Transplant Infectious Disease最新文献

{"title":"Posttransplant HBV Vaccine Compliance, Seroprotection, and Kinetics of Hepatitis B Surface Antibody in Thoracic Organ Transplant Recipients.","authors":"Chia-Yu Chiu, Priya Sampathkumar, Lisa M Brumble, Holenarasipur R Vikram, Kymberly D Watt, Elena Beam","doi":"10.1111/tid.70015","DOIUrl":"https://doi.org/10.1111/tid.70015","url":null,"abstract":"<p><strong>Introduction: </strong>Vaccination is crucial to the thoracic solid organ transplant (SOT) population to reduce vaccine-preventable infection. However, data on posttransplant hepatitis B virus (HBV) vaccination compliance and vaccine-induced seroprotection are lacking.</p><p><strong>Methods: </strong>We conducted a retrospective study of adult thoracic organ (heart and lung) transplant recipients at Mayo Clinic sites in Minnesota, Arizona, and Florida between January 2018 and August 2023. Recombivax HB was used before 2020, and Heplisav-B was preferred after 2020. Recipients with posttransplant hepatitis B surface antibody (HBsAb) < 10 IU/L were eligible for the HBV vaccine. HBV seroprotection was defined as an HBsAb ≥ 10 IU/L.</p><p><strong>Results: </strong>A total of 1116 recipients were evaluated, all of whom underwent posttransplant HBsAb testing. Of these, 751 (67%) had an HBsAb level < 10 IU/L and were eligible for posttransplant HBV vaccination. Of the eligible recipients, 117 (16%) completed the HBV vaccine series during the study period. Among these 117 recipients, 40 (34%) had their HBsAb levels rechecked after completing the vaccine series, with a seroprotection rate of 37.5% (15/40). There was no statistically significant difference in the seroprotection rates between Heplisav-B and Recombivax HB vaccines (39% [13/33] vs. 29% [2/7]; p = 0.691). In addition, HBsAb levels were lowest at week 2 but rebounded at week 4 posttransplant and pretransplant HBsAb levels of ≥100 IU/L ensured 5-year seroprotection.</p><p><strong>Conclusion: </strong>Suboptimal compliance with HBV vaccination and poor vaccine-induced seroprotection occur in thoracic organ transplant recipients, regardless of the vaccine used. These findings underscore the necessity of enhancing vaccination strategies for SOT recipients.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70015"},"PeriodicalIF":2.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493915","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":"Safety of Once-Weekly Dapsone for Pneumocystis jirovecii Pneumonia Prophylaxis in Kidney Transplant Recipients.","authors":"Lauren Schumacher, Olivia Philippart, Abbey Carr, Catherine J Cj Sadler, Sravanthi Paluri","doi":"10.1111/tid.70012","DOIUrl":"https://doi.org/10.1111/tid.70012","url":null,"abstract":"<p><strong>Background: </strong>Sulfamethoxazole-trimethoprim (SMX-TMP) is recommended first-line for Pneumocystis jirovecii pneumonia (PJP) prophylaxis in kidney transplant recipients. In cases of sulfa allergy or intolerance, our center utilizes dapsone 100 mg once weekly as alternative prophylaxis. As both agents have the potential to cause hematologic abnormalities, we sought to compare hematologic effect profiles of weekly dapsone versus SMX-TMP in kidney transplant recipients.</p><p><strong>Methods: </strong>This retrospective, single-center, cohort study included kidney transplant recipients who received SMX-TMP or dapsone for PJP prophylaxis. The primary endpoint was the change in hemoglobin from baseline to nadir. Secondary endpoints included hemoglobin and white blood cell (WBC) count at 1, 3, and 6 months posttransplant, time to hemoglobin nadir, neutropenia incidence, and ANC nadir. In addition, we evaluated the incidence of hospital readmission, bacteremia, and PJP.</p><p><strong>Results: </strong>A total of 509 kidney transplant recipients were included (334 SMX-TMP vs. 175 dapsone). Median decrease in hemoglobin (g/dL) from baseline to nadir was greater in the dapsone group (0 SMX-TMP vs. -0.20 dapsone; p = 0.046). Mean absolute hemoglobin count was lower in the dapsone group at all time points. There was no difference in WBC, ANC nadir, or incidence of neutropenia at any time point between groups. Greater frequencies in readmissions (30.7% vs. 55.7%; p < 0.001) and bacteremia (3.6% vs. 10.8%; p < 0.001) were observed in the dapsone arm.