Transplant Infectious Disease最新文献

{"title":"Hemorrhage Incognito.","authors":"Scott Borgetti, Katherine Ortell, Varun Phadke, Danielle Haakinson, Steven Fischer, Maricar Malinis","doi":"10.1111/tid.14433","DOIUrl":"10.1111/tid.14433","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14433"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin D Levels and the Risk of Post-Transplant Infection: Where There's Smoke, Is There Fire?","authors":"Eduardo Aparicio-Minguijón, Mario Fernández-Ruiz","doi":"10.1111/tid.14443","DOIUrl":"10.1111/tid.14443","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14443"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011671","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":"Frailty and Infection in Solid-Organ Transplant Recipients.","authors":"Sarah Taimur, Michael G Ison, John W Baddley, Maheen Z Abidi","doi":"10.1111/tid.14445","DOIUrl":"10.1111/tid.14445","url":null,"abstract":"<p><strong>Background: </strong>The association between frailty and infection in the transplant population is not well understood. Emerging data suggests that frailty at the time of transplant is associated with increased infection risk in liver and older kidney transplant recipients.</p><p><strong>Methods: </strong>The authors conducted a brief electronic survey of transplant infectious disease (TID) clinicians, to assess clinical practice trends on frailty assessment.</p><p><strong>Results: </strong>Among survey participants, only 40% reported a routine assessment of frailty in transplant candidates and recipients at their institutions, most commonly in liver transplant patients. The majority of respondents (77%) reported not being routinely involved in making clinical decisions utilizing frailty information. Seventy-one percent reported interest in the study of frailty in relation to infections in the transplant host.</p><p><strong>Conclusion: </strong>In this survey of TID clinicians, less than half reported a formal frailty assessment for candidates and recipients at their institutions. TID clinicians are mostly not involved in making clinical decisions related to frailty; however, the majority endorsed interest in frailty and infection research. We need future studies to enhance our understanding of the emerging data on the association between frailty and infection risk in the transplant host.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14445"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coccidioidomycosis Prophylaxis in Liver, Kidney, and Heart Transplant Recipients Residing in Endemic Areas Within the United States.","authors":"Faiza Morado, Roland Davoudi, Rachel Cartus, Pnada Kawewat-Ho, Apurva Akkad, Suhail A Shaikh","doi":"10.1111/tid.70004","DOIUrl":"10.1111/tid.70004","url":null,"abstract":"<p><strong>Background: </strong>Solid organ transplant (SOT) recipients residing in southwestern United States may be at an increased risk of symptomatic coccidioidomycosis (CM). Accordingly, clinical practice guidelines recommend the use of a universal oral azole antifungal prevention strategy for all SOT recipients residing in a CM endemic area. However, this recommendation is based on limited evidence. Our center does not routinely utilize CM azole antifungal prophylaxis for SOT recipients at low risk for de novo CM infection.</p><p><strong>Objective: </strong>To determine the incidence of CM with or without CM prophylaxis in Coccidioides seronegative liver, kidney, and heart transplant recipients residing in endemic areas with no documented history of CM at time of transplant.</p><p><strong>Study design: </strong>A retrospective chart review was performed for SOT recipients who resided in CM endemic areas and received an organ transplant at Keck Hospital of USC between March 2017 and June 2023. Patients receiving CM prophylaxis with fluconazole were compared to patients not receiving CM prophylaxis. The primary end point was incidence of CM infection or asymptomatic seroconversion.</p><p><strong>Results: </strong>In our 85-patient cohort, 18 patients received CM prophylaxis compared to 67 patients who did not. Most patients who received prophylaxis were heart transplant recipients (66.6%). No cases of CM occurred within a median follow-up period of 2.2 years.</p><p><strong>Conclusion: </strong>CM prophylaxis can be considered but may not be warranted for liver and kidney transplant recipients residing in Coccidioides endemic areas who are seronegative for Coccidioides and have no history of CM before transplant.