Transplant Infectious Disease最新文献

{"title":"Lessons From the Utilization of Hepatitis B Virus Nucleic Acid Test Positive Donors for Hepatitis B Vaccinated Lung Transplant Candidates (INHIBITOR) Study.","authors":"Andrew M Courtwright, Stacey Prenner, Jeffrey B Doyon, Tamara Claridge, Emily Blumberg, Christian A Bermudez, Maria M Crespo","doi":"10.1111/tid.70013","DOIUrl":"10.1111/tid.70013","url":null,"abstract":"<p><strong>Background: </strong>This was a single-center pilot study to determine the safety and efficacy of transplanting lungs from hepatitis B virus (HBV) nucleic acid positive (NAT+) donors to HBV vaccinated (sAb+) candidates. We report our study experience, including barriers to utilizing NAT+ donors.</p><p><strong>Methods: </strong>Primary candidate eligibility criteria included: HBV sAb+, < 70 years old, not on mechanical support, no liver fibrosis, normal esophageal motility, and cPRA < 60. Only brain-dead donors with no marginal characteristics or concurrent hepatitis C virus (HCV) were accepted. Recipients of HBV NAT+ organs would receive intravenous hepatitis B immunoglobulin as well as appropriate HBV antiviral therapy.</p><p><strong>Results: </strong>A total of 155 patients were screened for eligibility. Most (64.5%) were excluded because they were HBV sAb negative. Of the 25 eligible sAb+ candidates, 13 enrolled, and 6 were listed for HBV NAT+ organs. There were 16 donor offers, all of which were rejected because of quality or concurrent donor HCV infection. No other centers utilized these organs.</p><p><strong>Conclusions: </strong>Reduced enrollment related to strict eligibility criteria, few HBV immune candidates, and stringent requirements on HBV NAT+ donors were limiting factors. Further studies are needed to assess the safety and efficacy of HBV NAT+ donor lung transplants.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70013"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493819","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":"Transplant Infectious Disease Training: Bridging the Gap.","authors":"Ankit Mittal, Parikshit Prayag, Hanna Alexander, Priscilla Rupali","doi":"10.1111/tid.70060","DOIUrl":"10.1111/tid.70060","url":null,"abstract":"<p><p>An increasing complexity of organ transplantation, newer immunosuppressives, and an expanded donor pool requires a well-trained multidisciplinary workforce with surgeons, physicians, and infectious diseases (ID) physicians working together. In most countries, solid organ transplantation preceded the development of ID as a specialty leading to a lag in transplant infectious diseases (TID) physicians being a member of this team. This gap is further widened in low middle-income countries (LMIC) like India, where there is a dearth of laboratory facilities, which are essential for pretransplant screening and diagnosis of posttransplant infections. India though an LMIC does large volumes of organ and bone marrow transplantations. This article examines the current state of ID and TID training in India with an emphasis on the need for a structured and standardized educational pathway for future transplant professionals. Drawing on examples from existing programs and workforce data using a qualitative survey, we identify paramount challenges such as inconsistent exposure during medical and surgical training, limited access to transplant-specific education, and insufficient support for career development in transplant-related specialties. We propose a strategic framework to address these challenges with an emphasis on early exposure, interprofessional education, mentorship, and the integration of transplant content within undergraduate and postgraduate curricula. By encouraging a comprehensive national strategy, we aspire to bridge this training gap, ensuring workforce sustainability and ultimately improving patient outcomes for those awaiting transplantation.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70060"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258921","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":"Longitudinal Innate and Heterologous Adaptive Immune Responses to SARS-CoV-2 JN.1 in Transplant Recipients With Prior Omicron Infection: Limited Neutralization but Robust CD4⁺ T-Cell Activity.","authors":"Victor H Ferreira, Brandon Keith, Faranak Mavandadnejad, Alejandro Ferro, Sara Marocco, Golnaz Amidpour, Alexandra Kurtesi, Freda Qi, Anne-Claude Gingras, Victoria G Hall, Deepali Kumar, Atul Humar","doi":"10.1111/tid.70067","DOIUrl":"10.1111/tid.70067","url":null,"abstract":"<p><strong>Background: </strong>Solid organ transplant (SOT) recipients are at increased risk for severe COVID-19 and often exhibit reduced vaccine efficacy due to chronic immunosuppression. As new SARS-CoV-2 variants emerge, understanding immune responses following natural infection remains critical for informing protection strategies in this vulnerable population. We conducted a longitudinal study of SOT recipients who had recovered from Omicron BA.1 or BA.2 infection, evaluating immune responses to the JN.1 subvariant at 4-6 weeks and 1 year postinfection.</p><p><strong>Methods: </strong>Neutralizing antibodies to JN.1 were measured using a pseudovirus neutralization assay, and JN.1-specific T-cell responses were assessed by flow cytometry. Frequencies of bulk T-cells and innate immune cells, identified via flow cytometry, and their correlation with adaptive responses were also analyzed.