</p><p><strong>Conclusions: </strong>Once-weekly dapsone is associated with statistically significant decreases in hemoglobin when compared to SMX-TMP in a kidney transplant cohort, which may be clinically relevant in select patients. Dapsone use may also increase infection risk.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70012"},"PeriodicalIF":2.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493919","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":"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":"https://doi.org/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":"2025-02-24","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":"Seizures and Lung Lesions in a Solid Organ Transplant Recipient: Bringing Things Together.","authors":"Matthew B Roberts, Julien Coussement, David Lebeaux, P Toby Coates, Wanessa Trindade Clemente","doi":"10.1111/tid.14449","DOIUrl":"https://doi.org/10.1111/tid.14449","url":null,"abstract":"<p><p>A 28-year-old male presented to an Australian hospital with sudden-onset headache and seizure following a kidney transplant for end-stage renal disease due to IgA nephropathy. Clinical approach to the cases and management of the diagnosed disease are discussed.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14449"},"PeriodicalIF":2.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450479","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":"Mycobacterium abscessus Complex Infections Among Lung Transplant Recipients: A Multicenter Retrospective Cohort Study in Canada.","authors":"Roni Bitterman, Hafid Soualhine, Pierre-Marie Akochy, Charles Poirier, Pasquale Ferraro, Dima Kabbani, Alim Hirji, Gregory Tyrrell, Celine Bergeron, Robert D Levy, Alissa Wright, Victor Leung, Lianne G Singer, Cecilia Chaparro, Shaf Keshavjee, Melissa Richard-Greenblatt, Shahid Husain, Me-Linh Luong","doi":"10.1111/tid.70003","DOIUrl":"https://doi.org/10.1111/tid.70003","url":null,"abstract":"<p><strong>Background: </strong>Mycobacterium abscessus complex is known to cause life-threatening disease in lung transplantation (LT) recipients (LTRs). Therefore, many centers consider the presence of M. abscessus as a relative contraindication to LT.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective cohort study including all 4 LT centers in Canada. All LTRs transplanted in 2006-2016 with at least one respiratory sample positive for M. abscessus prior or posttransplantation were included. Pulmonary disease was defined using the American Thoracic Society criteria. Minimal follow-up duration was 5 years after transplantation.</p><p><strong>Results: </strong>Among 2181 LTRs across Canada, 14 had M. abscessus disease after LT (incidence rate 1.1/1000 transplant-years) and 6 had pulmonary colonization (incidence rate 0.5/1000 transplant-years). Fifteen patients had M. abscessus cultured before LT. Among those with pretransplant M. abscessus, 53% (8/15) developed M. abscessus infection posttransplant (6 disease, 2 colonization). Posttransplant disease was less frequent among those with microbiologic eradication before transplant (0% vs. 85.7%, p = 0.001). LTRs with pretransplant M. abscessus had comparable survival to those without M. abscessus (log rank p = 0.37). Among patients with pretransplant infection, mortality was higher in those who did not achieve microbiological eradication before transplantation (57.1% vs. 0%, p = 0.03) and those who developed disease after transplantation (66.7% vs. 0%, p = 0.01).</p><p><strong>Conclusions: </strong>M. abscessus is an uncommon cause of infection among LTRs. Survival among those with pretransplant M. abscessus infection was similar to that observed in noninfected LTRs. However, lack of eradication before transplantation was associated with higher posttransplant disease and mortality.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70003"},"PeriodicalIF":2.