Related Experiment Videos
Infection in solid organ transplantation
1Department of Medicine, New England Medical Center and Tufts University School of Medicine, Boston, Massachusetts 02111, USA.
Abstract:
Infection in the organ transplant recipient is a major determinant of the outcome of transplantation. The attributable mortality from invasive fungal disease and cytomegalovirus disease has been 50 and 30%, respectively. Determinants of infection include epidemiologic exposures to environmental pathogens or exposure to latent infection in the donated organ or recipient, and changes in the net state of immunosuppression. For the past two decades significant improvements have been made in the recognition, prevention and treatment of infections, such as cytomegalovirus and P. carinii. Future research will need to focus on treatment of invasive mold infections, and the management of hepatitis B and C in liver transplantation. In addition, improvement in the prevention of the post-transplant lymphoproliferative disease syndrome will be necessary.
Insights
Organ transplant recipients face significant mortality risks from infections like fungal disease and cytomegalovirus. Advances in prevention and treatment have improved outcomes, but challenges remain in managing mold infections and post-transplant complications.
Area of Science:
- Transplant medicine
- Infectious diseases
- Immunology
Background:
- Infection significantly impacts organ transplant outcomes, with high attributable mortality from fungal and cytomegalovirus diseases.
- Key infection determinants include environmental exposures, latent infections in donors or recipients, and altered immunosuppression.
- Despite progress in managing infections like cytomegalovirus and Pneumocystis carinii, significant challenges persist.
Purpose of the Study:
- To review the impact of infections on organ transplant recipients.
- To highlight advancements in infection recognition, prevention, and treatment.
- To identify future research priorities in transplant infectious disease management.
Main Methods:
- Literature review of infection determinants and outcomes in organ transplantation.
- Analysis of mortality data for specific infections.
- Synthesis of current knowledge on prevention and treatment strategies.
Main Results:
- Invasive fungal disease and cytomegalovirus disease cause 50% and 30% attributable mortality, respectively.
- Improvements in managing cytomegalovirus and P. carinii infections have been noted over the past two decades.
- Ongoing challenges include invasive mold infections, hepatitis B and C management in liver transplant recipients, and prevention of post-transplant lymphoproliferative disease.
Conclusions:
- Infection remains a critical factor influencing organ transplant success.
- Continued research is essential for addressing emerging infectious threats and improving long-term transplant outcomes.
- Focus on invasive mold infections, viral hepatitis management, and lymphoproliferative disease prevention is crucial for future advancements.