Transplant Infectious Disease最新文献

{"title":"Donor Microbiota Features Associated With Liver Transplant Recipient Infectious Complications: A Pilot Study Using Deep Intestinal Sampling During Liver Procurement.","authors":"Olivia C Smibert, Geraldine Kong, Kate A Markey, Louise M Judd, Benjamin Howden, Timothy P Stinear, Claire Gordon, Varun J Sharma, Rohit D'Costa, Marie Sinclair, Avik Majumdar, Graham Starkey, Adam Testro, Jason A Trubiano, Monica A Slavin, Jason C Kwong","doi":"10.1111/tid.70322","DOIUrl":"https://doi.org/10.1111/tid.70322","url":null,"abstract":"<p><strong>Background: </strong>The gut microbiota of living organ donors has been linked to transplant outcomes. However, little is known about the characteristics of the deceased donor gut microbiota or its potential impact on recipient outcomes.</p><p><strong>Methods: </strong>We analyzed the deep intestinal microbiota from 24 deceased donors. Samples included luminal stool from the right and left colon as well as bile. Microbial composition was characterized using 16S V4 rRNA sequencing. α- and β-diversity analyses were performed to compare microbial communities between donor enteric sites and against stool samples from 28 healthy community controls, 14 critically ill intensive care comparators, and 12 matched liver transplant recipients. Machine learning models and logistic regression analysis were applied to explore whether features of the donor microbiota could predict recipient post-transplant complications.</p><p><strong>Findings: </strong>The deceased donor microbiota showed an absence of the expected compositional variability between sampling sites, with no significant differences in either α- or β-diversity observed between bile, right and left colonic samples (all p > 0.05). Donor samples exhibited distinct microbial profiles compared with stool from both healthy and ICU comparators, including increased abundance of potential pathogens within the Enterobacteriaceae family (all p < 0.001). Features of the donor microbiota, particularly enrichment of Enterobacteriaceae, were associated with an increased risk of early post-transplant infection in recipients (≤ 30 days; p = 0.011).</p><p><strong>Interpretation: </strong>The deceased donor gut microbiota may represent a distinct microbial community with potential clinical relevance. Microbial profiling of donor enteric microbiota may help identify recipients at heightened risk of early post-transplant infectious complications.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70322"},"PeriodicalIF":2.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971494","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":"Kidney Transplantation in Patients at Risk for Chagas Reactivation or Transmission: A Real-World Cohort Study.","authors":"Marcelo Victor Radisic, Natalia Pujato, Roxana Del Grosso, Maria Del Carmen Rial, Constanza Lopez-Albizu, Javier Walther","doi":"10.1111/tid.70319","DOIUrl":"https://doi.org/10.1111/tid.70319","url":null,"abstract":"<p><strong>Background: </strong>Kidney transplant recipients in endemic areas are at risk of Trypanosoma cruzi reactivation or donor-derived infection.</p><p><strong>Methods: </strong>We performed a retrospective study of all kidney transplants conducted between January 2018 and October 2023. Patients at risk for Chagas disease were defined as those with a seropositive donor and seronegative recipient (D+/R-), a seronegative donor and seropositive recipient (D-/R+), or a seropositive donor and a seropositive recipient (D+/R+). Screening was based on serology. Posttransplant monitoring included parasitemia detection using direct microscopy (Strout method) and quantitative polymerase chain reaction (qPCR). Outcomes included Chagas reactivation or primary infection, parasitemia dynamics, and clinical outcomes. Data on immunosuppression, rejection treatment, and graft and patient survival were also collected.</p><p><strong>Results: </strong>Among 954 kidney transplant recipients, 48 (5%) were identified as being at risk. Two patients were excluded (follow-up at another center, n = 1; immediate graft loss due to hyperacute rejection, n = 1). qPCR detected parasitemia in 3/17 (18%) seropositive recipients and 2/28 (7%) recipients of organs from seropositive donors. (One of these two patients was non-adherent to monitoring, and developed parasitemia detectable by the Strout method and clinical disease). Antitrypanosomal therapy was initiated in five patients (benznidazole, n = 4; nifurtimox, n = 1), including three R+ and two D+/R- cases, all achieving molecular clearance. During follow-up (median: 29.77 months (range: 8.49-80.7), no patient developed further clinical manifestations after treatment.