Transplant Infectious Disease最新文献_第8页

Evaluation of Crushed Posaconazole Delayed Release Tablets in Lung Transplant Recipients. 对肺移植受者服用粉碎的泊沙康唑缓释片的评估

IF 2.6 4区医学

Transplant Infectious Disease Pub Date : 2024-11-04 DOI: 10.1111/tid.14402

Rachael Gordon, Bo Yen, Katherine Dewey, Ripal Jariwala, Jasleen Kukreja, Steven Hays, Jonathan P Singer, Rebecca Florez

{"title":"Evaluation of Crushed Posaconazole Delayed Release Tablets in Lung Transplant Recipients.","authors":"Rachael Gordon, Bo Yen, Katherine Dewey, Ripal Jariwala, Jasleen Kukreja, Steven Hays, Jonathan P Singer, Rebecca Florez","doi":"10.1111/tid.14402","DOIUrl":"https://doi.org/10.1111/tid.14402","url":null,"abstract":"Background: Invasive fungal infections can cause serious complications after lung transplant; therefore, prophylaxis with posaconazole is common. The posaconazole delayed-release (DR) tablet is preferred. Although the package insert states DR tablets cannot be crushed, recent data suggest it is reasonable. We hypothesized that crushed posaconazole DR tablets could reach therapeutic levels in lung transplant recipients.Methods: A retrospective study of lung transplant recipients between January 2018 and July 2023, who received crushed posaconazole DR for at least 5 days was completed. Posaconazole troughs were evaluated, and differences were compared between subjects who were therapeutic to those who were subtherapeutic. A cost analysis was also performed.Results: Thirty subjects received crushed posaconazole DR and 50% were therapeutic. The median trough was 1 mg/L for those who were therapeutic and 0.4 mg/L for those who were not (p < 0.001). The median cumulative dose was 2000 mg, and there were no significant differences in the incidence of diarrhea or tube feeds. More subjects in the therapeutic group were loaded (33% vs. 13%), although this was not statistically significant (p = 0.39). No subjects had breakthrough aspergillus one month after starting crushed therapy.Conclusion: Crushed posaconazole DR tablets are a viable and cost savings option, but loading doses and higher maintenance doses may be required to reach therapeutic levels. Those who received loading doses (intravenously or crushed) followed by a daily crushed dose of 400 mg were more likely to be therapeutic. Limitations of our study include that it is single-center, small in sample size, and retrospective.","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14402"},"PeriodicalIF":2.6,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569515","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}

引用次数: 0

Epidemiology of Infections in Lung Transplant Recipients Treated With Belatacept. 接受贝拉他赛普治疗的肺移植受者的感染流行病学。

IF 2.6 4区医学

Transplant Infectious Disease Pub Date : 2024-11-04 DOI: 10.1111/tid.14403

Madeleine R Heldman, Jennifer L Saullo, Brandon M Menachem, Julia A Messina, Sana Arif, Julie M Steinbrink, Patrick C K Tam, Manuela Carugati, Cameron R Wolfe, Arthur W Baker, Eileen K Maziarz

{"title":"Epidemiology of Infections in Lung Transplant Recipients Treated With Belatacept.","authors":"Madeleine R Heldman, Jennifer L Saullo, Brandon M Menachem, Julia A Messina, Sana Arif, Julie M Steinbrink, Patrick C K Tam, Manuela Carugati, Cameron R Wolfe, Arthur W Baker, Eileen K Maziarz","doi":"10.1111/tid.14403","DOIUrl":"10.1111/tid.14403","url":null,"abstract":"Background: Belatacept is a costimulatory blocker that can be used to prevent and treat rejection in lung transplant recipients (LuTRs). The epidemiology of infections in belatacept-treated LuTRs has not been systematically evaluated.Methods: We performed a single-center retrospective study of all adult LuTRs who received belatacept as prevention or treatment of antibody-mediated rejection (desensitization) or as part of maintenance immunosuppression from January 1, 2011, to June 30, 2022. We assessed the epidemiology of infections that occurred within 12 months following the first belatacept dose.Results: Fifty-two LuTRs received at least one dose of belatacept as either desensitization (n = 32) or maintenance immunosuppression (n = 20). Among 45 patients who were cytomegalovirus (CMV) donor and/or recipient seropositive, nine (20%) developed CMV infection. Seven (77%) CMV infections occurred despite valganciclovir prophylaxis and four (44%) were associated with antiviral resistance. Three (6%) LuTRs developed Epstein-Barr virus (EBV) associated post-transplant lymphoproliferative disorder (PTLD). Twenty-five (48%) LuTRs developed 43 bacterial infections and five (10%) developed proven or probable invasive fungal disease. Incidence rates of viral, bacterial, and fungal infections were similar between the desensitization and maintenance groups: incidence rate ratios (95% confidence interval) were 0.70 (0.32-1.57), 1.31 (0.70-2.46), and 2.82 (0.31-25.2), respectively. Infection/PTLD prompted belatacept discontinuation in eight (15%) patients.Conclusions: In the first year after belatacept initiation, LuTRs commonly developed CMV infections, EBV+ PTLD, and bacterial infections. Multicenter collaborations are needed to better understand infection risks in LuTRs treated with belatacept.","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14403"},"PeriodicalIF":2.6,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569513","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}