</p><p><strong>Results: </strong>At 4-6 weeks, 30% of participants had detectable JN.1-neutralizing antibodies, rising to 43% at one year, although titers remained low. In contrast, CD4⁺ T-cell responses were robust and detected in 75%-83% of participants at 4-6 weeks, increasing to 75%-93% by 1 year. CD8⁺ T-cell responses were observed less frequently. Exploratory correlations between innate and bulk T-cell subsets with heterologous adaptive immune responses were investigated but did not reveal statistically significant relationships.</p><p><strong>Conclusion: </strong>These findings offer important insights into the durability and breadth of immunity following natural infection in immunocompromised transplant recipients. While heterologous neutralizing antibodies were limited, sustained CD4⁺ T-cell responses may help mitigate severe disease following exposure to JN.1-derived variants, which continue to dominate the SARS-CoV-2 landscape.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70067"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555060","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":"Odynophagia Unveiling Tonsillar Histoplasmosis in a Renal Transplant Recipient.","authors":"Dinesh Pandian, Jasmine Sethi, Yogesh Khandagale, Dipanwita Biswas, Suvradeep Mitra, Amisha Jamwal, Raja Ramachandran, Shivakumar Patil","doi":"10.1111/tid.70050","DOIUrl":"10.1111/tid.70050","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70050"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041114","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":"Improving Vaccination Rates in Adult Solid Organ Transplant Candidates: Impact of an Infectious Diseases Pretransplant Clinic.","authors":"Zachary Hanna, Navina Birk, Joud Jarrah, Tommy Parraga, Jonathan Williams, Jennifer McCorquodale, Eloy E Ordaya, Odaliz Abreu-LanFranco, Ramon Del Busto, Mei Lu, Mayur Ramesh, George Alangaden","doi":"10.1111/tid.70059","DOIUrl":"10.1111/tid.70059","url":null,"abstract":"<p><strong>Background: </strong>Despite guidelines recommending pretransplant immunizations for solid organ transplant candidates (SOTc), vaccine uptake is suboptimal. We evaluated the impact of an Infectious Disease Pretransplant (IDPT) clinic for improving vaccinations in SOTc.</p><p><strong>Methods: </strong>A retrospective quality improvement study of SOTc seen in the IDPT clinic between January 2020 and February 2021 at the Henry Ford Transplant Institute. Vaccination status before (pre-IDPT clinic visit) and 6 months after (post-IDPT clinic visit) were determined for influenza, pneumococcus, hepatitis B, hepatitis A, tetanus, and zoster vaccines. Differences in per-person year (PPY) vaccination rates and uptake of each vaccine type between the two time points were assessed. Factors associated with vaccine completion (at least one dose of six adult vaccines) in the post-IDPT clinic visit period were analyzed with logistic regression.</p><p><strong>Results: </strong>Of the 200 SOTc included, 60% were men. Vaccination rates were significantly higher in the post-IDPT clinic visit period; difference in median PPY vaccination rate was 0.61 (p < 0.001). Uptake was statistically significant for all six vaccine classes. A total of 29% patients completed vaccination. Increasing age was associated with likelihood of vaccine completion (odds ratio [OR], 1.14; 95% CI 1.08-1.21). Heart and lung transplant candidates had significantly higher odds of vaccine completion than kidney candidates after IDPT clinic visits (Heart: OR, 7.01; 95% CI 2.39-20.55) (Lung: OR, 10.76; 95% CI 3.56-32.55).</p><p><strong>Conclusion: </strong>IDPT clinic visits significantly increased vaccination rates in SOTc, especially in heart and lung transplant candidates. The IDPT clinic optimized vaccine completion for this highly vulnerable population.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70059"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545002","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":"Knowledge and Adherence to Lifestyle Habits to Prevent Complications Associated With Immunosuppression in Kidney Transplant Recipients: A Single-Center Survey.","authors":"Tamara Ruiz-Merlo, Isabel Rodríguez-Goncer, Francisco López-Medrano, Natalia Polanco, Esther González, Hernando Trujillo, Marina Fayos, Natalia Redondo, Rafael San Juan, Amado Andrés, José María Aguado, Mario Fernández-Ruiz","doi":"10.1111/tid.70038","DOIUrl":"10.1111/tid.70038","url":null,"abstract":"<p><strong>Background: </strong>Chronic immunosuppression associated with certain lifestyle habits render kidney transplant (KT) recipients more susceptible to infection and cancer. We assessed the level of knowledge and adherence to safe living strategies to minimize the occurrence of posttransplant complications.</p><p><strong>Methods: </strong>Consecutive KT recipients were offered a self-administered questionnaire covering the following areas: demographics and socioeconomic factors; generic hygiene habits; sun exposure; smoking and alcohol consumption; vaccination status; animal contact and gardening; international travelling; and food safety and habits.</p><p><strong>Results: </strong>Between May 2019 and May 2021, 130 KT recipients responded the survey at a median of 61.5 posttransplant days (completion rate of 94.9%). Only 19.7% of participants visited the dentist at least every 3-6 months. Although the majority (88.5%) were aware of the need of sunscreen, only 23.3% used it throughout the year. Self-reported influenza vaccine uptake in the last session was 69.1%. Pet ownership was reported by 41.7% of participants, of which more than one-third had considered to give up the care of their animals. Gardening and international travel were uncommon. A notable proportion of participants acknowledged to consume the following products either \"usually\" or \"often\": raw or undercooked meat (12.4%), undercooked fish (24.8%), raw seafood (8.8%), homemade sausages or cured ham (51.5%), pâté or meat spreads (35.2%), and \"ready-to-eat\" salads (31.8%). Adherence was poorer among non-native-speaking patients and those with lower education and household incomes.