Infections in solid-organ transplantation: Difference between revisions
From IDWiki
m (Aidan moved page Special Immune Solid-organ transplant infections to Solid-organ transplant infections without leaving a redirect) |
mNo edit summary |
||
Line 1: | Line 1: | ||
⚫ | |||
− | = Infections in solid-organ transplantation = |
||
− | |||
⚫ | |||
* Bacterial: syphilis, urine and blood cultures, bronchoalveolar lavage |
* Bacterial: syphilis, urine and blood cultures, bronchoalveolar lavage |
||
Line 7: | Line 5: | ||
* Other: Strongyloides, Chagas (sometimes) |
* Other: Strongyloides, Chagas (sometimes) |
||
− | + | = Recipient Screen = |
|
− | Prednisone: TB/HBV/Strongy |
+ | * Prednisone: TB/HBV/Strongy |
+ | * Fludarabine: |
||
⚫ | |||
+ | ** 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-alpha inhibitors: like prednisone |
||
⚫ | |||
⚫ | |||
− | * 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-alpha inhibitors: like prednisone |
||
+ | * ≤30 days |
||
⚫ | |||
+ | * T-cell deficit greater than B-cell |
||
− | |||
⚫ | |||
+ | * Surgical site infection |
||
+ | ** Bacterial |
||
⚫ | |||
* LVAD infection |
* LVAD infection |
||
* Mycobacterial infection (very late) Lungs |
* Mycobacterial infection (very late) Lungs |
||
Line 23: | Line 28: | ||
* Anastomotic infection, including fungal Liver: anastamotic leak, including VRE peritonitis Hospital-acquired: central line infections and resistant organisms Donor-derived bacterial infections, including syphilis |
* Anastomotic infection, including fungal Liver: anastamotic leak, including VRE peritonitis Hospital-acquired: central line infections and resistant organisms Donor-derived bacterial infections, including syphilis |
||
− | + | = Late Infections = |
|
− | 30 days to 3-6 months |
+ | * 30 days to 3-6 months |
+ | * T-cell deficit greater than B-cell |
||
+ | * Reactivation infections |
||
* EBV/CMV/HSV/VZV |
* EBV/CMV/HSV/VZV |
||
* TB, PCP, invasive fungal infections Occur as your withdraw prophylactic antimicrobials |
* TB, PCP, invasive fungal infections Occur as your withdraw prophylactic antimicrobials |
||
− | + | = Very Late Infections = |
|
* More than 6 months |
* More than 6 months |
||
* B-cell deficits and variable T-cell deficits |
* B-cell deficits and variable T-cell deficits |
||
* Usually regular community-acquired infections, but more severe |
* Usually regular community-acquired infections, but more severe |
||
+ | |||
+ | [[Category:Transplant patients]] |
Revision as of 18:52, 14 August 2019
Donor screen
- Bacterial: syphilis, urine and blood cultures, bronchoalveolar lavage
- Viral: CMV, EBV, HIV HBV, HCV, HSV, VZV, HTLV-1
- Other: Strongyloides, Chagas (sometimes)
Recipient Screen
- Prednisone: TB/HBV/Strongy
- 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-alpha inhibitors: like prednisone
Early Infections
- ≤30 days
- T-cell deficit greater than B-cell
- Surgical site infection
- Bacterial
- Fungal: Aspergillus and Mucor Organ-specific Cardiac
- LVAD infection
- Mycobacterial infection (very late) Lungs
- Donor-derived VAP
- Anastomotic infection, including fungal Liver: anastamotic leak, including VRE peritonitis Hospital-acquired: central line infections and resistant organisms Donor-derived bacterial infections, including syphilis
Late Infections
- 30 days to 3-6 months
- T-cell deficit greater than B-cell
- Reactivation infections
- EBV/CMV/HSV/VZV
- TB, PCP, invasive fungal infections Occur as your withdraw prophylactic antimicrobials
Very Late Infections
- More than 6 months
- B-cell deficits and variable T-cell deficits
- Usually regular community-acquired infections, but more severe