引用次数: 0

Donor-derived dengue infections - A review of screening protocol and outcomes in an endemic country. 来自捐献者的登革热感染--一个登革热流行国家的筛查方案和结果回顾。

IF 2.6 4区医学

Transplant Infectious Disease Pub Date : 2024-11-01 Epub Date: 2024-08-16 DOI: 10.1111/tid.14356

Sophie Seine Xuan Tan, Samsudin Bin Nordin, Chee-Kiat Tan, Thuan Tong Tan, Shimin Jasmine Chung, Kian Sing Chan, Ban Hock Tan

{"title":"Donor-derived dengue infections - A review of screening protocol and outcomes in an endemic country.","authors":"Sophie Seine Xuan Tan, Samsudin Bin Nordin, Chee-Kiat Tan, Thuan Tong Tan, Shimin Jasmine Chung, Kian Sing Chan, Ban Hock Tan","doi":"10.1111/tid.14356","DOIUrl":"10.1111/tid.14356","url":null,"abstract":"Background: Donor-derived dengue infections present significant challenges to organ transplantation, particularly in endemic regions like Singapore. Although primarily transmitted by Aedes mosquitoes, dengue can also be transmitted through organ transplantation, occasionally with fatal outcomes. This study aims to evaluate the outcomes and evolution of dengue screening protocols for potential deceased donors in Singapore from 2006 to 2022.Methods: Initially, screening was done via dengue immunoglobulin M (IgM), targeting donors with specific clinical criteria (thrombocytopenia, drop in platelet count, prolonged prothrombin time/partial thromboplastin time, and discretion of the transplant team), later transitioning to blood dengue reverse transcription-polymerase chain reaction (RT-PCR) in 2007 with similar criteria, and subsequently universal screening in 2016. In 2021, urine dengue RT-PCR was added following a case of donor-derived dengue infection from an aviremic but viruric donor.Results: Out of 431 potential deceased donors, 395 (91.6%) underwent dengue screening, with six (1.5%) testing positive for dengue. In 2006, three positive screens were identified: two through dengue IgM and one via blood dengue RT-PCR; subsequent years saw one positive screen each in 2007, 2008, and 2019 via blood dengue RT-PCR. Potential deceased donors with a positive blood dengue screen were rejected as solid organ and tissue donors. Those with negative blood dengue RT-PCR but positive urine dengue RT-PCR would be rejected as kidney donors, but the use of other organs and tissues was at the discretion of the transplantation team.Conclusion: The optimal screening protocol remains uncertain, but our findings suggest that a universal screening strategy utilizing both blood and urine dengue RT-PCR could be considered in dengue-endemic countries.","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14356"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989006","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}

引用次数: 0

Impact of blood donation biovigilance and transfusion-transmitted infections on organ transplantation. 献血生物警戒和输血传播感染对器官移植的影响。

IF 2.6 4区医学

Transplant Infectious Disease Pub Date : 2024-11-01 Epub Date: 2024-06-27 DOI: 10.1111/tid.14324

