{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T14:50:49Z","timestamp":1780757449913,"version":"3.54.1"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,1,3]],"date-time":"2017-01-03T00:00:00Z","timestamp":1483401600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003329","name":"Ministerio de Econom\u00eda y Competitividad","doi-asserted-by":"publisher","award":["13\/00045"],"award-info":[{"award-number":["13\/00045"]}],"id":[{"id":"10.13039\/501100003329","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003329","name":"Ministerio de Econom\u00eda y Competitividad","doi-asserted-by":"publisher","award":["JR14\/00036"],"award-info":[{"award-number":["JR14\/00036"]}],"id":[{"id":"10.13039\/501100003329","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The incidence of visceral leishmaniasis (<jats:styled-content style=\"fixed-case\">VL<\/jats:styled-content>) after solid organ transplantation (<jats:styled-content style=\"fixed-case\">SOT<\/jats:styled-content>) is increasing. The optimal therapy for post\u2010transplant<jats:styled-content style=\"fixed-case\">VL<\/jats:styled-content>remains unclear, as relapses after liposomal amphotericin B (L\u2010AmB) are common. Miltefosine has been shown to be effective for treating<jats:styled-content style=\"fixed-case\">VL<\/jats:styled-content>in immunocompetent patients, although data in the specific population of<jats:styled-content style=\"fixed-case\">SOT<\/jats:styled-content>recipients are lacking. In the setting of an outbreak of leishmaniasis occurring in Southwest Madrid, we reviewed our experience in 6<jats:styled-content style=\"fixed-case\">SOT<\/jats:styled-content>recipients with persistent or relapsing<jats:styled-content style=\"fixed-case\">VL<\/jats:styled-content>who received a 28\u2010day course of miltefosine (2.5\u00a0mg\/kg\/day) as salvage therapy. All patients had been treated previously with L\u2010AmB as first\u2010line therapy. The incident episode of<jats:styled-content style=\"fixed-case\">VL<\/jats:styled-content>occurred at a median of 14\u00a0months after transplantation. Two patients experienced persistent infection and the remaining 4 had a relapse after a median interval of 168\u00a0days since the completion of the course of L\u2010AmB. All the patients had an apparent initial clinical improvement with miltefosine. However,<jats:styled-content style=\"fixed-case\">VL<\/jats:styled-content>relapsed in 3 of them (after a median interval of 46\u00a0days), which required retreatment with L\u2010AmB\u2010based regimens. Miltefosine therapy was followed by a prolonged secondary prophylaxis with L\u2010AmB in the only 2 cases with sustained clinical response and ongoing immunosuppression. No adverse effects associated with miltefosine were observed. Albeit limited, our experience suggests that miltefosine monotherapy likely has a limited utility to obtain a long\u2010lasting clinical response in complicated (persistent or relapsing) forms of post\u2010transplant<jats:styled-content style=\"fixed-case\">VL<\/jats:styled-content>, although its role in association with L\u2010AmB\u2010based secondary prophylaxis may merit further investigation.<\/jats:p>","DOI":"10.1111\/tid.12623","type":"journal-article","created":{"date-parts":[[2016,10,21]],"date-time":"2016-10-21T17:46:01Z","timestamp":1477071961000},"source":"Crossref","is-referenced-by-count":11,"title":["Experience with miltefosine for persistent or relapsing visceral\u00a0leishmaniasis in solid organ transplant recipients: A\u00a0case series from Spain"],"prefix":"10.1111","volume":"19","author":[{"given":"Maria A.","family":"P\u00e9rez\u2010Jacoiste As\u00edn","sequence":"first","affiliation":[{"name":"Unit of Infectious Diseases Hospital Universitario \u201c12 de Octubre\u201d Instituto de Investigaci\u00f3n Hospital \u201c12 de Octubre\u201d (i+12) School of Medicine Universidad Complutense Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nerea","family":"Carrasco\u2010Ant\u00f3n","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases Hospital Universitario \u201c12 de Octubre\u201d Instituto de Investigaci\u00f3n Hospital \u201c12 de Octubre\u201d (i+12) School of Medicine Universidad Complutense Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Fern\u00e1ndez\u2010Ruiz","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases Hospital Universitario \u201c12 de Octubre\u201d Instituto de Investigaci\u00f3n Hospital \u201c12 de Octubre\u201d (i+12) School of Medicine Universidad Complutense Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"San Juan","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases Hospital Universitario \u201c12 de Octubre\u201d Instituto de Investigaci\u00f3n Hospital \u201c12 de Octubre\u201d (i+12) School of Medicine Universidad Complutense Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo","family":"Alonso\u2010Moralejo","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Hospital Universitario \u201c12 de Octubre\u201d Instituto de Investigaci\u00f3n Hospital \u201c12 de Octubre\u201d (i+12) School of Medicine Universidad Complutense Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Department of Nephrology Hospital Universitario \u201c12 de Octubre\u201d Instituto de Investigaci\u00f3n Hospital \u201c12 de Octubre\u201d (i+12) School of Medicine Universidad Complutense Madrid 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