</p><p><strong>Conclusions: </strong>Molecular monitoring allows early detection of Chagas reactivation or transmission after kidney transplantation. Preemptive treatment triggered by parasitemia appears effective in preventing progression to clinical disease, with favorable long-term outcomes.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70319"},"PeriodicalIF":2.5,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963748","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":"Acute Q Fever Pneumonia in a Renal Transplant Recipient.","authors":"Quan Zhou, Peijun Zhou, Kun Shao","doi":"10.1111/tid.70308","DOIUrl":"https://doi.org/10.1111/tid.70308","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70308"},"PeriodicalIF":2.5,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956976","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":"Short Term Safety and Effectiveness of Valganciclovir Prophylactic Dosing for Cytomegalovirus in Solid Organ Transplant Recipients Requiring Intermittent Hemodialysis.","authors":"Megan Edwards, Ashley Sturm, Jenny Shulha, Kristin Cole, Maryam Mahmood, Lanea Glauner","doi":"10.1111/tid.70317","DOIUrl":"https://doi.org/10.1111/tid.70317","url":null,"abstract":"<p><strong>Background: </strong>Valganciclovir is the preferred antiviral agent for cytomegalovirus (CMV) prophylaxis in solid organ transplant (SOT) recipients; however, limited data exist to guide optimal dosing in patients requiring intermittent hemodialysis (iHD). This study evaluated the safety and efficacy of our institution's current dosing strategy of valganciclovir 450 mg three times weekly.</p><p><strong>Methods: </strong>In this single-center, retrospective study, adult liver, heart, lung, and kidney transplant recipients from January 2014 to November 2024 were included. Patients requiring ≥ 3 iHD sessions posttransplant and receiving valganciclovir 450 mg three times weekly were compared with recipients with normal renal function receiving 900 mg once daily. The primary outcomes were the risk of neutropenia, leukopenia, and thrombocytopenia within 3.5 months posttransplant.</p><p><strong>Results: </strong>A total of 116 patients were included in the iHD cohort and were matched 1:2 to 232 patients in the normal renal function cohort. Rates of leukopenia and neutropenia were comparable between cohorts. However, thrombocytopenia occurred significantly more frequently in the iHD cohort (45.2% vs. 26.7%; p = 0.002). No significant differences were observed in rates of CMV infection between groups.</p><p><strong>Conclusion: </strong>Valganciclovir 450 mg three times weekly appears safe and effective for CMV prophylaxis in SOT recipients requiring iHD, though it may be associated with an increased risk of thrombocytopenia.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70317"},"PeriodicalIF":2.5,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920240","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":"Recipient-Donor Sex Combinations and Posttransplant Infections: A Swiss Transplant Cohort Study.","authors":"Christian T J Magyar, Charlene P Gretener, Jaromil Frossard, Katell Mellac, Daniel Sidler, David Reineke, Nicolas J Mueller, Franz Immer, Christian van Delden, Oriol Manuel, Thorsten Krueger, Nina Khanna, Katia Boggian, Lara Beekman, Cédric Hirzel, Vanessa Banz","doi":"10.1111/tid.70245","DOIUrl":"10.1111/tid.70245","url":null,"abstract":"<p><strong>Background: </strong>Despite increasing interest in sex and gender in transplant medicine, the impact of recipient-donor sex combinations (RDSCs) on posttransplant infections, graft survival, and rejection remains unclear. To assess if RDSC is independently associated with infectious events in solid organ transplantion (SOT) recipients.</p><p><strong>Methods: </strong>This retrospective cohort study assessed a national prospectively maintained registry including six transplant centers. All adult patients, undergoing primary transplant of either heart, kidney, liver, or lung, between May 1, 2008, and December 31, 2021, were included. Endpoints were clinically significant infectious events (primary endpoint), graft survival, rejection, and overall survival within the first year. Patients were grouped as per RDSC. The primary statistical outcome of the organ-specific, a priori known risk factor-adjusted analyses are reported as incidence rate ratios (IRRs).