Full Library – TransplantID

HHV-6, HHV-7, and HHV-8: Forgotten Viruses in Transplantation

Haidar, G. - 2021 - In M. I. Morris, C. N. Kotton, & C. Wolfe (Eds.), Emerging Transplant Infections (pp. 683–708) - Springer International Publishing

Human herpesviruses (HHV)-6, HHV-7, and HHV-8 were identified as causes of infection in solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients nearly three decades ago. HHV-6 infection occurs early posttransplant and may cause fever of unknown origin, diarrhea, rash, pneumonitis, and encephalitis. Chromosomal integration of HHV-6 can complicate diagnostic testing for HHV-6, as these patients have markedly elevated HHV-6 DNA levels due to the presence of HHV-6...

American Society for Transplantation and Cellular Therapy Series: #3—Prevention of Cytomegalovirus Infection and Disease After Hematopoietic Cell Transplantation

Hakki, M., Aitken, S. L., Danziger-Isakov, L., … Marty, F. M. - 2021 - Transplantation and Cellular Therapy, 27(9), 707–719

The Practice Guidelines Committee of the American Society for Transplantation and Cellular Therapy partnered with its Transplant Infectious Disease Special Interest Group to update its 2009 compendium-style infectious diseases guidelines for the care of hematopoietic cell transplant (HCT) recipients. A new approach was taken with the goal of better serving clinical providers by publishing each standalone topic in the infectious disease series as a concise format of frequently asked questions...

Microsporidiosis in Humans

Han, B., Pan, G., & Weiss, L. M. - 2021 - Clinical Microbiology Reviews, 34(4), 40

Antimicrobial Prophylaxis in the Age of Emerging Transplant Infections

Hand, J. - 2021 - In M. I. Morris, C. N. Kotton, & C. Wolfe (Eds.), Emerging Transplant Infections (pp. 155–170) - Springer International Publishing

Solid organ transplantation and hematopoietic cell transplantation are life-saving procedures, yet carry signiﬁcant infection risk due to the signiﬁcant and prolonged immunosuppression they entail. Infection prevention strategies using antibiotic prophylaxis can mitigate problems that arise through immunosuppression, especially if clinicians have a keen awareness for local epidemiology and patient-speciﬁc microbiological factors. Antifungal prophylaxis, especially in stem cell...

Lung Transplantation for Severe Post–coronavirus Disease 2019 Respiratory Failure

Hawkins, R. B., Mehaffey, J. H., Charles, E. J., … Roeser, M. - 2021 - Transplantation, 105(6), 1381–1387

Managing the significant drug-drug interaction between tacrolimus and letermovir in solid organ transplant recipients

Hedvat, J., Choe, J. Y., Salerno, D. M., … Lange, N. W. - 2021 - Clinical Transplantation, 35(3), e14213

Global guideline for the diagnosis and management of rare mould infections: an initiative of the European Confederation of Medical Mycology in cooperation with the International Society for Human and Animal Mycology and the American Society for Microbiology

Hoenigl, M., Salmanton-García, J., Walsh, T. J., … Cornely, O. A. - 2021 - The Lancet Infectious Diseases, 21(8), e246–e257

The Antifungal Pipeline: Fosmanogepix, Ibrexafungerp, Olorofim, Opelconazole, and Rezafungin

Hoenigl, M., Sprute, R., Egger, M., … Jenks, J. D. - 2021 - Drugs, 81(15), 1703–1729

The epidemiology of invasive fungal infections is changing, with new populations at risk and the emergence of resistance caused by the selective pressure from increased usage of antifungal agents in prophylaxis, empiric therapy, and agriculture. Limited antifungal therapeutic options are further challenged by drug–drug interactions, toxicity, and constraints in administration routes. Despite the need for more antifungal drug options, no new classes of antifungal drugs have become available...

Pseudomonas aeruginosa Infections in Transplant: Epidemiology and Emerging Treatment Options

Hogan, J. I., Hill, B. K., & Sifri, C. D. - 2021 - In M. I. Morris, C. N. Kotton, & C. Wolfe (Eds.), Emerging Transplant Infections (pp. 343–370) - Springer International Publishing

As one of the most formidable bacterial pathogens encountered in clinical practice, infections related to Pseudomonas aeruginosa (PsA) present a number of challenges to the infectious disease physician. In immunocompromised hosts in particular, PsA has the potential to manifest with unique, recurrent, and often severe clinical syndromes that warrant infectious disease consultation. A staggering array of virulence factors combined with a host of intrinsic and acquired genetic elements...

Multidrug-Resistant Organisms: Posttransplant Management for Extended-Spectrum Beta-Lactamase Producers and Carbapenem-Resistant Enterobacterales

Howard-Anderson, J., & Pouch, S. M. - 2021 - In M. I. Morris, C. N. Kotton, & C. Wolfe (Eds.), Emerging Transplant Infections (pp. 313–342) - Springer International Publishing

The incidence of extended-spectrum β-lactamase (ESBL)-producing Enterobacterales (ESBL-EB) and carbapenem-resistant Enterobacterales (CRE) infections has been increasing worldwide, although the prevalence and mechanism of resistance vary by geographic region and institutional patterns of resistance. These multidrug-resistant infections are challenging to diagnose and treat and can cause significant morbidity and mortality in transplant patients. In this chapter we highlight recent trends in...

