The American Society of Transplantation Online Transplant Infectious Diseases Library

Background. The use of nucleos(t)ide analogs (NAs) with a high genetic barrier to resistance, namely entecavir and tenofovir, has improved the efficacy of antiviral prophylaxis against hepatitis B virus (HBV) recurrence after liver transplantation (LT). However, the optimal duration and dosage of hepatitis B immunoglobulin (HBIG) administration, particularly in patients transplanted for HBV and hepatitis D virus (HDV) coinfection, remains controversial. ...

Cytomegalovirus (CMV) reactivation remains one of the major and life-threatening complications after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Yet, there is still a lack of safe and effective ways to prevent CMV reactivation in allo-HSCT patients. Here, we retrospectively analyzed a cohort of patients who underwent HSCT at our transplant center between 2018 and 2022 to evaluate the efficacy of prophylactic CMV-specific intravenous immunoglobulin (CMV-IVIg) against CMV...

Cirrhosis and decompensated liver disease were the ninth leading cause of death for males in 2016 in the United States. Liver transplantation (LT) is a lifesaving gift and proven intervention in managing patients with acute and chronic end-stage liver disease. It restores normal health, lifestyle and extends lifespan by 15 years. The advent of liver transplantation came as a safety net to treat various liver diseases when all other medical interventions have failed. According to the...

Abstract Vaccination should be considered a routine practice for all HCT receptors , either autologous or allogeneic, adults or children. It should be implemented in all HCT programs. Adult cover is particularly important as they represent 90% of HCTs.

Background: Experience with lung transplantation (LT) in patients with human immunodeficiency virus (HIV) is limited. Many studies have demonstrated the success of kidney and liver transplantation in HIV-seropositive (HIV+) patients. Our objective was to conduct a national registry analysis comparing LT outcomes in HIV+ to HIV-seronegative (HIV−) recipients. Methods: The United Network for Organ Sharing database was queried to identify LTs performed in adult HIV+ patients between 2016 and...

Background Bacteriuria is common among kidney transplant recipients (KTR). Risk factors and outcomes associated with bloodstream infection due to a urinary source (BSIU) in KTR are poorly understood. Methods This single center case-control study from 2010 to 2022 compared KTR with BSIU to those with bacteria without bloodstream infection (BU). Multivariable logistic regression identified BSIU risk factors, and Cox models assessed its impact on graft failure. Results Among 3435 patients, who...

Pulmonary nodules and masses in immunocompromised patients represent a diagnostic challenge due to overlapping radiological and clinical presentations. By integrating clinical context, immune status, and imaging findings, clinicians can more accurately diagnose and manage these lesions, improving patient outcomes. This review presents an algorithmic approach for differentiating between various causes of pulmonary nodules and masses in non-HIV immunocompromised individuals, providing a valuable tool for clinical practice.

Early and accurate identification of pathogens in pulmonary infections after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is critically important. The clinical usefulness of metagenomic next-generation sequencing (mNGS) in the diagnosis of pulmonary infections after allo-HSCT remains under discussion. This multicenter retrospective study was conducted to compare mNGS and conventional microbiological tests (CMTs) in identifying the pathogens of pulmonary infections in...

Educational and preventive measures are the best strategy: vector control, knowledge of the vector’s habits, protection against mosquito bites, avoiding travel to endemic areas or with a current epidemic, and avoiding nonvector transmission according to local recommendations for donor deferral. Vaccination, currently only available for DENV, has not yet been studied in immunocompromised patients and is not currently recommended.

The International Pediatric Transplant Association (IPTA) convened an expert consensus conference to assess current evidence and develop recommendations for various aspects of care relating to post-transplant lymphoproliferative disorder after solid organ transplantation in children. In this report from the Prevention Working Group, we reviewed the existing literature regarding immunoprophylaxis and chemoprophylaxis, and pre-emptive strategies. While the group made a strong recommendation...

The number of transplant infectious disease (TID) fellowship programs has expanded rapidly in the past 5 years, with the creation of many new programs and the expansion of training tracks and dedicated years as the demand for TID physicians grows drastically. This editorial focuses on major factors and complexities that programs should consider in TID fellowship creation, as well as highlighting examples of formative experiences, programmatic structure, and fellow resources that trainees can...

Babesiosis is likely to become a more frequent infectious complication in immunosuppressed hosts as the areas of endemicity expand. Reduced efficacy of standard therapies is likely to continue emerging so more effort needs to be placed on methods of assessing resistance in vitro and developing more reliable treatments for resistant infections.

Abstract Acute graft-versus-host disease (GvHD) remains a major course of short term (100 days and 1 yr) mortality and morbidity after allogeneic stem cell transplantation. The pathophysiology of GvHD is described as a 3 step process starting with initial tissue damage by conditioning followed by host antigen presenting cell activation by damage and pathogen associated molecular patterns and finally resulting in activation of alloreactive T cells and proinflmmatory cytokines...

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...

Hematopoietic stem cell transplant (HPSCT), sometimes referred to as bone marrow transplant, involves administering healthy hematopoietic stem cells to patients with dysfunctional or depleted bone marrow. This procedure has several benefits. It helps to augment bone marrow function. In addition, depending on the disease being treated, it may allow for the destruction of malignant tumor cells. It can also generate functional cells that replace dysfunctional ones in cases like immune...

Background/aims: Direct-acting antiviral (DAA) therapy has revolutionized solid organ transplantation by providing an opportunity to utilize organs from HCV-viremic donors. Though transplantation of HCV-viremic donor organs into aviremic recipients is safe in the short term, midterm data on survival and post-transplant complications is lacking. We provide a midterm assessment of complications of lung transplantation (LT) up to 2 years post-transplant, including patient and graft survival...

Approximately 70% (90.5 million) of United States (US) households own at least one pet. Dogs are the most common, making up about 38% of all household pets, followed by cats, which make up 25%. Other pets such as fish, birds, reptiles, and small animals such as hamsters, gerbils, and rabbits are less common household members. Pets are often considered a part of the family and there are significant medical and psychosocial benefits to pet ownership; however, the possibility of disease...

Lung transplantation is a well-established life-saving treatment to improve the quality of life of patients with end-stage respiratory failure not responding to other medical or surgical interventions. The 36th adult lung and heart-lung transplant report summarize data from 69,200 adult lung transplants that have been performed through June 30, 2018, and reported to the International Thoracic Organ Transplant Registry. The US Organ Procurement and Transplantation Network (OPTN) and the...