</p><p><strong>Conclusion: </strong>There is room for improvement in health education and promotion practices among KT recipients, particularly those with potential cultural and socioeconomic barriers.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70038"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982951","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":"Successful Combination Therapy with Cefiderocol and Sulbactam-Durlobactam for Donor-Derived Carbapenem-Resistant Acinetobacter baumannii in a Kidney Transplant Recipient.","authors":"Allyssa R Webb, Anmary Fernandez, Nicholas Piccicacco","doi":"10.1111/tid.70048","DOIUrl":"10.1111/tid.70048","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70048"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996946","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":"Bacteremia in Pediatric Solid Organ Transplant Recipients within 1 Year of Transplant.","authors":"Mario M Landa, Ayelet Rosenthal, Caitlin Naureckas Li, Mehreen Arshad, Sameer Patel, Larry Kociolek, Alyah Barnes, Stella Karuri, William J Muller","doi":"10.1111/tid.70030","DOIUrl":"10.1111/tid.70030","url":null,"abstract":"<p><strong>Background: </strong>Bacteremia is a major cause of morbidity and mortality in immunocompromised children, yet there are limited data in children who have undergone solid organ transplantation (SOT).</p><p><strong>Methods: </strong>We retrospectively reviewed bloodstream infections (BSI) in 581 recipients of heart, liver, or kidney transplants over a 14-year period.</p><p><strong>Results: </strong>Overall 1-year incidence in this population was 8.4%, and was highest in recipients of liver transplants compared to heart or kidney. Younger age, transplantation earlier in the time period studied, need for repeat surgery within 30 days of transplant, and prior diagnosis of diabetes or tumor were associated with an increased risk of BSI. Most BSI occurred within 90 days of transplant, and most were associated with central venous lines. Coagulase-negative staphylococci and enteric commensals were commonly isolated. Multiple BSI within the year after transplant were uncommon. Although overall mortality was not increased in patients with BSI compared to those without, patients with BSI had more total hospitalizations and more days spent in the hospital in the year following SOT.</p><p><strong>Conclusion: </strong>In a large pediatric SOT population, overall BSI rates were significant but decreased over time. Identifying factors which contribute to BSI after SOT may direct interventions that can impact inpatient care requirements for these patients.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70030"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020383","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":"Histoplasmosis-Induced HLH in Immunosuppressed Host: Lessons from a Kidney Transplant Case.","authors":"Ayman Salih, Mai Safi, Fadi Safi","doi":"10.1111/tid.70058","DOIUrl":"10.1111/tid.70058","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70058"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226852","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":"Surgical Site Infection After Intestine Transplantation: Risk Factors and Outcomes.","authors":"Mayyadah H Alabdely, Jessica Lum, Blanca E Gonzalez, Masato Fujiki, Zachary A Yetmar","doi":"10.1111/tid.70069","DOIUrl":"10.1111/tid.70069","url":null,"abstract":"<p><strong>Background: </strong>Infections are a significant complication of intestine transplantation. The epidemiology and impact of surgical site infections (SSIs) in this population are not well defined. This study aimed to investigate the incidence, risk factors, and outcomes of SSIs in intestine transplant recipients.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of intestine transplant recipients at our institution from 2008-2022. SSIs were classified by CDC/NHSN criteria and evaluated in the first 30 days after transplantation. Multivariable Cox regression was used to evaluate risk factors for 30-day SSI and evaluate the association of SSI with death or allograft failure.</p><p><strong>Results: </strong>Among 152 intestine transplant recipients, 55 (36.2%) patients developed 30-day SSI, with 50 (90.9%) being organ/space SSI. Enterococcus faecium (62.7%) and Candida species (49.0%) were the most common organisms, and multidrug-resistant organisms (68.6%) were common. Liver-inclusive transplantation, Charlson comorbidity index ≥2, and gastrointestinal leak were associated with SSI, while vancomycin-resistant Enterococcus-active perioperative prophylaxis and pre-transplant multidrug-resistant organism colonization were not. In adjusted analysis, SSI was associated with death or allograft failure (hazard ratio [HR] 1.71, 95% confidence interval [CI] 1.04-2.82; p = 0.036), particularly within 1 year of transplantation (HR 3.30, 95% CI 1.51-7.22, p = 0.003).</p><p><strong>Conclusions: </strong>SSIs are frequent and severe complications following intestine transplantation, often involving multidrug-resistant organisms. SSIs appear mostly influenced by surgical factors and complications, with liver-intestine and multivisceral recipients at the highest risk. SSI was associated with poor long-term post-transplant outcomes, primarily within the first year. Strategies to mitigate these risks are needed.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70069"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545004","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}