Altered Mental Status in the Solid Organ Transplant Recipient

Ince, D. - 2021 - In M. I. Morris, C. N. Kotton, & C. Wolfe (Eds.), Emerging Transplant Infections (pp. 1661–1672) - Springer International Publishing

Altered mental status is common in the solid organ transplant recipient. A variety of etiologies, including infections, metabolic abnormalities, medications, malignancies, and rejection, can lead to altered mental status in a transplant patient. Timeline after transplantation as well as organ transplanted have signiﬁcant impact on etiology. Detailed physical examination, comprehensive laboratory evaluation, and in many cases imaging can help elucidate the etiology. Urgent treatment of underlying etiology can improve prognosis.

Invasive Fungal Disease Among Pediatric and Adolescent Patients Undergoing Itraconazole Prophylaxis After Hematopoietic Stem Cell Transplantation

Itsaradisaikul, S., Pakakasama, S., Boonsathorn, S., … Apiwattanakul, N. - 2021 - Transplantation Proceedings, S0041134521002578

Background. Invasive fungal disease (IFD) is a major cause of morbidity and mortality in patients after hematopoietic stem cell transplantation (HSCT). Itraconazole has been used for prevention of IFD, but data related to incidence and associated factors of IFD in pediatric and adolescent patients on itraconazole prophylaxis remain scarce. Objectives. To identify incidence and risk factors associated with IFD among pediatric and adolescent patients receiving itraconazole prophylaxis after...

Vaccination Strategies in Solid Organ and Stem Cell Transplant

Jain, S. R., & Kumar, D. - 2021 - In M. I. Morris, C. N. Kotton, & C. Wolfe (Eds.), Emerging Transplant Infections (pp. 253–284) - Springer International Publishing

Solid organ and hematopoietic stem cell transplant recipients are at high risk of contracting infectious diseases, including vaccine-preventable illnesses, in the post-transplant period. Given the high degree of immunosuppression immediately post-transplant, infection in the transplant patient results in higher morbidity and mortality than in the general population. Thus, it is the responsibility of the care team to ensure appropriate vaccines are given in an attempt to mitigate this risk....

Antifungals in Clinical Use and the Pipeline

Johnson, M. D. - 2021 - Infectious Disease Clinics of North America, 35(2), 341–371

A pilot study of an intensified ganciclovir dosing strategy for treatment of cytomegalovirus disease in kidney and/or pancreas transplant recipients

Jorgenson, M. R., Descourouez, J. L., Leverson, G. E., … Odorico, J. S. - 2021 - Clinical Transplantation, 35(10)

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...

Comparing posaconazole and itraconazole for antifungal prophylaxis in critically ill lung transplant recipients: Efficacy and plasma concentrations

Kallee, S., Scharf, C., Schroeder, I., … Liebchen, U. - 2021 - Transplant Infectious Disease, 23(4), e13675

Background Posaconazole and itraconazole are commonly used for systemic antifungal prophylaxis after lung transplantation. The aim of this study on critically ill lung transplant recipients was to assess the rate of adequate plasma concentrations and the frequency of fungal-induced transitions from antifungal prophylaxis to therapy after the administration of either posaconazole or itraconazole for systemic prophylaxis. Methods Critically ill lung transplant recipients with postoperative...

Viral Encephalitides Including Rabies and Lymphocytic Choriomeningitis Virus: Impact in Transplant Donors and Recipients

Khole, A., & Theodoropoulos, N. M. - 2021 - In M. I. Morris, C. N. Kotton, & C. Wolfe (Eds.), Emerging Transplant Infections (pp. 1027–1042) - Springer International Publishing

This chapter is a review of rare yet clinically relevant viral encephalitides that have been transmitted from organ donors to recipients. We will discuss the potential pitfalls in diagnosing and managing these illnesses and also discuss the challenges and next steps to better outcomes from these infections.

Antifungal Susceptibility Testing and Identification

Kidd, S. E., Crawford, L. C., & Halliday, C. L. - 2021 - Infectious Disease Clinics of North America, 35(2), 313–339

Hepatitis B and Hepatitis D Infections in the Transplant Setting

Kim, B., & Terrault, N. A. - 2021 - In M. I. Morris, C. N. Kotton, & C. Wolfe (Eds.), Emerging Transplant Infections (pp. 927–950) - Springer International Publishing

Hepatitis B virus (HBV) and hepatitis D virus (HDV) are hepatotropic viruses that can have a significant impact on patients undergoing solid organ and hematopoietic stem cell transplants. In the setting of transplant immunosuppression, patients with HBV or HDV coinfection can have acceleration in the natural history of their liver diseases with increased risk of developing cirrhosis, decompensation, and hepatocellular carcinoma. Immunosuppression can also reactivate HBV in patients with...

Solid organ transplant–specific antibiogram in a tertiary pediatric hospital in Canada

Kitano, T., Science, M., Nalli, N., … Campigotto, A. - 2021 - Pediatric Transplantation, 25(4), e13980

SOT recipients are more vulnerable to infections with antimicrobial-resistant organisms, and therefore, it may be useful for transplant centers to create transplant-specific antibiograms to direct empirical antimicrobial regimens and monitor trends in antimicrobial resistance. SOT-specific antibiograms were created using antimicrobial susceptibility data on isolates from 2012 to 2018 at The Hospital for Sick Children, Toronto, Ontario, Canada. The CLSI guidelines were followed to generate...

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