Transplant Infectious Disease最新文献

{"title":"Fatal Donor-Derived Kaposi Sarcoma Diagnosed at Autopsy and Allograft Explant in Two Recipients From a Single Donor: The Case for Risk-Based HHV-8 Screening.","authors":"Nathan G McGrath, John Skaugen, Bruce Johnson, Chadi A Hage, Sami Alasfar, Ann E McCullough, Rachel Sigler, Pablo G Sanchez, Janalee N Coster, Firas Marayati, Holenarasipur R Vikram, Ghady Haidar, Tanner Bartholow","doi":"10.1111/tid.70344","DOIUrl":"https://doi.org/10.1111/tid.70344","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149239545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cyclosporiasis in Solid Organ and Hematopoietic Cell Transplant Recipients: Diagnosis, Treatment, and Prevention.","authors":"Shipra Goel, Robin K Avery, Mary M Czech","doi":"10.1111/tid.70342","DOIUrl":"https://doi.org/10.1111/tid.70342","url":null,"abstract":"<p><strong>Background: </strong>Cyclospora cayetanensis is a foodborne coccidian protozoan that causes prolonged, often relapsing watery diarrhea. Once considered largely a travel-associated infection, it has become a recurring cause of large, domestically acquired, produce-associated outbreaks in temperate countries. The 2026 US season was the largest on record and prompted a CDC Health Advisory, placing substantial numbers of solid organ transplant (SOT) and hematopoietic cell transplant (HCT) recipients at risk of exposure.</p><p><strong>Aim: </strong>To provide a practical, transplant-specific approach to the diagnosis, treatment, and prevention of cyclosporiasis, using the 2026 outbreak as a worked example of a problem that will recur in future seasons.</p><p><strong>Observations: </strong>As of August 17 2026, CDC had reported 15 716 laboratory-confirmed domestically acquired cases since May 1, including 828 hospitalizations and two deaths, with at least 11 841 further cases under investigation; 1180 cases were reported during the whole of the 2025 season. A large multistate outbreak was traced to shredded iceberg lettuce sourced from central Mexico. Published data describing cyclosporiasis in transplant recipients are limited to small case series and seven individual case reports that provide detailed clinical descriptions. Among these seven reported cases, all occurred in SOT recipients more than one year after transplantation, none were receiving trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis at the time of diagnosis, and chronic watery diarrhea with weight loss predominated. Stool polymerase chain reaction (PCR), usually within a multiplex gastrointestinal panel, is the preferred diagnostic test, as routine ova-and-parasite examination does not reliably detect the parasite; unstained oocysts are easily mistaken for yeast or debris unless modified acid-fast or safranin staining or ultraviolet autofluorescence is specifically applied. TMP-SMX remains the treatment of choice; longer treatment courses may be required in immunocompromised patients, and secondary prophylaxis may be considered in select patients. Because person-to-person transmission is unlikely, Contact Precautions are only recommended for diapered or incontinent patients, and environmental control depends on mechanical removal because the bilayered oocyst wall resists chemical disinfection.</p><p><strong>Conclusion: </strong>Cyclospora should be considered in any transplant recipient with persistent or relapsing diarrhea during the May-August season, irrespective of travel history. Clinicians should specifically request Cyclospora testing, obtain stool PCR early, treat with TMP-SMX, and reinforce food- and water-safety counseling. The 2026 outbreak demonstrates how rapidly population exposure can escalate, and the same approach will apply to future seasons. Published transplant-specific experience remains strikingly limited.