View source for Infections in solid-organ transplantation

==Pretransplant Screening==

===Donor screen===

*Bacterial: [[syphilis]], urine and blood cultures, bronchoalveolar lavage
*Viral: [[CMV after solid organ transplantation|CMV]], [[EBV]], [[HIV]], [[HBV]], [[HCV]], [[HSV]], [[VZV]], [[HTLV-1]]
*Other: [[Strongyloides stercoralis]], [[Chagas disease]] (sometimes)

===Recipient Screen===

*[[Prednisone]]: [[TB]]/[[HBV]]/[[Strongyloides]]
*[[Fludarabine]]:
**Lasts 6-12 months after last dose
**Listeria, PCP, and Nocardia
*[[Rituximab]]: as well as B-cell, can allow [[HBV]] and [[PJP]] infections
*[[Adalimumab]]: T-cell deficiency for months after last dose
*[[TNF-α inhibitors]]: similar to [[prednisone]]

==Post-Transplant Infections==

===Early Infections (≤30 days)===

*Major risk factor is T-cell deficit, more than than B-cell deficit
*Surgical site infection
**Bacterial
**Fungal: [[Aspergillus]] and [[Mucorales]]
*Organ-specific
**Cardiac
***LVAD infection
***[[Non-tuberculous mycobacteria|Mycobacterial infection]] (very late)
**Lungs
***Donor-derived [[Ventilator-associated pneumonia|VAP]]
***Anastomotic infection, including fungal
**Liver: anastamotic leak, including [[VRE]] peritonitis
*Hospital-acquired: [[Central line-associated bloodstream infection|central line infections]] and resistant organisms
*Donor-derived bacterial infections, including [[syphilis]]

===Late Infections (30 days to 3-6 months)===

*Major risk factor is T-cell deficit, more than B-cell deficit
*Occur as your withdraw prophylactic antimicrobials
*Reactivation infections
**[[EBV]]/[[CMV after solid organ transplantation|CMV]]/[[HSV]]/[[VZV]]
**[[TB]], [[PCP]], [[Invasive fungal infection|invasive fungal infections]]

===Very Late Infections (>6 months)===

*B-cell deficits and variable T-cell deficits
*Usually regular community-acquired infections, but more severe

[[Category:Transplant patients]]