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70004"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microscopy: Not the Lost Art!","authors":"Renjith Mathew Verghese, Gurpreet Singh Bhalla","doi":"10.1111/tid.70007","DOIUrl":"10.1111/tid.70007","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70007"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473117","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":"Outcomes Associated With Blastomycosis in Solid Organ and Hematopoietic Cell Transplant Recipients.","authors":"Vaisak O Nair, Bradley Johnson, Paschalis Vergidis, Nischal Ranganath","doi":"10.1111/tid.14430","DOIUrl":"10.1111/tid.14430","url":null,"abstract":"<p><strong>Introduction: </strong>With reports of expanding epidemiology of blastomycosis across the United States, the purpose of this study was to evaluate the incidence and outcomes associated with blastomycosis in solid organ transplant (SOT) and hematopoietic cell transplant (HCT) recipients.</p><p><strong>Methods: </strong>We conducted a retrospective case series of adult SOT and HCT recipients at a tertiary care medical center between January 1, 2005 and September 30, 2023. Cases were defined as culture-proven blastomycosis. We performed descriptive statistical analysis to evaluate diagnosis, management, and outcomes (mortality) of blastomycosis in SOT.</p><p><strong>Results: </strong>The cumulative incidence of blastomycosis was 0.11% with a median time to infection following transplant of 743 days. Of the 19 cases, the majority of patients were SOT recipients (90%). Supratherapeutic immunosuppression within 30 days of diagnosis was observed in 42% of cases with documented drug monitoring. Urine antigen testing was highly sensitive (100%). Fourteen (73.7%) patients received induction therapy with liposomal amphotericin B followed by azole therapy for a minimum of 12 months. Despite appropriate treatment, 1-year mortality was high at 26.3%, with attributable mortality of 21.1%.</p><p><strong>Conclusions: </strong>While rates of blastomycosis remain low among SOT and HCT recipients, infection is associated with poor posttransplant outcomes. Antigen testing can aid in timely assessment of disease severity and initiation of appropriate therapy. Among survivors, no relapses were observed while on lifelong secondary suppression. Future studies should aim to better define risk factors associated with developing blastomycosis and establish effective strategies for prevention.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14430"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898187","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":"Allogeneic Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia With Active Left Neck Tuberculosis: A Case Report.","authors":"Ying He, Yan Deng, Hai Yi","doi":"10.1111/tid.14435","DOIUrl":"10.1111/tid.14435","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14435"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955725","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":"Comparative Effectiveness of Outpatient COVID-19 Therapies in Solid Organ Transplant Recipients.","authors":"Zachary A Yetmar, Viengneesee Thao, David A Helfinstine, Kelly M Pennington, Raymund R Razonable","doi":"10.1111/tid.14436","DOIUrl":"10.1111/tid.14436","url":null,"abstract":"<p><strong>Background: </strong>Multiple outpatient therapies have been developed for COVID-19 in high-risk individuals, but solid organ transplant (SOT) recipients were not well represented in controlled clinical trials. To date, few comparative studies have evaluated outcomes between outpatient therapies in this population.</p><p><strong>Methods: </strong>We performed a retrospective cohort study using de-identified administrative claims data from OptumLabs Data Warehouse. Patients were included if they were age ≥ 18 years, diagnosed with COVID-19 between January 2022 and December 2023, and underwent SOT prior to COVID-19. The primary outcome was 30-day hospitalization. Stabilized inverse probability of treatment weighting was used to account for potential confounding variables.</p><p><strong>Results: </strong>4192 SOT recipients with COVID-19 were identified. 1403 received an outpatient COVID-19 therapy, including anti-spike monoclonal antibodies (N = 748, 53.3%), molnupiravir (N = 327, 23.3%), ritonavir-boosted nirmatrelvir (N = 217, 15.5%), or remdesivir (N = 141, 10.0%). In weighted analysis compared to no treatment, anti-spike monoclonal antibodies (hazard ratio [HR] 0.39, 95% confidence interval [CI] 0.28-0.55; p < 0.001), molnupiravir (HR 0.56, 95% CI 0.36-0.89; p = 0.013), and nirmatrelvir (HR 0.47, 95% CI 0.25-0.89; p = 0.020) were associated with reduced hospitalization risk, while remdesivir (HR 1.00, 95% CI 0.50-1.98; p = 0.992) was not. Hospitalization rates were similar between the treatment agents, apart from remdesivir showing a higher risk compared to anti-spike monoclonal antibodies.</p><p><strong>Conclusions: </strong>Outpatient COVID-19 therapies were largely associated with improved outcomes among SOT recipients. These treatment agents showed similar rates of 30-day hospitalization, except for remdesivir. The choice of outpatient COVID-19 therapy in SOT recipients should primarily account for patients' individual circumstances and drug-drug interactions rather than differential therapeutic efficacy.