</p><p><strong>Results: </strong>The cohort included 5033 recipients: 2886 (57.3%) kidney, 1224 (24.3%) liver, 515 (10.2%) lung, and 408 (8.1%) heart transplants, documenting 6067 infections. Recipient-donor sex mismatch was not associated with weighted posttransplant infection risk in heart (IRR: 1.06; 95% CI: 0.75, 1.48; p = 0.75), kidney (IRR: 1.03; 95% CI: 0.90, 1.17; p = 0.69), liver (IRR: 1.10; 95% CI: 0.81, 1.50; p = 0.52), or lung (IRR: 1.02; 95% CI: 0.82, 1.26; p = 0.89) recipients. Female kidney recipients had significantly higher infection rates than males (IRR: 1.50; 95% CI: 1.32, 1.71; p < 0.001), largely explained by urinary tract infections. One-year graft survival, rejection, and overall survival were unaffected by RDSC across all organs.</p><p><strong>Conclusion: </strong>RDSC does not influence 1-year SOT infectious outcome, as well as rejection or graft survival as exploratory outcomes.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70245"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148035573","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":"Antibiotic Tolerability in Nocardia Infection Among Kidney Transplant Recipients: A Multicenter Cohort Study.","authors":"M Pérez-Mir, C Canal Girol, L Escolà-Vergé, S Codina Sánchez, B O Chamoun, Z Castañeda, A Gonzalez Rojas, Ángela Isabel Casas Parra, Marc Gordo, Guillem López de Egea Vegas, Cristina Pitart, Adrià Antuori, Lluís Guirado, Leonor Fayos De Arizon, Núria Serra Cabañas, Christian Cordoba Herrera, Carme Facundo Molas","doi":"10.1111/tid.70239","DOIUrl":"10.1111/tid.70239","url":null,"abstract":"<p><strong>Background: </strong>Nocardia infection is a rare but severe complication in kidney transplant (KT) recipients, with high morbidity and mortality. Data on antibiotic tolerability in this population are scarce.</p><p><strong>Methods: </strong>We conducted a retrospective, multicentric study across six Spanish transplant units to analyze clinical characteristics, treatment strategies, and antibiotic tolerability in KT patients diagnosed with Nocardia infection.</p><p><strong>Results: </strong>Twenty-six cases of Nocardia infection were identified, predominantly in elderly male patients with significant comorbidities and a high immunosuppressive burden. Pulmonary involvement was the most common presentation, although extrapulmonary manifestations also occurred. Only 36% of infections occurred within the first posttransplant year. Most patients received initial combination therapy, followed by prolonged treatment-primarily with trimethoprim-sulfamethoxazole (TMP-SMX) or linezolid. However, antibiotic tolerability was poor: TMP-SMX was discontinued in 80% of cases due to adverse effects, mainly hyperkalemia, metabolic acidosis, and acute kidney injury. Linezolid was withdrawn in 90% of patients because of myelotoxicity. Tedizolid, used in 38.4% of cases, showed better tolerability, with only 20% of treatment discontinuation and no relapses reported during follow-up. Overall, mortality during treatment reached 30.8%, mainly due to infectious causes.</p><p><strong>Conclusions: </strong>This is the largest series of Nocardia infection in KT recipients in Spain and the first to specifically evaluate antibiotic tolerability. TMP-SMX and linezolid were poorly tolerated, reinforcing the need for alternative strategies. Tedizolid showed a favorable safety profile and may be considered a promising first-line option in high-risk patients. Further prospective studies are needed to confirm these findings and support guideline development.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70239"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147960352","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":"Optimizing Pneumocystis jirovecii Prophylaxis in Immunocompromised Patients: Defining the Clinical Role of Atovaquone.","authors":"To N Pham, Kelly A Cairns, Adithi Ramachandra, Susan G Poole, Carmela E Corallo, Bradley J Gardiner","doi":"10.1111/tid.70255","DOIUrl":"10.1111/tid.70255","url":null,"abstract":"<p><strong>Background: </strong>Pneumocystis jirovecii pneumonia (PJP) is associated with poor outcomes in immunocompromised patients. Cotrimoxazole is the first-line prophylactic agent, with atovaquone an alternative. At our center, atovaquone use considerably increased after 2020. The aims of this retrospective cohort study were to understand the usage of atovaquone over time and explore the reasons for this increase.</p><p><strong>Methods: </strong>Patients receiving atovaquone for PJP prophylaxis from 2015 to 2022 were included. Clinical data were extracted to characterize atovaquone prescribing patterns and cotrimoxazole contraindications, with comparisons made between patients before 2020 and those afterward.