Diagnosis and Management of Infections in Solid Organ Transplant Recipients
Submission Deadline: October 30, 2018 (Open) Submit Now
Maricar Malinis, MD FACP, FIDSA
Assistant Professor of Medicine and Surgery (Transplant), Medical Director, Transplant Infectious Diseases, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA;
Department of Surgery (Transplant), Yale School of Medicine, New Haven, CT, USA
Tel.: 203 785 3561
E-Mail: [email protected]
Research Interests: Aging; Cytomegalovirus; Fungi; HIV; Transplantation; Immunocompromised host; Transplant infectious diseases
About This Topic
Solid organ transplantation is an established life -saving therapy for end-organ diseases of the kidney, liver, heart, and lungs. The improved patient and graft survivals have been attributed to advancements in surgical techniques and effective immunosuppressive therapies. However, immune suppression, pre-existing co-morbidities, and potential surgical complications can result in infectious complications after organ transplantation. In this particular issue of OBM transplantation, solicited articles will focus on review of current approaches to the diagnosis and management of post-transplant infections in solid organ transplant recipients due to bacterial, viral and fungal pathogens. Each article will also address strategies of screening and prevention of post-transplant infections.
Title: Fungal Infections in Solid Organ Transplant
Authors: Mrudula Munagala and Anita Phancao
Title: Clinical management of bacterial and fungal infections in the early and late post-transplant
Authors: Umberto Baccarani, MD, PhD, FEBS, Elda Righi, MD
Abstract: Bacterial and fungal infections negatively impact the outcomes of liver transplant recipients, increasing mortality rates especially in the early post-transplant period. Abdominal, biliary tract, and bloodstream infections caused by Gram-negative bacteria such as Enterobacteriaceae and Pseudomonas aeruginosa and Gram-positive bacteria (e.g., Staphylococcus aureus, including methicillin-resistant strains) are commonly seen in liver transplant recipients within the first month following surgery due to the type of operation and potential surgical complications. In the late post-transplant period (> 6 months post-transplant), infections with uncommon presentations are possible and physicians should be aware of the risk of severe late bacterial and fungal infections. Due to prolonged hospitalisation and common exposure to broad-spectrum antibiotics and invasive procedures and/or devices, liver transplant recipients are at high-risk of infections caused by multidrug-resistant bacteria. The increase in antimicrobial resistance is one of the biggest challenges in managing post-transplant infections due to the lack of new targeted antimicrobial therapies against highly resistant bacteria. The main challenges from a surgical and medical point of view along with the management of bacterial and fungal infections in liver transplant recipients are discussed.
Title: New frontiers in Solid Organ Transplantation from donors with human immunodeficiency virus infection, hepatitis C virus infection, and multidrug resistant organisms
Authors: Jessica Lum, Sherif Beniameen Mossad
Title: Non-CMV viral infections following solid-organ transplantation – focus on HTLV-1 and human herpes virus 6,7 and 8
Author: Sarah Taimur
Title: Fungal Diagnostics in Solid Organ Transplantation
Authors: David Gaston MD, Marwan Azar MD
Title: Role of the Procalcitonin for predicting infection in Solid Organ Transplant Recipients: Review
Authors: Caytlin Deering, Dagan Coppock, Dong Heun Lee
Title: Current Management of CMV in Adult Liver Transplant Patients
Authors: John Joseph Nguyen-Lee M.D., Mozhgon Moaddab PharmD, BCPS, Stephanie G. Yi M.D., Constance Mobley M.D., Ph.D. FACS
Title: Specific Antibody Deficiency in a heart recipient with systemic aspergillosis
Author: Javier Carbone
Title: Tuberculosis screening and treatment in Solid Organ Transplantation
Authors: David Epstein, MD, Aruna Subramanian, MD
Title: Challenges in Diagnosis and Management of Non-Tuberculous Mycobacterial Infections in SOT
Authors: Joanna Nelson, MD, Dora Ho, MD, PhD, Aruna Subramanian, MD
Title: Diagnosis and Management of Flaviviruses in Solid Organ Transplantation
Author: Dora Ho, MD, PhD
Title: Screening for BK nephropathy: is there any evidence?
