Transplant Infectious Disease最新文献

{"title":"Antibiotic Exposure and Risk of Allograft Rejection and Survival After Liver Transplant: An Observational Cohort Study From a Tertiary Referral Centre.","authors":"Olivia C Smibert, Sara Vogrin, Marie Sinclair, Avik Majumdar, Mohamed Nasra, Dinesh Pandey, Hossein Jahanabadi, Jason A Trubiano, Kate A Markey, Monica A Slavin, Adam Testro, Jason C Kwong","doi":"10.1111/tid.70026","DOIUrl":"10.1111/tid.70026","url":null,"abstract":"<p><strong>Introduction: </strong>Our goal is to understand whether there is an association between Abx exposure-and the inferred downstream damage to the intestinal microbiome-and the key patient outcomes of overall survival and rejection following liver transplant.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 462 liver transplant recipients treated at a multistate liver transplant (LTx) service during a 7-year period. The association between antibiotic exposure and outcome was tested across models that addressed antibiotic spectrum, duration, and timing relative to transplant. Cox proportional hazard regression was used to evaluate the relationship between antibiotics with survival and rejection.</p><p><strong>Results: </strong>The observed 1-year survival in this cohort was 95% (95% CI: 93%, 97%), and 20.8% of patients (96/462) experienced rejection at 1 year. In multivariable analyses, exposure to anaerobe-targeting antibiotics for longer than 14 days pretransplant (p = 0.055) or posttransplant (p = 0.040) was significantly associated with reduced 1-year survival. In multivariable analyses, exposure to any anaerobe-targeting Abx posttransplant was significantly associated with an increased risk of rejection (p = 0.001).</p><p><strong>Conclusions: </strong>Exposure to anaerobic spectrum antibiotics either before or after LTx was associated with poor outcomes during the first year posttransplant and provides an impetus to further characterize the relationship between antibiotic use, microbiota disruption, and cellular immunity in liver transplantation.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70026"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735699","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":"Vaccine Adjuvants in the Immunocompromised Host: Science, Safety, and Efficacy.","authors":"Haya Hayek, Lana Hasan, Justin Z Amarin, Yasmeen Z Qwaider, Olla Hamdan, Wanderson Rezende, Kevin C Dee, James D Chappell, Natasha B Halasa","doi":"10.1111/tid.70053","DOIUrl":"10.1111/tid.70053","url":null,"abstract":"<p><p>Vaccine adjuvants are essential for enhancing immune responses to vaccines, particularly in immunocompromised populations who typically demonstrate suboptimal responses to standard vaccination. This narrative review evaluates the safety and efficacy of approved and candidate adjuvants in immunocompromised hosts, with emphasis on solid organ and hematopoietic cell transplant recipients. We examine conventional aluminum-based adjuvants alongside modern adjuvant systems such as AS01_B, MF59, and AS04, analyzing their mechanisms of action and clinical applications. The review synthesizes current evidence on the safety profiles of approved adjuvanted vaccines in immunocompromised individuals and explores emerging adjuvant candidates, including saponin complexes and toll-like receptor agonists. By examining factors that influence adjuvant immunogenicity and safety in these vulnerable populations, we identify critical knowledge gaps and future research priorities. This comprehensive analysis provides clinicians and researchers with an updated perspective on the rapidly evolving landscape of vaccine adjuvants and their specific applications in immunocompromised hosts.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70053"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094996","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":"Crusted Scabies with Facial Involvement in a Patient Following Haploidentical Hematopoietic Stem Cell Transplantation: A Case Report.","authors":"Yingying Qian, Siyuan Song, Yan Li","doi":"10.1111/tid.70002","DOIUrl":"10.1111/tid.70002","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70002"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442186","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":"Addressing the Challenge of Bacterial Infections and Antimicrobial Stewardship in Heart Transplant Recipients: Beating in Harmony.","authors":"Miranda So","doi":"10.1111/tid.70034","DOIUrl":"10.1111/tid.70034","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70034"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983820","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":"Reply to: Critique on \"Infection-Associated Immune Reconstitution Inflammatory Syndrome in Hematopoietic Cell Transplantation\".","authors":"Mansi Chaturvedi, Brian Epling, Maura Manion, Jennifer