</p><p><strong>Results: </strong>Here, 149 patients were included, 24 (16%) before 2020 and 125 (84%) after 2020. The cohort comprised solid organ transplant recipients (49%), patients with hematologic conditions (35%), and human immunodeficiency virus (5%). Reasons for not prescribing cotrimoxazole included cytopenias (37%), renal impairment (15%), and drug interactions (12%). Median duration was significantly longer after 2020 (6.0 vs. 2.3 months, p = 0.047). Before 2020, most patients (71%) had underlying hematologic disease, but after 2020, solid organ transplant recipients accounted for 60%. Renal impairment appeared as a contraindication to cotrimoxazole only post-2020. After atovaquone, 67 patients transitioned to an alternative, most commonly cotrimoxazole (56/67, 84%). There were no breakthrough PJP cases.</p><p><strong>Discussion: </strong>Atovaquone is an alternative PJP prophylaxis agent, used predominantly when cotrimoxazole is not tolerated. Increased usage was related to broader indications, uptake in new patient groups, difficulty tolerating or accessing alternatives, and longer durations. While atovaquone appears safe and effective, regular review of patients receiving it could facilitate reassessment of the initial indication, aiming to reinstate cotrimoxazole whenever appropriate.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70255"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148144906","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":"Uses of Human Tissue Bioburden Data.","authors":"Melissa A Greenwald, Eduardo Nunes","doi":"10.1111/tid.70264","DOIUrl":"10.1111/tid.70264","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70264"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412991","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":"The Impact of Systematic Latent Tuberculosis Infection Screening in Kidney Transplant Candidates: Experience From a Single UK Transplant Center.","authors":"Innocent Lule Segamwenge, Hameed Anijeet, Anirudh Rao, Abdul Hammad, Matthew Howse","doi":"10.1111/tid.70273","DOIUrl":"10.1111/tid.70273","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>UK guidance recommends targeted screening for latent tuberculosis infection (LTBI) in kidney transplant candidates based on epidemiological or clinical risk factors, whereas international guidelines favor systematic screening. We aimed to determine whether a targeted screening strategy would miss cases compared with systematic interferon-gamma release assay (IGRA) screening in a UK kidney transplant cohort.</p><p><strong>Methods: </strong>We conducted a single-center retrospective cohort study of adult kidney transplant candidates assessed at the Royal Liverpool University Hospital between July 2021 and December 2024. LTBI prevalence was estimated among candidates with definitive IGRA results. Systematic screening was compared with a hypothetical targeted strategy restricted to high-risk candidates, using risk ratios, numbers needed to screen, and diagnostic performance measures. Multivariable logistic regression examined predictors of LTBI positivity.</p><p><strong>Results: </strong>Of 527 candidates assessed, 465 had definitive IGRA results, including 27 LTBI-positive and 438 LTBI-negative candidates. LTBI prevalence was 5.8% (95% CI 3.9%-8.3%). Of 96 high-risk candidates, 17 (17.7%) were LTBI-positive; targeted screening would have missed 10 cases (37.0%; 95% CI 19.4%-57.6%) in low-risk candidates and had a sensitivity of 63.0%. In multivariable analysis, LTBI positivity was associated with birth outside the UK, older age, and abnormal chest radiograph. All 22 treated candidates completed therapy with no hepatotoxicity or active TB during follow-up.</p><p><strong>Conclusions: </strong>Systematic IGRA screening identified LTBI in low-risk kidney transplant candidates who would have been missed by targeted screening. These findings support consideration of routine pretransplant IGRA testing in comparable UK transplant settings, while recognizing the limitations of a single-center, low-prevalence cohort.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70273"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412950","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":"Beyond the First Pathogen: Concurrent Pulmonary Aspergillosis and Nocardiosis in a Kidney Transplant Recipient.","authors":"Thotanolla Surya Prakash, Kokila Raghavendra, Srikanth Kumar Muppalaneni","doi":"10.1111/tid.70261","DOIUrl":"10.1111/tid.70261","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70261"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253483","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}