Infection in the Organ Transplant Recipient

Prophylactic Measures in the Solid‐Organ Recipient before Transplantation

“…Rubin noted development of TB in only 1 of 73 unprophylaxed PPD-positive patients [2]. He therefore recommends consideration of INH prophylaxis only in the presence of other risk factors, such as recent skin test conversion; Asian, African, or Native American heritage; the presence of other immunosuppressing conditions, such as protein malnutrition; a history of active TB; and significant abnormalities on chest radiograph [2]. In a series from an endemic area, Qunibi et al noted development of active TB in 2 of 18 patients with pretransplant positive PPD test results, but 3 of 70 patients with negative PPD test results also developed TB after transplantation [46].…”

“…Treatment of active TB after transplantation can be problematic, in light of the potential interactions of antituberculous medications, especially rifampin, with cyclosporine. In patients who have a positive PPD test result before transplantation or other risk factors for TB, a vigorous search for active TB should be conducted, and any active disease should be fully treated before transplantation is considered [2,42]. The role of prophylaxis after transplantation is discussed in the article by Soave [44] in this issue.…”

“…Although administration of INH prophylaxis before a course of immunosuppressive therapy has been recommended for such patients, some centers have observed a low likelihood of development of TB in the unprophylaxed PPD-positive transplant recipient who does not have other risk factors for TB. Rubin noted development of TB in only 1 of 73 unprophylaxed PPD-positive patients [2]. He therefore recommends consideration of INH prophylaxis only in the presence of other risk factors, such as recent skin test conversion; Asian, African, or Native American heritage; the presence of other immunosuppressing conditions, such as protein malnutrition; a history of active TB; and significant abnormalities on chest radiograph [2].…”

“…Strongyloides stercoralis can produce a severe and potentially fatal hyperinfection syndrome or disseminated infection in immunocompromised individuals [2,48]. Pretransplant patients, especially those from endemic areas, may harbor this parasite asymptomatically.…”

Bacterial and Fungal Infections in the Early Post-transplantation Period After Simultaneous Pancreas-kidney Transplantation: Etiological Agents and Their Susceptibility

“…Pancreas recipients are at significant risk for infectious complications that can lead to significant morbidity and mortality [2]. Infections in simultaneous pancrease kidney transplantation (SPK) recipients are a common cause of infectious complications in the early postoperative period [3]. According to the Poltransplant database, 293 infection [5e6].…”