A Humar

..Routine use of antifungal prophylaxis warrants concern given the emergence of non-albicans Candida spp. as significant pathogens after liver transplantation and higher mortality in patients with these infections...

..002). In D+/R- patients, CMV serology testing is for the most part not clinically useful for predicting subsequent disease. However, seroconversion by 6 months may be useful for identifying patients at risk of late-onset CMV disease...

..HCV-negative patients (47.6% vs. 72.7%; P=0.006). In conclusion, these results suggest that HCV infection does not appear to promote herpesvirus reactivation after liver transplantation...

..The impact of different cytomegalovirus (HCMV) glycoprotein B (gB) genotypes on pathogenesis remains controversial...

..Routine monitoring for viral co-infection in patients with CMV disease is not indicated...

..Further study of viral screening modalities may reduce disease transmission risk without excessive donor loss...

..The number needed to treat to avoid one additional patient with CMV disease up to 12 months posttransplant is approximately 5...

..Whether the early reduction in cytomegalovirus (CMV) disease seen at 1 year with prolongation of antiviral prophylaxis (up to 200 days) persists in the long term is unknown...

..We aimed to characterize the molecular epidemiology of gN and IE1 genotypes in organ transplant patients with CMV disease in the context of clinical and virologic endpoints...

..0%) patients with a detectable interferon-gamma response (cutoff 0.1 IU/mL) versus 10/25 (40.0%) patients with a negative CMI, p = 0.12. Monitoring of CMI may be useful for predicting late-onset CMV disease...

..Therefore, CMV transmission presents rarely after IT and with low incidence compared to solid organ transplantation, but occurs late posttransplant. The use of lymphocyte depleting therapies is a primary risk factor...

..013; odds ratio, 7.26; 95% confidence interval, 1.52-34.72). HHV-6 is associated with CMV infection and disease, thus supporting an interaction between these viruses...

..As new information emerges about novel H1N1, updates will be made to the electronic version of the document posted on the websites of the AST and TTS...

..Preemptive therapy based on regular CMV antigenemia monitoring is superior to screening bronchoscopy for the prevention of CMV disease after allogeneic BMT...

..In patients awaiting liver transplantation, both the TST and QFT-G were comparable for the diagnosis of LTBI with reasonable concordance between tests. Indeterminate QFT-G result was more likely in those with more advanced liver disease...

..Pneumococcal conjugate vaccine (PCV7) may improve immunogenicity in this population, and a donor vaccination strategy may benefit patients undergoing HSCT...

..Epidemiologic data in lung transplant recipients are lacking. We determined the incidence and clinical characteristics of herpes zoster, and the risk factors for developing herpes zoster, after lung transplantation...

..We assessed the contribution of these viruses in the development of bronchiolitis obliterans syndrome (BOS) after lung transplantation...

..It may be possible to enhance immunogenicity by priming the recipient with the 7-valent pneumococcal conjugate vaccine (PCV7), followed by boosting with PPV23...

..031). In conclusion, HHV-6 and CMV infection and viral load were not associated with increased overall rates of HCV recurrence or HCV viral load after liver transplantation but may be associated with more severe forms of recurrence...

..The use of sensitive molecular methods that can simultaneously detect a large panel of respiratory viruses may help better define their effects...

..This article describes the current knowledge about respiratory viral infections as it relates to solid organ transplant, hematopoietic stem cell transplant, and oncology settings...

..He received three-weeks of antiviral treatment post-operatively and he had uneventful procedure with favorable outcome...

..We aimed to establish the outcomes of pandemic influenza A H1N1 and factors leading to severe disease in a cohort of patients who had received transplants...

..Three of five developed protective titers against H1N1. A proportion of pediatric patients may respond to influenza vaccine even when immunized in the early post-transplant period...

..Herein, we report successful lung transplantation for a patient with life-threatening pulmonary hemorrhage and respiratory failure as a consequence of this pulmonary renal syndrome...

..After therapy with rituximab, she developed Pneumocystis jirovecii pneumonia (PJP) requiring hospitalization. We discuss the increasing literature for the use of rituximab for AMR and the need for PJP prophylaxis in this setting...

..CMV prophylaxis may have modified the natural history of some of these non-CMV viral infections...

..Little is known about adenovirus infections in adult lung transplant recipients. Because the virus can establish latency, re-activation may be relatively common after transplantation...

..17 days among patients without recurrence (P=.001). This was not explainable by detectable ganciclovir resistance. CMV load kinetics are useful for identifying, at a very early stage, patients who are more likely to have recurrence...

