Transplant Infectious Disease最新文献

{"title":"Aging and Infections in Solid Organ Transplantation: Unchartered Territory.","authors":"Maheen Z Abidi, Sara Belga, Ajit Limaye, Mara A McAdams-DeMarco","doi":"10.1111/tid.14431","DOIUrl":"10.1111/tid.14431","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14431"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898183","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":"A 2-year Review of the Diagnostic Performance of Serum and Bronchoalveolar Lavage Galactomannan Testing in Lung Transplant Recipients in a National Heart and Lung Transplant Centre.","authors":"Clare O'Donnell, Breda Lynch, Louise O'Sullivan, Assumpta Killarney, Michelle Murray, Peter Riddell, Margaret M Hannan","doi":"10.1111/tid.14404","DOIUrl":"10.1111/tid.14404","url":null,"abstract":"<p><strong>Background: </strong>The 2015 International Society for Heart and Lung Transplant (ISHLT) fungal guidelines recommend the use of bronchoalveolar lavage (BAL) galactomannan over serum galactomannan for the diagnosis of invasive aspergillosis (IA) in lung transplant (LTx) recipients, based on limited evidence. Galactomannan testing is costly.</p><p><strong>Methods: </strong>A single-center, retrospective cohort study reviewing all 814 serum and BAL galactomannan samples received from 184 LTx recipients in our center between 2021 and 2022 and assessing their diagnostic performance in the diagnosis of IA.</p><p><strong>Results: </strong>Over the study period, 394 serum galactomannan samples were received from 144 patients and 420 BAL galactomannan samples from 143 patients. Using a cut-off of ≥ 1.0 for BAL galactomannan, the sensitivity and specificity were 65.9% and 98.4%, respectively. In total, 30 patients had positive BAL galactomannan. Antifungal therapy was commenced or continued in 29 of these patients either as targeted or pre-emptive treatment. Using a cut-off of ≥ 0.5 for serum galactomannan, the sensitivity and specificity were 9.7% and 99.7%, respectively. In total, four patients had a positive serum galactomannan. All four patients were either already on antifungal treatment for IA or were started before the serum galactomannan result was available, supported by laboratory, clinical, and radiological findings. A positive serum galactomannan was used to monitor treatment response in one patient.</p><p><strong>Conclusion: </strong>Serum galactomannan is not a valuable test in the diagnosis of IA in our LTx recipients, is costly, and does not remove the need for bronchoscopy and BAL galactomannan. This supports the ISHLT recommendation.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14404"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629020","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":"Riders on the Storm.","authors":"Andrea Cona, Mario Luppi, Rosy Priya Kodiyanplakkal, Simone Perra, Alessandra Mularoni, Maricar Malinis","doi":"10.1111/tid.14426","DOIUrl":"10.1111/tid.14426","url":null,"abstract":"<p><p>This case involves a 52-year-old male, who underwent a deceased donor orthotopic liver transplant 7 months prior, presented with a 2-week history of persistent fever, anemia, thrombocytopenia, and mild elevation of liver enzymes. Upon hospital admission, the patient was febbrile, alert and oriented, hemodynamically stable. Laboratory exams revealed worsening leukopenia, anemia, thrombocytopenia, hyponatremia, and elevated ferritin. On hospital day 5, the general condition of the patient rapidly deteriorated with dyspnea, asthenia, and worsening fever and pancytopenia.Computed tomography revealed splenomegaly and minimal bilateral pleural effusion.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14426"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898207","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":"A First Case of Bacterial Pericarditis Due to Campylobacter fetus Infection in a Kidney Transplant Recipient.","authors":"Shota Obata, Sumi Hidaka, Shuzo Kobayashi","doi":"10.1111/tid.14419","DOIUrl":"10.1111/tid.14419","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14419"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847676","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":"Confronting the Challenges of Prevention, Diagnosis, and Management of Donor-Derived Coccidioidomycosis.","authors":"Holenarasipur R Vikram","doi":"10.1111/tid.14424","DOIUrl":"10.1111/tid.14424","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14424"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839599","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":"Universal azole prophylaxis for prevention of coccidioidomycosis among lung transplant recipients transferring care to a center within a highly endemic region.","authors":"Kellie J Goodlet, Rhiannon Garcia, Michael D Nailor","doi":"10.1111/tid.14379","DOIUrl":"10.1111/tid.14379","url":null,"abstract":"<p><strong>Background: </strong>Coccidioidomycosis may cause severe disseminated disease and mortality among lung transplant recipients. A strategy of lifelong azole prophylaxis was previously associated with low rates of coccidioidomycosis. Whether lung transplant recipients relocating to the Coccidioides endemic region are also at risk and would benefit from antifungal prophylaxis is unknown.