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[Viral infections after transplantation]
1Abteilung für Infektiologie am Kantonsspital Basel und Transplantations-Virologie am Institut für Medizinische Mikrobiologie, Universität Basel. hans.hirsch@unibas.ch
Therapeutische Umschau. Revue Therapeutique
|November 13, 2003
Summary
Understanding host, graft, and virus factors is crucial for managing viral infections after organ transplantation. Advances in diagnostics and antivirals, especially for cytomegalovirus (CMV), improve patient outcomes.
Area of Science:
- Virology
- Immunology
- Transplantation Medicine
Context:
- Viral infections pose significant risks in organ transplantation, impacting morbidity and mortality.
- The interplay between host immunity, graft characteristics, and viral factors determines infection outcomes.
- Immunosuppression and inflammation are key modulators of the host-graft-virus interaction.
Purpose:
- To outline the determinants influencing viral infection risk in organ transplant recipients.
- To highlight advancements in understanding and managing cytomegalovirus (CMV) infections.
- To discuss the potential of new diagnostic tools for emerging viral threats.
Summary:
- Host factors (immune status, age), graft factors (type, HLA mismatch), and viral factors (tropism, fitness) dictate infection risk.
- Immunosuppression, inflammation, and antiviral therapies modulate the host-graft-virus dynamics.
- Progress in CMV management is driven by clinical definitions, quantitative assays, and effective antivirals.
Impact:
- Improved clinical-virological definitions and quantitative assays enhance diagnosis and management of viral infections.
- Quantitative real-time PCR assays are expected to improve diagnosis of Epstein-Barr virus, polyomavirus BK, and respiratory viruses.
- Characterizing cellular immunity and broader assay availability will further refine transplant patient care and outcomes.