-inoculated treatments than in Aspergillus-inoculated treatments. However, the ratio of the FB analogs FB2 and FB1 was altered by inoculation with some Aspergillus strains, indicating that FB2 production by Aspergillus strains occurred in the field. These results demonstrate the pathogenic capabilities of strains of Aspergillus in section Nigri, but suggest that their effects on maize ears and seedlings are not related to their ability to produce fumonisins, and that fumonisin contamination of grain caused by Aspergillus spp. is not as significant as that caused by Fusarium spp.

Incidence of post-transplantation lymphoproliferative disease in Andalusia (1990-2009).

BACKGROUND: Post-transplantation lymphoproliferative disease (PTLD) is a severe complication of renal transplantation (RT) but information about its incidence and predisposing factors is diverse, varying according to geographic area and study period. METHODS: We analyzed the incidence of PTLD after all RT performed at adult transplantation centers in Andalusia from January 1, 1990 to December 31, 2009, recorded in the Andalusian Transplant Co-ordination Information System (SICATA) regional computerized database (n = 5577). We calculated the risk of PTLD using the Kaplan-Meier curve, censoring for organ failure and incidence rate per patient-year of exposure. Log-rank comparisons were made by center (n = 5), decade (1990-1999 vs 2000-2009), age group, recipient gender, hepatitis C virus (HCV) serology, transplantation number, and duration of pre-RT replacement therapy (per quartiles). RESULTS: We identified 60 cases of PTLD. The pre-RT treatment time was 48.2 ± 60 months; 11.7% were retransplantations, and 10.4% had a positive HCV serology. The median post-RT time before diagnosis of PTLD was 5.98 years. At the time of the database analysis, only 11 patients (18%) were alive with a functioning transplant; 10% had returned to dialysis and 72% had died. The actuarial incidence of PTLD at 1, 5, 10, and 20 years post-RT was 0.2%, 0.5%, 1.6%, and 2.9%, respectively; the exposure rate was 14.71 PTLD/10,000 patient-years (95% confidence interval [CI], 12.3-17.1). Although the incidence tended to be higher in 1990-1999 than 2000-2009 (16.8 vs 12.1 cases/10,000 patient-years), in the actuarial study the difference was far from significant (at 7.5 years, 1.2 vs 0.8%; P = .4). Nor were there significant differences in the curves of incidence per RT center (1%-1.2% of patients) or recipient characteristics. CONCLUSIONS: The cumulative incidence of PTLD in Andalusia in patients with a functioning kidney transplant during 1990-2009 was 2.9% at 20 years. There was no significant variation between the RT centers or over time. No associated factors were identified among the basic recipient variables studied.

Associated characteristics and impact on survival of post renal-transplantation lymphoproliferative disease: case-control study from a regional registry.

BACKGROUND: Lymphoproliferative disease (LPD) after renal transplantation (RT) is an unusual complication but one that impacts greatly on survival. We examined possible predisposing factors and their effect on survival using data from the Andalusian Transplant Co-ordination Information System (SICATA) regional computerized database of patients on renal replacement therapy due to chronic kidney disease (CKD). METHODS: The study population comprised all RT undertaken at adult centers in Andalusia from January 1, 1990 to December 31, 2009 (N = 5577). We retrospectively analyzed cases at December 31, 2011 (N = 60). A control group comprised the 2 closest RT in time done at the same center and with equal or greater graft survival at the time of diagnosis of LPD in the associated case (N = 120). The basic variables were obtained from the general register (1990-2009) and widened from the specific register (2000-2009). Case-control comparison of survival was done with Kaplan-Meier from diagnosis to death or organ loss censored for death. Cox univariate and multivariate (LPD plus available covariables of demonstrated effect) analyses were done. RESULTS: We found no significant differences between cases and controls regarding the characteristics of the recipient or of the donor/organ, initial immunosuppression by intention to treat, or post-RT course. The impact on recipient survival 5 years after diagnosis was as follows: LPD, 35%; controls, 90% (P < .000). Cox univariate analysis showed the relative risk (RR) of death for LPD was 11.36 (95% confidence interval [CI], 6.2-20.9; P < .000) and the multivariate analysis showed relative risk (RR) = 13.87 (7.45-25.3; P < .000). The impact on death-censored graft survival 5 years after diagnosis was as follows: LPD, 65%; controls, 87% (P = .007). Cox univariate analysis was as follows: RR of failure for LPD, 2.70 (95% CI, 1.3-5.7; P = .009). CONCLUSIONS: We found no significant differences between LPD cases and contemporary controls regarding the basic characteristics of the recipient, donor/organ, initial immunosuppression, or initial graft evolution. There was an enormous impact on both patient and graft survival.

Information channels and the dynamics of uptake of living kidney donors: a retrospective study in a reference area.

INTRODUCTION: Activity in renal transplantation at our center continues to grow due to the gradual increase in living donor kidney transplantations (LDKT). Our objective was to describe the generation process of living donation in our area of influence including two provinces and 18 chronic kidney disease (CKD) treatment units in particular the origin of paired donor/recipients and information channels. METHODS: We included all actual and discarded potential donors from 2005 to 2009. History and telephone interviews provided a description of the cases, sources and process information. RESULTS: Among 95 potential pairs we performed 44 LDKT during this period. The recipients were predialysis (38%), on dialysis (54%), or after prior transplantation (8%). Among the 10 dialysis centers, the referral rate ranged between 0 and 8.6 pairs per 100 patients. We contacted 78 (83%) donors for an interview, among whom 53% first learned of LDKT when the recipient already had advanced CKD at predialysis or dialysis stages. Television was the main means of this first knowledge (38%), followed by the health care staff. LDKT was not primarily a treatment option offered by the nephrologist for 65% of subjects; however, the nephrologists were the major reference sources followed by the Internet and transplant coordinators. CONCLUSIONS: The majority of donations are initiated before the recipient is on dialysis, but eventuates predialysis in only 38% of cases. The possibility of being referred seems to be influenced by the recipient's treatment center. We need a more proactive role of nephrologists to offer this therapeutic option. This study identified the importance of public information to identify targets and design strategies to disseminate quality information on LDKT.