Adam G Stewart, Camille Nelson Kotton

{"title":"Impact of blood donation biovigilance and transfusion-transmitted infections on organ transplantation.","authors":"Adam G Stewart, Camille Nelson Kotton","doi":"10.1111/tid.14324","DOIUrl":"10.1111/tid.14324","url":null,"abstract":"Over 118 million blood donations are collected globally each year. Recipients of blood products include those who experience major trauma or surgery, have acute blood loss and anemia, or impaired bone marrow function. Solid organ transplant recipients often require transfusion of blood products which places them at risk of transfusion-associated adverse events including transfusion-transmitted infection. National hemovigilance networks have documented low rates of transfusion-transmitted infection in the general population. Incidence transfusion-transmitted infection continues to occur in solid organ transplant patients and arises mainly from existing gaps in blood donor biovigilance processes. Emerging infectious diseases have highlighted existing gaps in the donor-recipient pathway to administering safe blood products. This article reviews the current process and regulatory oversight of blood donor biovigilance, including donor screening and microbiological testing, highlights cases of transfusion-transmitted infection documented in the literature, and addresses ways in which biovigilance may be improved, with a focus on the impact of solid organ transplantation.","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14324"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459514","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}

引用次数: 0

Perspectives on donor-derived infections from Germany. 德国对供体源性感染的看法。

IF 2.6 4区医学

Transplant Infectious Disease Pub Date : 2024-11-01 Epub Date: 2024-09-23 DOI: 10.1111/tid.14372

Ana Paula Barreiros, Klaus Böhler, Kerstin Mönch, Carl-Ludwig Fischer-Fröhlich, Axel Rahmel

{"title":"Perspectives on donor-derived infections from Germany.","authors":"Ana Paula Barreiros, Klaus Böhler, Kerstin Mönch, Carl-Ludwig Fischer-Fröhlich, Axel Rahmel","doi":"10.1111/tid.14372","DOIUrl":"10.1111/tid.14372","url":null,"abstract":"Aim: Often, organ transplantation is the only option to improve the life expectancy and quality of life of patients with terminal organ failure. Despite improved donor and organ assessment, a residual risk remains for transmitting infection, tumor, or other disease from the donor to recipients. Analysis, reporting, and managing of donor-derived diseases through a vigilance and surveillance system (V&S) is mandatory in many countries. We report on suspected and proven/probable donor-derived infections (DDI) in Germany over a period of 8 years (2016-2023).Methods: All incoming serious-adverse-event and serious-adverse-reaction (SAE/SAR) reports from 01.01.2016 to 31.12.2023 were evaluated for suspected DDI. Analysis of imputability followed the definition of the US Disease Transmission Advisory Committee (DTAC). Only probable and proven cases according to DTAC classification were defined as DDI.Results: During the study period, 9771 donors in Germany donated post-mortem organs to 27 919 recipients. In that period 612 SAE/SAR cases were reported, 377 (62%) involved infections. 41 cases were proven/probable DDI affecting 58 recipients (seven recipients died, 12%). Suspected infections were bacterial (182/377, 48%), fungal (135/377, 36%), viral (55/377, 15%), and parasitic (5/377, 1%). In case of bacterial DDI, no recipient died, but organ loss occurred in six recipients. In case of fungal or viral DDI, 19% (3/16) and 21% (3/14) of the recipients died, respectively.Conclusions: DDI are rare in solid organ transplantation (58/27 919, 0.21%), but when they occur, they are associated with high morbidity and mortality in affected recipients. Careful and detailed donor evaluation and a reliable V&S help improve recipient safety.","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14372"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296426","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}

引用次数: 0

Organ vigilance in the Middle East: Challenges and prospects. 中东的器官警戒：挑战与前景。

IF 2.6 4区医学

Transplant Infectious Disease Pub Date : 2024-11-01 Epub Date: 2024-11-08 DOI: 10.1111/tid.14392

Reem Alameer, Yamama Aljishi, Ahmed Alhammadi, Yasar Bayindir, Reem S Almaghrabi

引用次数: 0

Perspective on donor-derived infections in Italy. 透视意大利的供体源性感染。

IF 2.6 4区医学

Transplant Infectious Disease Pub Date : 2024-11-01 Epub Date: 2024-10-15 DOI: 10.1111/tid.14398