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441401","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":"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":"https://doi.org/10.1111/tid.70002","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70002"},"PeriodicalIF":2.6,"publicationDate":"2025-02-18","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":"Universal Multiplex Panel Testing of Donor Lungs as a Strategy to Optimize Antibiotic Prophylaxis Against Multidrug-Resistant Bacteria.","authors":"Rayid Abdulqawi, Rana A Saleh, Reem M Alameer, Roaa Alabiri, Ruba Alabiri, Khaled Alkattan, Reem S Almaghrabi, Zainab Al Duhailib, Sahar Althawadi, Najib M Rahman, Waleed Saleh, Amani H Yamani, Eid A Al-Mutairy","doi":"10.1111/tid.14446","DOIUrl":"https://doi.org/10.1111/tid.14446","url":null,"abstract":"<p><strong>Background: </strong>Twenty percent of lung donors in our transplant program carry respiratory carbapenem-resistant (CR) gram-negative bacteria (GNB), most commonly CR Acinetobacter baumannii. Universal multiplex panel testing of lung transplant donors was introduced in June 2022 as a strategy to expedite CR-GNB detection and optimize perioperative antibiotic prophylaxis. We herein describe our experiences with this approach.</p><p><strong>Methods: </strong>Retrospective single-center cohort study including 53 adult patients who underwent lung-only transplantation between June 2022 and December 2023.</p><p><strong>Results: </strong>The most common bacteria identified by the multiplex panel were Staphylococcus aureus (n = 20), A. baumannii (n = 13), Klebsiella pneumoniae (n = 13), and Pseudomonas aeruginosa (n = 10). The panel detected 6/9 A. baumannii, 2/2 CR K. pneumoniae, 1/1 CR P. aeruginosa, and 7/8 methicillin-resistant S. aureus that were grown on conventional cultures, corresponding to negative predictive values of 94%, 100%, 100%, and 98%. Based on panel or culture results, IV tigecycline was administered as prophylaxis in 19% of patients, colistin in 17%, and novel beta-lactams in 15%.</p><p><strong>Conclusion: </strong>The multiplex panel rapidly detected donor CR-GNB with a high negative predictive value and resulted in clinical effects of reducing broad-spectrum antibiotic prescriptions and maintaining adequate posttransplant outcomes. Prospective studies with predefined outcomes are needed to compare panel-directed therapy against current standards of care.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14446"},"PeriodicalIF":2.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441411","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":"Application of Syndromic Panels for respiratory Tract Infections in Lung Transplantation: A Critical Review on Current Evidence and Future Perspectives.","authors":"Andrea Lombardi, Giulia Renisi, Arianna Liparoti, Chiara Bobbio, Alessandra Bandera","doi":"10.1111/tid.14448","DOIUrl":"https://doi.org/10.1111/tid.14448","url":null,"abstract":"<p><strong>Background: </strong>Infections are a common complication among lung transplant recipients (LuTR), particularly in the first year post-transplant, with respiratory tract infections (RTI) being predominant. Syndromic molecular panels have been suggested to reduce morbidity and mortality by providing a diagnosis quickly. However, integrating these panels into clinical practice remains debated.</p><p><strong>Methods: </strong>An electronic search was conducted in PubMed, Scopus, and Embase to identify studies on applying syndromic panels for RTI diagnosis in LuTR. Three reviewers independently screened-extracted data from relevant studies, focusing on concordance between syndromic panels and standard microbiologic tests and reporting isolates not detected by syndromic panels.</p><p><strong>Results: </strong>Four studies met the inclusion criteria, including 308 patients. The BioFire FilmArray Pneumonia Panel was the syndromic panel most frequently employed. In three studies, the syndromic panel was employed in LuTR with suspected RTI or during routine surveillance bronchoalveolar lavage; only in one case was the syndromic panel employed during the transplant procedure on samples from the donor. Agreement between syndromic panels and standard tests ranged from 0.56 to 0.98, with result turnaround times between 2.3 and 21.2 h. Sensitivity ranged from 58% to 94%, and specificity from 78% to 100%. Pathogens outside syndromic panels targets but identified by standard tests included Candida spp., unspecified gram-negative rods, and Aspergillus spp.