Pretransplant screening for infections in lung and heart transplant candidates

Solid organ transplantation (SOT) is the definitive treatment for end-stage organ disease but also introduces a heightened risk of infection in the post-transplant period. In heart and lung transplantation, unique factors predisposing to infection include exposure of the lungs to the external environment, alteration of airway anatomy, pretransplant infection and colonization with difficult-to-treat organisms, and pretransplant presence of infected devices. This is in addition to risks common to all SOT leading, including immunosuppression. The aim of pretransplant infectious disease screening in SOT recipients is to prospectively identify infectious risks through careful history taking, examination, and laboratory testing, as well as mitigating these risks through vaccination, treatment, prophylaxis, and counseling on safe living. In this article, we review infectious risks in heart and lung transplant candidates and discuss recommendations for screening before transplantation.