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14436"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955726","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":"Efficacy and Safety of Letermovir for Cytomegalovirus Prophylaxis in Pediatric Hematopoietic Stem Cell Transplantation Recipients: A Systematic Review, Meta-Analysis, and Meta-Regression.","authors":"Abdullah Yousef Aldalati, Ayham Mohammad Hussein, Elsayed Balbaa, Bara M Hammadeh, Muhammad Idrees, Osama Aloudat, Moath Albliwi, Mohammad Abuassi, Iyad Sultan","doi":"10.1111/tid.70006","DOIUrl":"10.1111/tid.70006","url":null,"abstract":"<p><strong>Objective: </strong>Letermovir (LTV) is a novel antiviral agent approved by the FDA in 2017 for CMV prophylaxis in adult CMV-seropositive allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients and approved for pediatric use in 2024. This study systematically evaluates the efficacy and safety of LTV prophylaxis for CMV infection in pediatric allo-HSCT recipients.</p><p><strong>Methods: </strong>We systematically searched PubMed, Scopus, Web of Science, Embase, and Cochrane Library up to December 2024 for studies that evaluated the use of LTV prophylaxis in pediatric allo-HSCT recipients. We conducted single-arm meta-analysis using Open Meta Analyst software and double-arm meta-analysis using R Studio. We pooled the dichotomous outcomes as event and total using the fixed-effects model.</p><p><strong>Results: </strong>Twelve articles were included in the analysis. The single-arm meta-analysis indicated that the prophylactic use of LTV against CMV among pediatrics was associated with a 10.9% (95% CI: 0.065, 0.153) infection rate without any disease occurrence. The percentage of patients who discontinued the drug due to adverse reactions was only 2.4% (95% CI: 0.003, 0.045), and all-cause mortality was 7.9% (95% CI: 0.032, 0.126). The double-arm meta-analysis results indicated that the incidence of CMV infection was significantly lower in the LTV group in comparison to the control group (RR: 0.29; 95% CI: 0.16, 0.56; p < 0.001).</p><p><strong>Conclusion: </strong>LTV has demonstrated safety and efficacy in preventing CMV infection and disease among high-risk pediatric patients. Future large scale randomized trials are necessary to validate the findings.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70006"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442187","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":"Reactivation of Chagas Disease in the Central Nervous System Among Heart Transplant Recipients: A Clinical Series From Brazil, 2006-2023.","authors":"Jacqueline Ferreira de Oliveira, Ana Luiza Barbosa, Gláucia Cota, Fábio Morato de Castilho, Silvio Amadeu de Andrade, Guilherme Ferraz Messina de Pádua Andrade, Juliana Rodrigues Soares Oliveira, Paulo Pereira Christo, Breno Franco Silveira Fernandes, Rodrigo Santiago Gomez, Israel Molina","doi":"10.1111/tid.70021","DOIUrl":"https://doi.org/10.1111/tid.70021","url":null,"abstract":"<p><strong>Background: </strong>Chagas disease is a relevant cause of heart transplantation. The risk of reactivation is a potential concern. This study aimed to describe the reactivation of Trypanosoma cruzi in the central nervous system (CNS).</p><p><strong>Methods: </strong>We performed a retrospective study of all heart transplants for Chagas disease undertaken between 2006 and 2023 at a single institution in Brazil to define the prevalence of neurological reactivation and reviewed clinical characteristics and outcomes associated with CNS T. cruzi involvement.</p><p><strong>Results: </strong>Among 187 Chagas disease recipients, 11 episodes of neurologic reactivation were identified in nine patients, at a median of 160 days after transplant. Two patients had a relapse more than a year after the first episode. Three patients died and the remaining six had neurological sequelae. Of the 11 episodes of CNS reactivation, eight were confirmed based on finding T. cruzi parasites or DNA in cerebrospinal fluid or brain tissue biopsy, the remaining three episodes were considered probable by demonstrating parasites in blood and other tissues. Focal neurological manifestations (8 of 11 episodes) and a single lesion with the predominant involvement of white matter (6 of 11 episodes) were the most common features. Brain biopsy was the gold standard tool, detecting five of seven CNS reactivation. T. cruzi PCR in cerebrospinal fluid confirmed two of three cases, and direct examination has a low diagnostic yield, detecting only one of six episodes.</p><p><strong>Conclusion: </strong>Neurological Chagas reactivation is a rare and severe posttransplant complication that should be considered in any at-risk heart recipient.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":"27 2","pages":"e70021"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}