Transplant Infectious Disease最新文献

{"title":"Bridging the Gaps in CMV Management in Transplantation: Lessons From Resource-Limited Settings.","authors":"Carlos A Gomez, Andre C Kalil","doi":"10.1111/tid.70009","DOIUrl":"10.1111/tid.70009","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70009"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473073","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":"Evaluating Adverse Effects of Dapsone in Solid Organ Transplants.","authors":"Kevin D He, Linh Nguyen, Maxwell Norris, Gregory Malat, Carson Shalaby, Chelsea Sammons, Emily Blumberg, Jennifer Trofe-Clark","doi":"10.1111/tid.70001","DOIUrl":"10.1111/tid.70001","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70001"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442189","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":"Infection-Associated Immune Reconstitution Inflammatory Syndrome in Hematopoietic Cell Transplantation.","authors":"Mansi Chaturvedi, Brian P Epling, Luxin Pei, Brigit Sullivan, Hye Sun Kuehn, Dima A Hammoud, Sergio Rosenzweig, Sung-Yun Pai, Irini Sereti, Alexandra F Freeman, Jennifer Cuellar-Rodriguez, Corina E Gonzalez, Maura Manion","doi":"10.1111/tid.70000","DOIUrl":"10.1111/tid.70000","url":null,"abstract":"<p><p>Immune reconstitution inflammatory syndrome (IRIS) is a well-recognized complication in people with HIV (PWH) starting antiretroviral therapy (ART), but data on IRIS in hematopoietic cell transplantation (HCT) recipients are limited. To address this gap, we conducted a narrative review of the literature on IRIS in HCT recipients, including 21 studies encompassing 53 patients. The majority of reported patients had inborn errors of immunity (IEI) and developed IRIS associated with Bacillus Calmette-Guérin (BCG)-infection from prior vaccination (\"BCG-IRIS\"). The remainder had IRIS linked to other infections, most commonly Aspergillus and Non-tuberculous mycobacteria (\"non-BCG-IRIS\"). The median time between transplant and IRIS was 3 months; however, some patients developed IRIS multiple years posttransplant. BCG-IRIS was predominantly unmasking, while non-BCG-IRIS was mostly associated with a new infection acquired after HCT alongside immune recovery and/or changes in immunosuppression (\"post-HCT infection IRIS\"). Inflammatory biomarkers and tissue pathology were helpful in distinguishing IRIS from uncontrolled infection. Initiation or continuation of appropriate antimicrobial therapy in the peri-transplant period was foremost in the prevention and treatment of IRIS. Use of steroidal and nonsteroidal immunosuppression was common, while surgery was used as an adjunctive measure to infection control. Recrudescence of IRIS symptoms was common with discontinuation or decrease in immunosuppression. About one-third of the patients were reported to have graft-versus-host disease, and the rate of graft failure was 8%. The mortality rate was 15%, with most deaths attributed to superimposed infections. Through this review, we aim to highlight that IRIS is an under-recognized entity in HCT recipients and future research is needed to explore its pathogenesis, risk factors, and management in this complex patient population.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70000"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442191","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":"Real-World Experience With Maribavir for Treatment of Refractory or Resistant Cytomegalovirus Infection in Hematopoietic Cell Transplant Recipients and Hematologic Malignancy Patients.","authors":"Marilyne Daher, Fareed Khawaja, Amy Spallone, Terri L Shigle, Micah Bhatti, Nancy N Vuong, Ella J Ariza-Heredia, Victor Mulanovich, Richard E Champlin, Roy F Chemaly","doi":"10.1111/tid.14444","DOIUrl":"10.1111/tid.14444","url":null,"abstract":"<p><strong>Background: </strong>Refractory and/or resistant (R/R) cytomegalovirus (CMV) infection is a serious complication after allogeneic hematopoietic cell transplantation (HCT). Maribavir, an oral antiviral agent, was approved in November 2021 for the treatment of R/R CMV in transplant recipients. However, real-world data on the use of maribavir in HCT recipients and hematologic malignancy (HM) patients are limited. We described our early experience with the use of maribavir in the year after its Food and Drug Administration approval in HCT recipients and HM patients.</p><p><strong>Methods: </strong>We performed a retrospective study of all patients who received maribavir for treatment of CMV infection at our center from November 2021 to December 2022. Clinical characteristics and outcomes of CMV infection were collected for each case. Descriptive statistics were calculated.</p><p><strong>Results: </strong>Our study included 13 patients (11 of whom were HCT recipients and two with HM) who received a median of 58 days of maribavir therapy. While on maribavir, nine (69%) patients had a resolution of CMV infection. Treatment-emergent maribavir resistance was documented in one patient with a CMV UL97 C480F mutation. Patients with higher baseline viral loads were less likely to achieve CMV resolution compared to those with lower levels. Additionally, six patients received combination therapy with maribavir. Six patients developed dysgeusia, none requiring maribavir discontinuation.</p><p><strong>Conclusion: </strong>Maribavir is an effective and safe option for the treatment of R/R CMV infections in HCT recipients and HM patients. Our study highlights the complexities of managing CMV infections in this patient population and some challenges associated with maribavir therapy.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14444"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011501","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":"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}