{"title":"The Unseen Battleground: How Anaerobic Antibiotics Shape GVHD Risk Post-HSCT.","authors":"Ildefonso Espigado, Laura de la Torre Corona","doi":"10.1111/tid.70075","DOIUrl":"10.1111/tid.70075","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70075"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691676","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":"Cytomegalovirus, the Troll of Transplantation and Cellular Therapy?","authors":"Joseph Sassine, Emily A Siegrist","doi":"10.1111/tid.70065","DOIUrl":"https://doi.org/10.1111/tid.70065","url":null,"abstract":"","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70065"},"PeriodicalIF":2.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310493","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}
Chia-Yu Chiu, Priya Sampathkumar, Lisa M Brumble, Holenarasipur R Vikram, Kymberly D Watt, Elena Beam
{"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":"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":"2025-05-01","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}
Julia S Slagter, Carolina A M Schurink, Ga-Lai M Chong, Marlies E J Reinders, Robert J Porte, Robert C Minnee
{"title":"Limited Risk of Microbial Contamination During Hypothermic and Normothermic Machine Perfusion of Donor Kidneys.","authors":"Julia S Slagter, Carolina A M Schurink, Ga-Lai M Chong, Marlies E J Reinders, Robert J Porte, Robert C Minnee","doi":"10.1111/tid.70019","DOIUrl":"10.1111/tid.70019","url":null,"abstract":"<p><strong>Background: </strong>Both hypothermic machine perfusion (HMP) and normothermic machine perfusion (NMP) are increasingly used for preservation of deceased donor kidneys. However, especially NMP can pose as a risk for microbial contamination of the kidney graft as the 37°C perfusate can act as a breeding ground for microbial contaminants.</p><p><strong>Methods: </strong>In this study, we investigated the cultures of HMP and NMP perfusates of deceased donor kidneys.</p><p><strong>Results: </strong>Between January 2021 and April 2024, a total of 99 perfusates were examined (73 HMP and 26 NMP perfusates)-. We found that contamination of HMP perfusate was common, occurring in 21 of 73 cultures (29%). Most bacteria originated from the skin. Microbial contamination during NMP was rare, occurring only in 2 of 26 cultures (8%). Microbial contamination during machine perfusion did not lead to infectious complications in the recipients.</p><p><strong>Conclusion: </strong>Machine perfusion poses a very limited risk of infection in kidney transplant recipients.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70019"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568396","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}
Emily M Eichenberger, Wairimu Magua, Geeta Karadkhele, Grace Zhou, Payaswini Vasanth, Christian Larsen
{"title":"Impact of Severe Persistent BK Polyomavirus on Graft Function and Quality of Life Outcomes in Kidney Transplant Recipients.","authors":"Emily M Eichenberger, Wairimu Magua, Geeta Karadkhele, Grace Zhou, Payaswini Vasanth, Christian Larsen","doi":"10.1111/tid.70010","DOIUrl":"10.1111/tid.70010","url":null,"abstract":"<p><strong>Background: </strong>The risk factors and outcomes associated with severe persistent BK polyomavirus (BKPyV) in kidney transplant recipients (KTR) are unknown.</p><p><strong>Methods: </strong>This is a single-center retrospective study of KTR with severe persistent BKPyV compared to (1) KTR with low/no BKPyV-DNAemia and (2) KTR with high BKPyV-DNAemia. Severe persistent BKPyV was defined as BKPyV load reaching > 6 log<sub>10</sub> (1 000 000 copies/mL) for ≥ 90 days. Low/no BKPyV was defined as BKPyV load remaining < 3 log<sub>10</sub> (1000 copies/mL), and high BKPyV was defined as BKPyV load ≥ 3 log<sub>10</sub> without meeting criteria for severe persistent BKPyV.</p><p><strong>Results: </strong>Out of 2586 KTR, 22 had severe persistent BKPyV and were compared to 1843 KTR with low/no BKPyV and 721 KTR with high BKPyV. A low absolute lymphocyte count during the first month posttransplant was associated with an increased risk of severe persistent BKPyV relative to those with low/no BKPyV and high BKPyV (OR 0.91, 95%CI 0.84, 0.99). KTR with severe persistent BKPyV had significantly lower eGFR at 2 years posttransplant relative to low/no and high BKPyV groups eGFR (36 vs. 61 and 59 mL/min; p < 0.001 for both). Additionally, KTR with severe persistent BKPyV required more lab draws and incurred significantly higher total lab-associated costs relative to KTR with low/no BKPyV and high BKPyV ($7516 vs. $4631, p < 0.001; $7516 vs. $5811, p < 0.001, respectively).</p><p><strong>Conclusions: </strong>Severe persistent BKPyV is uncommon but associated with poor outcomes including impaired renal function, a higher burden of labs, and lab-associated costs. Future studies are needed to determine underlying factors that predict severe persistent BKPyV.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70010"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658619","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":"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":"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":"2025-05-01","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}