..The antimicrobial resistance rates were high, especially for trimethoprim/sulfamethoxazole. HSCT recipients are at significantly greater risk for IPD than the general population. Preventative strategies are necessary...

..It appears that the gB genotype, which causes CMV disease, does not significantly influence CMV-load kinetics or clinical response to therapy...

..Data on the epidemiology of MRSA infection in lung transplantation is limited...

..We studied human cytomegalovirus (CMV) donor-to-recipient transmission patterns in organ transplantation by analyzing genomic variants on the basis of CMV glycoprotein B (gB) genotyping...

..As no transmissions occurred in recipients of nonhepatic organs from these donors, these cases also suggest that liver recipients may be at higher risk of donor transmitted bacteremia...

..All dialysis tubing was to be disinfected before patient connection. CONCLUSION: Outbreak was due to contamination during dialysis setup. After institution of appropriate control measures, no new cases have occurred...

..Response rates were lower in patients with increasing numbers of primary (P=0.045) or secondary (P=0.001) PI mutations. The addition of increasing numbers of reverse transcriptase mutations further impaired response rates (P=0.004)...

..024). After a single standard dose of influenza vaccine, a booster dose given by intradermal injection did not significantly improve vaccine immunogenicity in lung transplant recipients...

..Polymorphisms in the CMV glycoprotein B (gB) gene allow discrimination of 4 distinct genotypes (gB1-gB4). We assessed the influence of gB genotypes on the clinical and virologic outcome of CMV disease...

..Cytomegalovirus (CMV) is an important infection in lung transplant recipients. Center-to-center variation in preventive and treatment strategies is unknown...

..CONCLUSIONS: Solid organ transplant recipients represent a unique group of compromised travelers; however, few were adequately protected against travel-associated enteric, vector-borne and bloodborne pathogens...

..78%). With the prominent feature of concurrent CMV gB genotyping and quantitation in a single reaction, the new assay provides a rapid and cost-effective method for monitoring CMV infection in SOT recipients...

..Lessons learned from West Nile virus and severe acute respiratory syndrome in transplantation should be applicable to future outbreaks of other emerging infectious diseases...

..The objective of this study was to determine the clinical impact of HHV-6 infection after liver transplantation including both direct and indirect effects...

..030). CONCLUSIONS: The gB genotype did not correlate with peak CMV viral load and with the development of CMV disease or acute rejection following liver transplantation...

..09). The response rate and mean fold increase in OPA titers were not significantly different between groups. There was a trend toward enhanced immunogenicity for PCV7 by ELISA. However, functional antibody responses were not different...

..Concurrent infections are common and may contribute to mortality in this immunosuppressed population...

..As SARS spreads throughout the world, it may become an increasingly significant problem for transplant patients and programs...

..2%, vs 3.2% ganciclovir) the safety profile was similar for both drugs. Overall, once-daily oral valganciclovir was as clinically effective and well-tolerated as oral ganciclovir tid for CMV prevention in high-risk SOT recipients...

..CONCLUSIONS: The greater systemic exposure to ganciclovir delivered by valganciclovir was associated with delayed development of viremia. There was only a weak association between AUC and hematological toxicity...

..No serious clinical sequelae or effects on subsequent acute rejection were observed...

..Valganciclovir prophylaxis had similar efficacy to either intravenous ganciclovir (D+/R- patients), or oral ganciclovir (R+ patients) in lung recipients...

..Compared with historic data, data from the present study suggest that antiviral prophylaxis may lower the incidence, prevalence, or level of DNAemia for infection with HHV-6, HHV-8, VZV, and EBV but not for infection with HHV-7...

..Cytomegalovirus (CMV) D+/R- solid-organ transplant (SOT) recipients carry increased risk of developing CMV disease; however, other risk factors in these patients have not been delineated...

..We performed a multi-center trial assessing two different antiviral regimens and their effect on EBV replication...

..Valganciclovir was associated with negligible risk of resistance and thus constitutes a useful alternative to ganciclovir prophylaxis for CMV in high-risk SOT recipients...

..Similarly, single time point measures at the end of prophylaxis or month 4 had low sensitivity for disease prediction. Overall, regular CMV plasma viral load measurements were only of modest value in predicting CMV disease...

..Two patients treated with valganciclovir required a switch to iv ganciclovir, because of a lack of response. Valganciclovir is useful for the treatment of CMV infection and disease in selected organ-transplant recipients...