</p><p><strong>Methods: </strong>Lung transplant recipients transplanted at an outside center with low Coccidioides endemicity before relocating for post-transplant follow-up at a transplant center in Phoenix, Arizona from January 2013 to March 2024 were included. The primary outcome was proven or probable coccidioidomycosis per Mycoses Study Group consensus definitions.</p><p><strong>Results: </strong>Forty lung transplant recipients were included, with 62.5% not receiving antifungal prophylaxis at the time of transfer. The median time from transplant to relocation was 34 months. Of those not on prophylaxis, 96% were initiated on azole therapy at the first clinic visit, with 72% prescribed itraconazole. Coccidioides serologic testing was performed in 30% of the cohort, most often in the context of a broad diagnostic work-up for suspected infection during hospitalization. After a median follow-up of 31 months, one case (2.5%) of proven pulmonary coccidioidomycosis was identified, occurring 4.8 years post-transplant and >2 years post-transfer in a cystic fibrosis patient who had a pause in fluconazole prophylaxis for >1 month prior to diagnosis due to gastrointestinal intolerance and access issues. The patient was treated and maintained on isavuconazole without complications.</p><p><strong>Conclusion: </strong>Azole antifungal prophylaxis was associated with a low rate of coccidioidomycosis among lung transplant recipients relocating to the highly endemic region.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14379"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296428","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":"Presentation and Outcomes of Histoplasmosis in Transplant Recipients: A Retrospective Single-Centre Cohort Study.","authors":"Sasinuch Rutjanawech, Julio C Zuniga-Moya, Ige George, Patrick B Mazi, Matthew R Osborn, Samuel M Fallon, Andrej Spec, Adriana M Rauseo","doi":"10.1111/tid.14421","DOIUrl":"10.1111/tid.14421","url":null,"abstract":"<p><strong>Background: </strong>Histoplasmosis is an important infection among transplant recipients. Few studies have described its epidemiology and outcomes in the modern era.</p><p><strong>Methods: </strong>We conducted a retrospective analysis using medical records from a single center in the United States. We included patients 18 years or older with histoplasmosis. We divided the cohort into transplant recipients and immunocompetent groups to assess the outcomes in both groups. We utilized Cox hazard models to assess 90-day all-cause mortality.</p><p><strong>Results: </strong>The study included 137 patients; with 28 (20%) transplant recipients. After the first year post-transplant, patients with lung transplant (30%) had a diagnosis of histoplasmosis. Transplant recipients exhibited a significantly higher incidence of disseminated histoplasmosis than immunocompetent patients (64% vs. 34%, p = 0.001), higher admission to ICU (39% vs. 16%; p = 0.01) and higher but not significant 90-day crude all-cause mortality (14% vs. 11%, p = 0.71). Patients with transplants had a higher, but not significant hazard of all-cause mortality at 90 days (hazard ratio: 1.5; 95% confidence interval: 0.4-3.9) when compared to immunocompetent patients.</p><p><strong>Conclusion: </strong>Transplant recipients were more commonly diagnosed with histoplasmosis after the first year post-transplantation, and although they exhibited a higher hazard for death at 90 days, this increase was not statistically significant.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14421"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847755","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":"The Outcomes of Adenovirus Infection in Kidney Transplant Recipients.","authors":"Hay Me Me, Sumi Nair, Carrie A Schinstock, Tambi Jarmi, Nan Zhang, Pooja Budhiraja, Lavanya Kodali, Holenarasipur R Vikram, Girish Mour","doi":"10.1111/tid.14409","DOIUrl":"10.1111/tid.14409","url":null,"abstract":"<p><strong>Background: </strong>Adenovirus (ADV) infection can lead to significant morbidity and mortality in immunocompromised patients, particularly in those with hematopoietic stem cells or solid organ transplants. The incidence of ADV infection in kidney transplant (KT) is not well-defined as ADV is often asymptomatic and not routinely checked.</p><p><strong>Methods: </strong>This retrospective case-series study included KT and simultaneous pancreas-KT (SPKT) recipients from January 1, 2008, to January 31, 2024, across three Mayo Clinic sites (Arizona, Florida, and Minnesota) with symptomatic adenovirus polymerase chain reaction cases. The primary outcomes were allograft function at various intervals post-ADV infection, allograft, and patient survival.</p><p><strong>Results: </strong>We report one of the largest multi-site case series regarding outcomes of ADV in KT with 17 patients. The median time to ADV infection was 30 weeks (5-74). Five patients (29%) developed disseminated infection. Nine patients (53%) of the entire cohort experienced graft loss within a median of 35 (4-168) weeks, with four (44%) of graft loss attributed to ADV. Nine patients (53%) developed rejections post-ADV infection with a median of 4 (2-8) weeks after resolution. One patient died from acute hypoxic respiratory failure from ADV infection.