Authors: Kate Stevens, Colin Geddes, Patrick Mark
Title: A Certain Uncertainty: acceptance of HPV vaccination in kidney transplant recipients
Authors: Sean A. Hebert MD 1, *, Aleksandra D. De Golovine MD 2, Sonal Bhatnagar MD 3, Cynthia S. Bell MS 4, Karen Vigil MD 5, Rita D. Swinford MD 3
1. Division of Nephrology, Department of Internal Medicine and Pediatrics, University of Texas at Houston McGovern Medical School, Memorial Hermann Hospital and Children’s Memorial Hermann Hospital, 6411 Fannin Street, Houston, Texas, United States of America.
2. Division of Nephrology, Department of Internal Medicine, University of Texas at Houston McGovern Medical School, Memorial Hermann Hospital, 6411 Fannin Street, Houston, Texas, United States of America.
3. Division of Pediatric Nephrology, Department of Pediatrics, University of Texas at Houston McGovern Medical School, Children’s Memorial Hermann Hospital, 6411 Fannin Street, Houston, Texas, United States of America.
4. Division of Pediatric Nephrology, Department of Pediatrics, University of Texas at Houston McGovern Medical School, 6431 Fannin Street, Houston, Texas, United States of America.
5. Division of Infectious Disease, Department of Internal Medicine, University of Texas at Houston McGovern Medical School, Memorial Hermann Hospital, 6411 Fannin Street, Houston, Texas, United States of America.
* Correspondence: Sean A. Hebert, MD
Background: Human Papilloma virus (HPV) infections are an increasingly concerning etiology for post-transplantation viral-related malignancies. The nonavalent HPV vaccine (Gardasil 9) affords transplant recipients the best opportunity for malignancy prevention, but remains underutilized. Not previously reported for solid organ transplant recipients, we studied influential factors for HPV vaccine non-initiation.
Methods: This survey, conducted from May to December 2017, examined influential factors for HPV vaccine non-initiation. HPV-related disease period prevalence was also analyzed in this regional survey.
Results: Of the 164 patients approached for the study, 157 participated and 154 completed the survey resulting in a 95% response rate. Twenty-nine percent of patients within the United States Food and Drug Administration (FDA) approved age range had started or completed the HPV vaccine series at survey administration. The most significant reason for HPV vaccine non-initiation among age eligible transplant patients was a reduced physician intention to recommend.
Conclusions: HPV vaccination remains underutilized in solid organ transplant patients. Emphasis on physician intention to recommend HPV vaccination will reduce vaccine non-initiation rates.
Solid organ transplantation, Human papillomavirus, Immunosuppression, Malignancy
Title: Parvovirus Infections in Solid Organ Transplant Recipients
Author: Kenneth Pursell
Title: Chagas disease, leishmaniasis and malaria in solid organ transplant recipients
Authors: Spinello Antinori, Laura Milazzo
Title: Beta HPV detection in Solid Organ Transplant Recipients: our case series
Authors: E. Zavattaro, F. Veronese, L. Camillo, C. Borgogna, M. Gariglio, P. Savoia
Title: Epidemiology, clinical features and outcome of urinary tract infections in kidney transplant patients due multidrug-resistant bacteria
Authors: Marta Bodro, Frederic Cofan, Laura Linares, Fritz Diekmann and Asunción Moreno
Title: Evaluation of the renal graft function after HCV treatment with interferon-free directly acting antiviral: a centre experience
Authors: Oscar Andrés Calle Mafla 2, †, *, Ney Arencibia Pérez 2, †, María Luisa Agüera Morales 1, 2, †, Francisco Javier Serrano Ruiz 1, 3, †, María Dolores Navarro Cabello 1, 2, †, Victoria Eugenia García Montemayor 1, 2, †, Miguel Esaul Llanos Olivera 4, †, José Luis Montero Álvarez 1, 3, †, Alberto Rodríguez Benot 1, 2, †, Pedro Aljama García 1, 2, †
1 Maimonides Biomedical Research Institute of Cordoba, Spain;
2 Renal Department, Reina Sofia University Hospital. Cordoba, Spain;
3 Hepatology Department, Reina Sofia University Hospital. Cordoba, Spain;
4 Surgery Department, Reina Sofia University Hospital. Cordoba, Spain;
† These authors contributed equally to this work.