Cuellar-Rodriguez","doi":"10.1111/tid.70033","DOIUrl":"10.1111/tid.70033","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70033"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025295","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":"Cytomegalovirus-Induced Arterial Intimal Fibrosis in the Kidney Transplant.","authors":"Anukul Ghimire, Simon R Walker, Fareed Kamar","doi":"10.1111/tid.70027","DOIUrl":"10.1111/tid.70027","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70027"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701655","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":"Point-of-Care Testing by Multiplex-PCR in Different Compartments in Suspected Lower Respiratory Tract Infection After Lung Transplantation-Results of a Prospective Study.","authors":"Susanne Simon, Merle Sophie Kaiser, Marcus Bachmann, Gérard Krause, Jens Gottlieb","doi":"10.1111/tid.70036","DOIUrl":"https://doi.org/10.1111/tid.70036","url":null,"abstract":"<p><strong>Background: </strong>Respiratory tract infections (RTIs) are a leading cause of morbidity and mortality following lung transplantation (LTx). This study evaluated a point-of-care multiplex-PCR testing system (POCTmPCR) for pathogen detection in various respiratory samples from LTx recipients.</p><p><strong>Methods: </strong>In a prospective single-center study, LTx recipients with RTI undergoing bronchoscopy were enrolled. Samples from bronchoalveolar lavage (BAL), sputum, and nasopharyngeal swabs (NPS) were analyzed by POCTmPCR in conjunction with conventional diagnostics. The primary study endpoint was the concordance of POCTmPCR results between samples (DRKS00032359).</p><p><strong>Results: </strong>Fifty participants with a median age of 48 years were included; 28 (56%) were previously colonized. Using POCTmPCR, 44 bacterial pathogens were identified in BAL from 30 patients, 49 in sputum (30 patients), and 33 in NPS (17 patients). POCTmPCR identified 24 viral pathogens in BAL from 20 patients, 22 pathogens in sputum of 19 patients, and 19 in NPS of 19 patients. For viral POCTmPCR, sensitivity and specificity compared to BAL were 84% and 97% in sputum, and 80% and 97% in NPS, respectively. For bacterial POCTmPCR, sensitivity and specificity were 80% and 67% in sputum, and 37% and 85% in NPS, respectively. POCTmPCR in comparison to conventional workup had a sensitivity of 89% and 80% and specificity of 75% and 76% for viral and bacterial pathogens, respectively.</p><p><strong>Conclusion: </strong>POCTmPCR in nasal swabs and sputum may serve as an alternative to BAL for detecting respiratory viruses. Performance for bacterial detection in noninvasive samples was lower. The POCTmPCR system used lacks detection for SARS-CoV-2 and Aspergillus spp.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70036"},"PeriodicalIF":2.6,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035882","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":"Clinically Significant EBV Infection in Allogeneic Stem Cell Transplanted Children Receiving Letermovir as Primary CMV Prophylaxis.","authors":"Christina Oikonomopoulou, Anna Paisiou, Aikaterini Kaisari, Eleni-Dikaia Ioannidou, Anna Komitopoulou, Marina Letsiou, Ioannis Grafakos, Michalis Kastamoulas, Georgia Stavroulaki, Sofia Hante, Evgenios Goussetis","doi":"10.1111/tid.70032","DOIUrl":"https://doi.org/10.1111/tid.70032","url":null,"abstract":"<p><strong>Background: </strong>Cytomegalovirus (CMV) infection and disease constitute an important complication of allogeneic hematopoietic stem cell transplantation with high morbidity. Letermovir prophylactic use in adult recipients has reduced the incidence of CMV infection with minimal toxicity. Relevant data on children is scarce, and letermovir has been used off-label. Recently, a couple of studies indicated an association of letermovir with EBV reactivation/PTLD in adults, raising a significant concern.</p><p><strong>Methods: </strong>We aimed to retrospectively compare ultra-high-risk for CMV infection children with leukemia [seropositive children/seronegative donors], who received (LET-group) or did not receive (not LET-group) letermovir. Primary objectives were cumulative incidence (CI) of CMV reactivation, EBV reactivation, and clinically significant EBV infection (csEBVi).</p><p><strong>Results: </strong>A total of 37 patients (median age 8.2 years), LET-group-11 and not LET-group-26, were included. The median follow-up was 34.3 months. Compared to the not LET group, patients of the LET group had a lower CI of CMV reactivation, 10% versus 38.4%, p = 0.07, a higher CI of EBV reactivation, 55%, referring to 6/11 patients, versus 23%, p = 0.07, and a higher CI of csEBVI, 40% (4/11 patients) versus 0%, p < 0.001. No patient in the LET group developed GvHD, compared to 23% for aGvHD p = 0.08 and 11.5% for cGvHD p = 0.25 in the non-LET group.