</p><p><strong>Conclusion: </strong>ADV should be considered in KT/SPKT patients with renal dysfunction, hematuria, and with or without fever. Despite the low mortality rate, there is a significant risk of graft loss and rejection after ADV infection. It is crucial to screen for ADV and develop intervention strategies for treatment. Further multicenter studies are needed to better define, stage, and manage ADV infection.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14409"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644642","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":"Coccidioidomycosis Transmission Through Solid Organ Transplantation (2013-2022): A Report of the Organ Procurement and Transplantation Network ad hoc Disease Transmission Advisory Committee.","authors":"Dong Heun Lee, Maheen Z Abidi, Cynthia Fisher, Anna L Hughart, Mitsuru Toda, Samantha Williams, Gerald J Berry, Riki Graves, Dzhuliyana Handarova, Chak-Sum Ho, Michelle Kittleson, Marilyn E Levi, Taylor Livelli, Charles C Marboe, Pallavi Annamabhotla, Rachel A Miller, Tanvi Sharma, Marty T Sellers, Sarah Taimur, Helen S Te, Anil J Trindade, R Patrick Wood, Lorenzo Zaffiri, Stephanie M Pouch, Lara Danziger-Isakov","doi":"10.1111/tid.14406","DOIUrl":"10.1111/tid.14406","url":null,"abstract":"<p><strong>Background: </strong>Coccidioidomycosis is a fungal infection that poses a serious risk when transmitted through organ transplantation. We analyzed cases reported to the Organ Procurement and Transplantation Network ad hoc Disease Transmission Advisory Committee from 2013 to 2022.</p><p><strong>Methods: </strong>Donors and/or recipients who had positive Coccidioides immitis/posadasii serology, pathology, and/or culture were included in this study. Cases adjudicated as 'proven' or 'probable' were analyzed for donor infection risk factors, the timing of infection, transmission by organ type, clinical manifestations, and recipient outcomes. Patient and facility identifiers were removed prior to review.</p><p><strong>Results: </strong>During this time period, 73 potential instances of Coccidioides donor disease transmission events were reported. Among them, infection was transmitted from seven deceased donors to eight recipients. All seven deceased donors had prior infection or exposure to regions where coccidioidomycosis is endemic. Of 20 individuals receiving organs from these donors, eight developed infection, resulting in a 40% transmission rate. The median time to diagnosis post-transplant was 39 days. Disseminated disease occurred in six recipients, five of whom died from the infection. Notably, none of the recipients who received prophylactic antifungal treatment died from the infection.</p><p><strong>Conclusion: </strong>Despite its rarity, donor-derived Coccidioides infection is a serious concern, particularly due to the high mortality rate in the early post-transplant period. To mitigate these risks, a thorough assessment of donor exposure history, coupled with donor serology and bronchoalveolar lavage cultures, can effectively guide post-transplant antifungal prophylaxis. Prompt reporting is crucial to prevent Coccidioides infections among other recipients.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14406"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740518","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":"Alternative Pneumocystis Pneumonia Prophylaxis in Solid Organ Transplants.","authors":"Kevin D He, Linh Nguyen, Maxwell Norris, Gregory Malat, Stephanie Witek, Chelsea Sammons, Abigail Forte, Tamara Claridge, Jennifer Trofe Clark, Emily Blumberg","doi":"10.1111/tid.14410","DOIUrl":"10.1111/tid.14410","url":null,"abstract":"<p><strong>Background: </strong>Despite limited data supporting use in solid organ transplant (SOT) recipients, atovaquone and dapsone are often used as alternatives to trimethoprim-sulfamethoxazole (TMP-SMX) for Pneumocystis jirovecii pneumonia (PJP) prophylaxis.</p><p><strong>Methods: </strong>This single-center, retrospective cohort study describes a multi-organ program's experience with alternative PJP prophylaxis. Adult SOT recipients transplanted November 13, 2020 to November 13, 2022 who received non-TMP-SMX PJP prophylaxis and had > 1 year follow-up were included.</p><p><strong>Results: </strong>Among 953 SOTs performed, 333 (34.9%) recipients received alternative PJP prophylaxis (319 [95.8%] atovaquone and 14 [4.2%] dapsone). Alternative prophylaxis was initiated in 76 (22.8%) recipients without starting TMP-SMX, mostly due to sulfa allergy (62, 81.6%). In 257 recipients who started TMP-SMX, common reasons for switching to alternatives were hyperkalemia (105, 40.9%) and leukopenia (77, 30.0%). While 79.8% of recipients had these adverse effects resolve, only 27.3% resumed TMP-SMX. Tolerance was high after resumption (85.7%). Barriers to accessing alternative prophylaxis included cost (25, 7.5%) and prior authorizations (26, 7.8%). There was one case of severe disseminated toxoplasmosis, one case of Nocardia infection, and no cases of PJP.</p><p><strong>Conclusion: </strong>Alternative PJP prophylaxis carries risk of breakthrough infection and barriers to initiation. Since most recovered from adverse effects of TMP-SMX and tolerated resumption, providers should re-trial TMP-SMX when feasible.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14410"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740238","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}