Title: KIDNEY FUNCTION AFTER TREATMENT OF HEPATITIS C INFECTION WITH NEW DIRECT-ACTION ANTIVIRALS IN KIDNEY TRANSPLANT PATIENTS
Authors: Matilde Sánchez Conde, Ana Moreno Zamora
Title:Viral infections in Lung Transplant Recipients and Implications for Long Term Outcomes
Authors: Sheila Krishnan DO1, Chadi Hage MD2, David Van Duin MD3, and Leonard Jason Lobo MD1
1. University of North Carolina, Division of Pulmonary Diseases and Critical Care, Chapel Hill, North Carolina, USA
2. Indiana University Health Thoracic Transplant Program, Indianapolis, Indiana, USA
3. University of North Carolina, Division of Infectious Disease, Chapel Hill, North Carolina, USA
Lung transplant recipients are at greater risk of viral infections as compared to other solid organ transplant recipients due to constant exposure to the external environment. There are no standardized methods for surveillance, prevention, or treatment of these infections despite their association with increased morbidity and mortality. Various studies have shown linked viral infections with acute cellular rejection and chronic allograft dysfunction, and emerging data indicates a role in antibody mediated rejection. This paper will review the prevalence and impact of community acquired respiratory viruses in lung transplant recipients, review the evidence linking viral infections to long term graft dysfunction and rejection, describe existing strategies for surveillance and prevention, and list the currently available and promising investigational therapies.
Title: Isolated Hepatic Mucormycosis in the Early Post-Transplant Period: A Case Report and Literature Review
Authors: Michael Czapka, Carlos Santos, Laurie Proia
Katerina G. Oikonomou, Sarah Taimur
Received: February 14, 2019; Published: June 17, 2019; doi:10.21926/obm.transplant.1902066
Sheila Krishnan, Chadi Hage, Raymond Coakley, David van Duin, Leonard Jason Lobo
Received: February 18, 2019; Published: June 10, 2019; doi:10.21926/obm.transplant.1902065
Javier Carbone, Juan Fernandez-Yañez, Iago Sousa, Patricia Muñoz, Elizabeth Sarmiento
Received: November 23, 2018; Published: March 22, 2019; doi:10.21926/obm.transplant.1901058
Dagan Coppock, Caytlin Deering, Shara Epstein, Dong Heun Lee
Received: December 23, 2018; Published: March 01, 2019; doi:10.21926/obm.transplant.1901054
Jessica Lum, Sherif B. Mossad
Received: October 26, 2018; Published: February 14, 2019; doi:10.21926/obm.transplant.1901050
David J. Epstein, Aruna K. Subramanian
Received: November 18, 2018; Published: February 12, 2019; doi:10.21926/obm.transplant.1901048
Joanna K. Nelson, Aruna Subramanian
Received: November 30, 2018; Published: February 01, 2019; doi:10.21926/obm.transplant.1901047
Marion Hemmersbach-Miller, Cameron R. Wolfe, Kenneth E. Schmader
Received: November 30, 2018; Published: February 01, 2019; doi:10.21926/obm.transplant.1901046
Michael Czapka, Carlos A.Q. Santos, Laurie A. Proia
Received: October 8, 2018; Published: February 1, 2019; doi:10.21926/obm.transplant.1901045
Margaret E. Newman, Kenneth Pursell, David Pitrak
Received: November 05, 2018; Published: January 21, 2019; doi:10.21926/obm.transplant.1901040
Spinello Antinori, Laura Milazzo
Received: October 28, 2018; Published: January 15, 2019; doi:10.21926/obm.transplant.1901039
Makeda L. Robinson, Kyle Enriquez, Dora Y. Ho
Received: November 02, 2018; Published: January 09, 2019; doi:10.21926/obm.transplant.1901038
David C. Gaston, Marwan M. Azar
Received: November 14, 2018; Published: December 29, 2018; doi:10.21926/obm.transplant.1804037
Ashrit Multani, Stanley Deresinski
Received: October 31, 2018; Published: December 27, 2018; doi:10.21926/obm.transplant.1804035
Michael Y. Shino, Ariss DerHovanessian, David M. Sayah, Rajan Saggar, Ying Ying Xue, Abbas Ardehali, Barry R. Stripp, David J. Ross, Joseph P. Lynch, Robert M. Elashoff, S. Samuel Weigt, John A. Belperio
Received: September 11, 2018; Published: November 30, 2018; doi:10.21926/obm.transplant.1804029