Infections in liver and lung transplant recipients: a national prospective cohort

Abstract

Infections are a major complication of solid organ transplants (SOTs). This study aimed to describe recipients' characteristics, and the frequency and etiology of infections and transplant outcome in liver and lung SOTs, and to investigate exposures associated to infection and death in liver transplant recipients. The study population included recipients of SOTs performed in Italy during a 1-year period in ten Italian lung transplant units and eight liver transplant units. Data on comorbidities, infections, retransplantation, and death were prospectively collected using a web-based system, with a 6-month follow-up. The cumulative incidence of infection was 31.7% and 47.8% in liver and lung transplants, respectively, with most infections occurring within the first month after transplantation. Gram-negatives, which were primarily multidrug-resistant, were the most frequent cause of infection. Death rates were 0.42 per 1000 recipient-days in liver transplants and 1.41 per 1000 recipient-days in lung transplants. Infection after SOT in adult liver recipients is associated to an increased risk of death (OR = 13.25; p-value < 0.001). Given the frequency of infection caused by multidrug-resistant microorganisms in SOT recipients in Italy and the heavy impact of infections on the transplant outcome, the reinforcement of surveillance and control activities to prevent the transmission of multidrug-resistant microorganisms in SOT recipients represents a priority. The implementation of the study protocol in liver and lung transplant units and the sharing of results have increased the awareness about the threat due to antimicrobial resistance in the country.

Burden and Timeline of Infectious Diseases in the First Year After Solid Organ Transplantation in the Swiss Transplant Cohort Study

“…Major efforts to reduce these risk factors, including improved surgical techniques, adequate source control, and early removal of indwelling catheters and prosthetic material will be essential. Infections with ESBL- and carbapenemase-producing E. coli and K. pneumoniae , multidrug-resistant and pan-drug-resistant P. aeruginosa , and vancomycin-resistant enterococci are on the rise worldwide and affect SOT recipients, with an important impact on survival [ 15 , 35–40 ]. The major burden represented by these particular bacterial species in SOT recipients in our study is particularly alarming.…”

Identification of Urinary Exosomal miRNAs for the Non-Invasive Diagnosis of Prostate Cancer

“…26,27 In the case of PCa, the interest in miRNA is linked to the fact that prostate-specific antigen shows several limitations, 28,29 as infection, very common in frail patients. 30,31 Early diagnosis, especially in the high risk, as the main cause of death for PCa, is needed. 32,33 The challenge nowadays is to better understand the mechanism of cancer development, finding real PCa markers and developing new specific therapies in order to reduce the mortality of PCa.…”

COVID‐19 health restrictions in a transplanted Italian cohort

“…Liver recipients are a population at high risk of infection [3]. A strict outpatient follow-up and an increased awareness in LRs about prevention measures are fundamental to reduce post-transplant complications [4].…”