</p><p><strong>Conclusion: </strong>Our study confirms letermovir's effectiveness against CMV. Yet, it also reports a high incidence of EBV reactivation and significant EBV infection, as well as a reduced GvHD prevalence in children receiving the drug. Our single-center, retrospective analysis has major limitations but raises a concern. Our findings require further validation in larger, multicenter, prospective studies.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70032"},"PeriodicalIF":2.6,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014673","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":"Proof of Concept that Implementation of a Multispecialty Educational Intervention May Improve Acceptance of Organs from Donors with HIV at a Tertiary Care Hospital: A Single-Center Study.","authors":"Neeraja Swaminathan, Yoram A Puius, Jonathan Czeresnia, Victoria A Muggia, Yorg Azzi, Harith Raees, Enver Akalin, Vagish Hemmige","doi":"10.1111/tid.70039","DOIUrl":"https://doi.org/10.1111/tid.70039","url":null,"abstract":"<p><strong>Background: </strong>People living with HIV have a higher waitlist mortality and decreased access to transplants. The enactment of the HIV Organ Policy Equity Act (HOPE Act) in 2013 was a step toward increasing the donor population. However, utilization of organs through the act has been less than initially anticipated, both nationally and initially at our center.</p><p><strong>Methods: </strong>To improve the acceptance of abdominal organs from donors with positive HIV tests (D+) for recipients with HIV (R+), we implemented a multidisciplinary educational intervention at our center in December 2020.</p><p><strong>Results: </strong>Comparing the preintervention period (March 2018-November 2020) to the postintervention period (December 2020-April 2022), the number of organs that were declined for potentially HIV-related reasons decreased significantly from 91% to 63% (p = 0.004). The proportion of organs declined at our center for potentially HIV-related reasons that were accepted later by another center was 40% (10/25) preintervention and 24% (12/49) postintervention (p = 0.2). The rate of transplants/patient-years on our center's waiting list overall tripled (IRR 3.11; 95% CI 1.08-9.44, p = 0.036), with the rate of HIV D+/R+ transplants increasing more dramatically (IRR 16.3; 95% CI 2.90-305, p = 0.009).</p><p><strong>Conclusion: </strong>Intensive provider education may have an impact on improving rates of transplantation of HIV+ recipients and realizing the potential of the HOPE ACT.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70039"},"PeriodicalIF":2.6,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038699","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":"Direct-Acting Antiviral Treatment Failure and Retreatment Strategies Following Hepatitis C-Positive Solid Organ Transplantation in Hepatitis C-Negative Recipients: A Multicenter Case Series.","authors":"Alicia B Carver, Claire Özoral, Morgan Lange, Alysa Mattise, Kristen Whelchel, Roman Perri","doi":"10.1111/tid.70024","DOIUrl":"10.1111/tid.70024","url":null,"abstract":"<p><strong>Background: </strong>Transplanting solid organs from hepatitis C virus (HCV) nucleic acid testing (NAT+) donors (D+) into HCV-negative recipients (R-) has become more common with the development of curative direct-acting antiviral (DAA) treatment. Limited information exists to guide retreatment strategies for patients not achieving sustained virologic response (SVR) with DAAs. This multisite case series examines retreatment strategies and subsequent SVR rates in HCV-negative solid-organ transplant (SOT) recipients who did not achieve SVR following reactive initial DAA therapy following NAT+ SOT.</p><p><strong>Methods: </strong>A retrospective multisite case series was conducted on patients not achieving SVR with initial DAA treatment post-NAT+ HCV SOT between September 2016 and September 2022 across four tertiary medical centers in the United States.</p><p><strong>Results: </strong>Thirteen patients were identified, predominantly receiving HCV NAT+ kidneys (77%) and SOF/VEL for 12 weeks as initial DAA therapy (43%). Baseline resistance testing was not performed. Median time to treatment initiation post-SOT was 35 [IQR 22-41] days, and to retreatment postpositive viral load was 35 days [IQR 17-76]. Most patients (62%) were retreated with sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX) for 12 weeks. Two patients required retreatment extension with SOF/VEL/VOX and SOF/VEL/VOX + ribavirin (RBV) from 12 to 24 weeks due to persistent viremia. Only one patient did not achieve SVR following retreatment with SOF/VEL/VOX for 12 weeks but did achieve SVR after a third course of treatment with SOF + GLE/PIB + RBV for 24 weeks.</p><p><strong>Conclusion: </strong>Despite initial DAA failures, all HCV-negative SOT recipients achieved SVR following one or more courses of retreatment with DAAs.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70024"},"PeriodicalIF":2.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701662","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}