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149246463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building a One-Year Transplant Infectious Diseases Fellowship: A North American Perspective From Established Programs.","authors":"Aruna K Subramanian, Robin K Avery, Asma Syed, Takahiro Matsuo, Michael Boeckh, Raymund R Razonable, Jay A Fishman","doi":"10.1111/tid.70349","DOIUrl":"https://doi.org/10.1111/tid.70349","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149246515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pretransplantation Risk Stratification for BK Polyomavirus DNAemia After Kidney Transplantation: Impact of Donor Viruria, Anti-BKPyV IgG Antibodies, and Viral Subtype.","authors":"Yuko Miwa, Satoshi Ashimine, Kenta Iwasaki, Kosei Horimi, Takaharu Nagasaka, Masato Shizuku, Kohei Ishiyama, Asami Takeda, Takaaki Kobayashi","doi":"10.1111/tid.70339","DOIUrl":"https://doi.org/10.1111/tid.70339","url":null,"abstract":"<p><strong>Background: </strong>BK polyomavirus (BKPyV) DNAemia is a major complication of kidney transplantation and can progress to BKPyV-associated nephropathy. In the absence of effective antiviral therapies, pretransplant risk stratification is essential. We evaluated the utility of pretransplant virological and serological markers for identifying recipients at risk for posttransplant BKPyV DNAemia.</p><p><strong>Methods: </strong>This retrospective single-center cohort study included 111 living donor-recipient pairs who underwent kidney transplantation between 2016 and 2023 and had available pretransplant urine and serum samples. Urinary BKPyV-DNA levels were quantified by PCR, anti-BKPyV VP1 IgG levels were measured by ELISA, and viral subtypes were determined by VP1 sequencing. ROC-derived cutoff values were used to construct combined risk models.</p><p><strong>Results: </strong>BKPyV DNAemia developed in 18 recipients. Pretransplant donor viruria (> 130 copies/mL) and higher donor anti-BKPyV IgG levels (> 5.27) were associated with subsequent DNAemia. The incidence of DNAemia was higher among recipients with lower anti-BKPyV IgG levels (≤ 1.82). Recipients with low antibody levels receiving grafts from donors with high viruria had the highest incidence of DNAemia (62.5%). BKPyV subtype III was detected in 7 of 18 recipients (38.9%) during posttransplant DNAemia despite its rare detection before transplantation.</p><p><strong>Conclusions: </strong>A pretransplant risk stratification model combining donor urinary BKPyV-DNA and recipient anti-BKPyV IgG identified a subgroup at increased risk for posttransplant BKPyV DNAemia in this single-center cohort. Although external validation is required, this simple two-factor approach may facilitate risk-adapted surveillance after kidney transplantation.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149246540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Conventional Imaging Is Nondiagnostic: FDG-PET/CT as a Diagnostic Roadmap to Pulmonary Nocardiosis After Kidney Transplantation.","authors":"Thotanolla Surya Prakash, Kokila Raghavendra","doi":"10.1111/tid.70348","DOIUrl":"https://doi.org/10.1111/tid.70348","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149246555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging Guideline-Based CMV Prevention and Emerging Pediatric Evidence After Hematopoietic Cell Transplantation.","authors":"Taha Jamal Ahmad Bhutta, Noor Fatima Arshad","doi":"10.1111/tid.70345","DOIUrl":"https://doi.org/10.1111/tid.70345","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149239530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Donor-Derived Bartonella Infection After Kidney Transplantation: Challenges of Microbiological Confirmation and Heterogeneous Clinical Manifestations in Two Recipients From a Single Donor.","authors":"Mikus Saulīte, Samanta Cvetkova, Dana Kigitoviča","doi":"10.1111/tid.70340","DOIUrl":"https://doi.org/10.1111/tid.70340","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70340"},"PeriodicalIF":2.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Indicator of Cytomegalovirus Infection After Allogeneic Hematopoietic Cell Transplantation: Current CMV Reactivation.","authors":"Shunto Kawamura, Hideki Nakasone, Yuki Honjo, Junko Takeshita, Yukiko Misaki, Kosuke Takano, Kazuki Yoshimura, Koki Hashino, Kaisuke Yamamoto, Yuya Nakata, Takuto Ishikawa, Akari Matsuoka, Tomohiro Meno, Yuhei Nakamura, Masakatsu Kawamura, Nozomu Yoshino, Ayumi Gomyo, Masaharu Tamaki, Machiko Kusuda, Shun-Ichi Kimura, Shinichi Kako, Yoshinobu Kanda","doi":"10.1111/tid.70337","DOIUrl":"https://doi.org/10.1111/tid.70337","url":null,"abstract":"<p><strong>Background: </strong>Cytomegalovirus reactivation (CMVR) after allogeneic hematopoietic cell transplantation (allo-HCT) is a reversible event, and conventional indicators such as the simple cumulative incidence cannot reflect transitional CMVR states. We propose a novel indicator, current CMVR (cCMVR), which visualizes both the occurrence and remission of CMVR over time.