Full Library

A transplant infectious disease (TID) assessment is essential to select recipients for an allogeneic-hematopoietic cell transplant (HCT) and tailor prophylactic and empirical treatment recommendations.We performed a retrospective single-center study to describe our model of care based on a routine TID consultation prior to an allogeneic-HCT between 2018 and 2022 in 292 adult (≥18-year-old) consecutive patients. We describe the performance of a TID consultation, arbitrarily defined as major (HCT-postponement, procedure, cytomegalovirus recipient (CMV-R) serology reinterpretation) and minor interventions.Overall, 765 interventions were observed in 257/292 (88%) patients: 88/765 (11.5%) major and 677/765 (88.5%) minor interventions. Amongst major interventions, HCT was postponed in 8/292 (2.7%) patients and a procedure was requested in 18/292 (6.2%) patients. The CMV-R serostatus was changed from indeterminate/low-titer positive to negative in 60/292 (20.5%) patients. Amongst 677 minor interventions, there were: 68 (8.8%) additional consultations with other services requested, 260 (33.7%) additional diagnostic tests requested, 102 (13.2%) additional treatments recommended, 60 (7.8%) non-CMV serology reinterpretations performed, 115 (14.9%) deviations from routine anti-infective prophylaxis, and 72 (9.3%) deviations from routine empirical antibiotic treatment recommendations in case of neutropenic fever.We are proposing a structured, clearly defined, and comprehensive pre-transplant checklist for an effective assessment of ID risks and complications prior to an allogeneic-HCT. Further studies or experiences like ours could help to define a global strategy or new models of care to be implemented in HCT centers in the future.