Book contents
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- 83 Evaluation of Suspected Immunodeficiency
- 84 Infections in the Neutropenic Patient
- 85 Infections in Patients with Neoplastic Disease
- 86 Corticosteroids, Cytotoxic Agents, and Infection
- 87 Infections in Transplant Patients
- 88 Diabetes and Infection
- 89 Infectious Complications in the Injection Drug User
- 90 Infections in the Alcoholic
- 91 Infections in the Elderly
- 92 Neonatal Infection
- 93 Pregnancy and the Puerperium: Infectious Risks
- 94 Dialysis-Related Infection
- 95 Overwhelming Postsplenectomy Infection
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
87 - Infections in Transplant Patients
from Part XI - The Susceptible Host
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- 83 Evaluation of Suspected Immunodeficiency
- 84 Infections in the Neutropenic Patient
- 85 Infections in Patients with Neoplastic Disease
- 86 Corticosteroids, Cytotoxic Agents, and Infection
- 87 Infections in Transplant Patients
- 88 Diabetes and Infection
- 89 Infectious Complications in the Injection Drug User
- 90 Infections in the Alcoholic
- 91 Infections in the Elderly
- 92 Neonatal Infection
- 93 Pregnancy and the Puerperium: Infectious Risks
- 94 Dialysis-Related Infection
- 95 Overwhelming Postsplenectomy Infection
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
Summary
INTRODUCTION
Collectively, infections are the single most common complication of organ and tissue transplantation. Virtually any bacterial, fungal, viral, and parasitic pathogen can cause clinical disease in a transplant recipient. Several factors inherent to the transplant recipient or related to the donor, the environment, and the circumstances surrounding the transplant procedure (such as surgical techniques and immunosuppressive drugs) remarkably increase the risk of infectious complications. Generally, the overall infection risk is determined by (1) epidemiologic exposures and (2) the net state of immunosuppression.
RISK FACTORS OF INFECTION AFTER TRANSPLANTATION
Epidemiologic Exposures
The major sources of pathogens are (1) the transplant recipient who may harbor latent, active, or subclinical infection prior to transplantation; (2) the donor who may harbor latent, active, or subclinical infection that could be transmitted through the allograft; and (3) the environment surrounding the immunocompromised transplant patient. Table 87.1 lists some risk factors for acquiring infection after solid organ transplantation.
THE TRANSPLANT RECIPIENT
The epidemiologic exposures of potential transplant recipients should be assessed to determine the risk of infection and guide preventive measures. Table 87.2 lists the recommended screening tests in the evaluation of potential recipients (and their donors) prior to transplantation; these include screening for herpes simplex virus (HSV) 1 and 2, varicellazoster virus (VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), human T-cell lymphotrophic virus (HTLV) I/II, hepatitis viruses, Mycobacterium tuberculosis, Toxoplasma gondii, and Treponema pallidum.
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- Clinical Infectious Disease , pp. 611 - 624Publisher: Cambridge University PressPrint publication year: 2008
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