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Invasive fungal infections (IFIs) are one of the most feared complications associated with liver transplantation, with high rates of morbidity and mortality. We discuss the most common invasive fungal infections in the setting of liver transplant, including Candida, Aspergillus, and Cryptococcal infections, and some less frequent but devastating mold infections. Further, we evaluate the use of prophylaxis to prevent invasive fungal infection in this population as a promising mechanism to...
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Problem: Incidence and impact of CMV infection in pancreas-transplant recipients (PTRs) in the valganciclovir prophylaxis era has not be completely elucidated.
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Purpose: Valganciclovir (VGC) is the gold-standard for cytomegalovirus (CMV) prophylaxis (PPX) after solid organ transplant (SOT). Letermovir (LTV) was recently approved in high-risk kidney transplant and has reduced myelosuppressive toxicity. Conversion from VGC to LTV may be pursued in the setting of leukopenia. It is unknown if this strategy is effective. Methods: Adult patients receiving abdominal SOT were included if converted from VGC to LTV between January 1, 2018 and January 31,...
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ABSTRACT Purpose Evaluate cytomegalovirus (CMV) post‐prophylaxis surveillance in high‐risk (D+/R‐) kidney and liver transplant recipients. Methods Adult D+/R‐ patients were included if transplanted between 6/1/15 and 11/30/22 and divided into a pre‐CMV‐stewardship‐era (6/1/15–5/31/18), CMV‐stewardship‐era (6/1/18–6/30/20), and a surveillance‐era (7/1/2020–11/30/2022) then followed through 12...
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Methods: Adult kidney and/or pancreas transplant recipients admitted with CMV (4/29/19–7/15/20) received IV ganciclovir(10 mg/kg Q12 h × 7 days) with step-down to standard-of-care (SOC) dosing thereafter (5 mg/kg Q12). A SOC cohort admitted before implementation of the dosing strategy (10/20/16–3/2/19) served as a comparator. Primary objective: rate of viral clearance (delta log CMV) at therapy day 7. Secondary objective: safety/short term efficacy. Results: Fifty-four patients met inclusion...
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Purpose Antimicrobial stewardship programs (ASPs) are essential entities that promote the appropriate use of antimicrobials, leading to improved patient outcomes and reduced resistance. Application to the immunocompromised host is a natural progression for expansion. Cytomegalovirus (CMV) infection is a common complication following solid organ transplant with significant implications on graft survival, making it an attractive ASP target. The aim of this piece is to review our...
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Background Few options are available for cytomegalovirus (CMV) treatment in transplant recipients resistant, refractory, or intolerant to approved agents. Letermovir (LET) is approved for prophylaxis in hematopoietic cell transplant (HCT) recipients, but little is known about efficacy in CMV infection. We conducted an observational study to determine the patterns of use and outcome of LET treatment of CMV infection in transplant recipients. Methods Patients who received LET for treatment of...
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FUNGI
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CMV
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