Paolo Antonio Grossi, Letizia Lombardini, Raffaele Donadio, Daniela Peritore, Giuseppe Feltrin

{"title":"Perspective on donor-derived infections in Italy.","authors":"Paolo Antonio Grossi, Letizia Lombardini, Raffaele Donadio, Daniela Peritore, Giuseppe Feltrin","doi":"10.1111/tid.14398","DOIUrl":"10.1111/tid.14398","url":null,"abstract":"Background: Expected and unexpected donor-derived infections (DDI) are a rare event in solid organ transplant (SOT) recipients but are potentially associated with significant morbidity and mortality. To assure the microbial safety of transplantation, both national guidelines and the current, regional, and local epidemiology of infectious diseases must be considered.Methods: In the present paper the strategies adopted by the Italian National Center for Transplantation (CNT) since 2003 and their evolution to guarantee the safety of organ transplantation are reported. Starting in 2012 mandatory reporting to the CNT of all adverse reactions was started. The number and type of DDI reported to the CNT are currently being analyzed.Results: The infectious diseases second opinion has written and updated the guidelines on the safety of organs for transplantation and supported the Italian transplant network for the use of organs from donors with suspected or documented potentially transmissible infections.Conclusion: A transplant safety network was developed in Italy in 2003 and has been updated according to the evolving knowledge and the changing epidemiology. This is an evolving field, and a continuous update of the recommendation is needed.","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14398"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475774","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}

引用次数: 0

Donor-derived infections in the United States: Opportunities to learn from the Disease Transmission Advisory Committee's experience. 美国的供体源性感染：从疾病传播咨询委员会的经验中学习的机会。

IF 2.6 4区医学

Transplant Infectious Disease Pub Date : 2024-11-01 Epub Date: 2024-06-17 DOI: 10.1111/tid.14316

Lara Danziger-Isakov, Ricardo M La Hoz, Cameron R Wolfe, Emily A Blumberg

引用次数: 0

Minding the gap: How transplant infectious disease can help close the organ donation gap. 弥合差距：移植传染病如何帮助缩小器官捐献缺口。

IF 2.6 4区医学

Transplant Infectious Disease Pub Date : 2024-11-01 Epub Date: 2024-09-28 DOI: 10.1111/tid.14383

Rachel Sigler, Nancy Law

引用次数: 0

Clinical approach to donor-derived infection in solid organ transplant recipients. 实体器官移植受者感染供体源性感染的临床方法。

IF 2.6 4区医学

Transplant Infectious Disease Pub Date : 2024-11-01 Epub Date: 2024-07-16 DOI: 10.1111/tid.14344

Varun K Phadke

{"title":"Clinical approach to donor-derived infection in solid organ transplant recipients.","authors":"Varun K Phadke","doi":"10.1111/tid.14344","DOIUrl":"10.1111/tid.14344","url":null,"abstract":"Donor-derived infection is an uncommon but potentially devastating complication of solid organ transplantation (SOT). Accurate and timely identification of unexpected infectious disease transmission events has implications not only for the recipient(s) experiencing infection, but also other recipients of organs or tissues from the same donor who may require additional testing or risk mitigation, as well as the broader organ transplant regulatory framework. This narrative review synthesizes data from published reports of symptomatic unexpected donor-derived infections in SOT recipients to provide clinicians with a systematic approach to the evaluation of undifferentiated illnesses that may be of donor origin. Key reasons to consider donor-derived infection include certain microbiologically proven infections in the recipient, especially early after transplant, characteristics of the donor or their management that suggest potential exposure to or infection with specific pathogens prior to organ procurement, and select clinical syndromes that occur in the post-transplant period. Syndromes for which expedited consideration and evaluation of donor-derived infection may be warranted include central nervous system infection, graft or perigraft complications developing in the absence of typical risk factors, and unexplained critical illness/sepsis syndrome in the early post-transplant period. When embarking on an investigation of a suspected donor-derived infection, clinicians should apply knowledge of the entire continuum of the organ procurement and transplant process to ensure unbiased and comprehensive data collection that will facilitate appropriate adjudication of these uncommon but high-consequence events.","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e14344"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621015","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}

引用次数: 0