</p><p><strong>Methods: </strong>To evaluate the utility of cCMVR, we analyzed 389 CMV seropositive patients who had received their first allo-HCT. cCMVR was defined as the probability of the state where anti-CMV drugs were administered for CMVR or CMV disease without relapse or death at any time.</p><p><strong>Results: </strong>We compared two groups with or without letermovir prophylaxis (LTV and no-LTV groups). The 1-, 2-, 3-, and 6-month cCMVR values were 0.0%, 0.0%, 2.9%, and 2.9% in the LTV group, and 7.1%, 31.9%, 11.0%, and 0.8% in the no-LTV group. In the LTV group, cCMVR never exceeded 10%, while in the no-LTV group, cCMVR peaked at approximately 2 months after allo-HCT, and fewer than 5% of patients developed CMVR after 4 months post-HCT. Next, in the no-LTV group, we assessed cCMVR stratified according to the presence of risk factors for the simple cumulative incidence of CMVR, and this revealed that patients grafted from HLA-mismatched related donors and those who received alemtuzumab for GVHD prophylaxis appeared to experience repeated episodes of CMVR, whereas the early difference in cCMVR according to pretransplant CMV-IgG titer diminished over time.</p><p><strong>Conclusion: </strong>cCMVR could be a valuable indicator for visualizing recurrent CMV infection and illustrating differences in the time course of CMVR.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70337"},"PeriodicalIF":2.5,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Invasive Fungal Infections in Liver Transplant Recipients Receiving Risk-Stratified Echinocandin Prophylaxis: A Descriptive Single-Center Cohort Study.","authors":"Giulia Viero, Barbara Antonelli, Clara Dibenedetto, Vittorio Scaravilli, Luca Del Prete, Giulia Renisi, Laura Alagna, Anna Celotti, Michele Sagasta, Chiara Abbruzzese, Giacomo Grasselli, Pietro Lampertico, Cristiano Quintini, Alessandra Bandera, Andrea Lombardi","doi":"10.1111/tid.70338","DOIUrl":"https://doi.org/10.1111/tid.70338","url":null,"abstract":"<p><strong>Background: </strong>Invasive fungal infection (IFI) remains a cause of morbidity and mortality after liver transplantation; guidelines recommend targeted antifungal prophylaxis in recipients with specific risk factors.</p><p><strong>Methods: </strong>We retrospectively studied adult liver transplant recipients (LTR) at a single center, 2017-2023. High-risk recipients received a planned 14-day course of echinocandin prophylaxis, caspofungin in 97.6%. The primary endpoint was IFI within 30 days of transplantation, a window spanning the planned prophylaxis and the 2 weeks after it. Secondary endpoints were fungal etiology and factors associated with IFI. We also examined the temporal distribution of early aspergillosis across the whole institutional registry to 2025.</p><p><strong>Results: </strong>Of 286 recipients, 85 (29.72%) were high risk. IFI was more frequent in high-risk than non-high-risk LTR (8/85, 9.41% vs. 4/201, 1.99%; p = 0.0077); most were breakthrough (7/8) mold infections. In exploratory analyses, IFI was associated with high-risk status (unadjusted odds ratio: 5.12, 95% CI: 1.50-17.49), MELD > 30 (4.67, 1.25-17.41) and diabetes (4.64, 1.37-15.79); with 12 events, these estimates are imprecise, and no multivariable model was fitted. Among 452 transplants performed in 2017-2025, seven developed early aspergillosis across four calendar years, with no significant variation in annual incidence (p = 0.146), never more than two cases in any 90-day window (Monte Carlo p = 0.82) and none among the 117 transplants of the following 28 months.</p><p><strong>Conclusion: </strong>Early IFI under risk-stratified echinocandin prophylaxis concentrated in the sickest recipients and was dominated by mold disease. No clear temporal pattern suggestive of a sustained common-source outbreak was identified, although environmental transmission cannot be excluded.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70338"},"PeriodicalIF":2.5,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: The Impact of Systematic Latent Tuberculosis Infection Screening in Kidney Transplant Candidates: Experience From a Single UK Transplant Center.","authors":"Joseph Sturman","doi":"10.1111/tid.70335","DOIUrl":"https://doi.org/10.1111/tid.70335","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70335"},"PeriodicalIF":2.5,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}