</p><p><strong>Conclusion: </strong>Syndromic panels offer a faster alternative to standard microbiologic tests. However, they miss numerous possible pathogens, highlighting the necessity for concurrent standard testing. Further research is needed to establish the most efficient integration of syndromic panels in LuTx infection diagnostic.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14448"},"PeriodicalIF":2.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068308","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":"Drug-Induced Hypersensitivity Syndrome/Drug Reaction With Eosinophilia and Systemic Symptoms With Reactivation of Human Herpesvirus-6 in a Liver Transplant Recipient.","authors":"Rebecca Unterborn, Kaitlin Blotske, Maheen Z Abidi","doi":"10.1111/tid.14447","DOIUrl":"10.1111/tid.14447","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14447"},"PeriodicalIF":2.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066670","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":"Diagnostic Performance of Two Different Techniques to Quantify CMV-Specific Cell-Mediated Immunity in Intermediate-Risk Seropositive Kidney Transplant Recipients.","authors":"Mario Fernández-Ruiz, Marcos Nuévalos, Isabel Rodríguez-Goncer, Estéfani García-Ríos, Tamara Ruiz-Merlo, Natalia Redondo, Hernando Trujillo, Esther González, Natalia Polanco, José María Caso, Eduardo Aparicio-Minguijón, Francisco López-Medrano, Rafael San Juan, Amado Andrés, Pilar Pérez-Romero, José María Aguado","doi":"10.1111/tid.14437","DOIUrl":"https://doi.org/10.1111/tid.14437","url":null,"abstract":"<p><strong>Background: </strong>Kidney transplant (KT) recipients at intermediate risk for cytomegalovirus (CMV) infection constitute a potential target for individualized prevention strategies informed by the CMV-specific cell-mediated immunity (CMV-CMI). The optimal method for the functional assessment of CMV-CMI in this group remains unclear.</p><p><strong>Methods: </strong>We included 74 CMV-seropositive KT recipients that did not receive T-cell-depleting induction and were managed by preemptive therapy. CMV-CMI was monitored at baseline and months 1, 3, 6, and 12 by intracellular cytokine staining (ICS) and a interferon (IFN)-γ-release assay (QuantiFERON-CMV [QTF-CMV]). Both methods were compared for discriminative capacity (areas under the receiving operating characteristic curve [auROCs]) and diagnostic accuracy to predict protection against high-level (≥1000 IU/mL) CMV DNAemia and/or disease.</p><p><strong>Results: </strong>Eighteen patients (24.3%) experienced high-level CMV DNAemia or disease. There were no significant differences in the discriminative capacity to predict protection of CMV-specific CD8+ (auROC: 0.719) and CD4+ T-cell counts (auROC: 0.664) enumerated by ICS and IFN-γ production measured by QTF-CMV (auROC: 0.666). Optimal cutoff values of ≥9.8 CMV-specific CD4+ T-cells/µL and ≥5.7 CD8+ T-cells/µL by ICS yielded excellent specificity (95.7% and 86.9%, respectively) and positive predictive values (PPVs) (>98.0%), but a sensitivity below 60%. A reactive QTF-CMV (IFN-γ ≥0.2 IU/mL) provided good sensitivity (81.6%) and PPV (92.5%), at the expense of a poor specificity (22.2%).</p><p><strong>Conclusions: </strong>The discriminative capacity to predict immune protection against clinically relevant CMV infection among intermediate-risk KT recipients was comparable for ICS and QTF-CMV. A selected ICS threshold may provide better specificity than the interpretative cut-off values currently recommended for QTF-CMV.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14437"},"PeriodicalIF":2.6,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955727","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}