Skip to main content

Clinical Aspects of Infection

  • Chapter
  • First Online:
Pathology of Solid Organ Transplantation
  • 1190 Accesses

Abstract

Infections in solid organ transplant recipients continue to be a significant source of morbidity and mortality. More than 80% of recipients develop at least one infection during the first year [16]. Kidney transplant recipients have the lowest risk of infection as compared to lung, liver, and heart allograft recipients, and this is likely related to the more elective nature of the surgery and better overall status of the patient prior to transplantation. Infections in this patient population, however, can lead to graft dysfunction, allograft rejection, alterations in immune status, and affect the overall transplant outcome [11]. Moreover, chronic graft rejection will necessitate more rigorous immunosuppression which will, in turn, increase the risk of developing infections with immunomodulating viruses [16]. There is thus a fine balance between developing the adequate immunosuppressive regimen that will prevent allograft rejection while at the same time not posing a significant risk for infection.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Adami, J., Gabel, H., Lindelof, B., et al.: Cancer risk following organ transplantation: a nationwide cohort study in Sweden. Br. J. Cancer 89(7), 1221–1227 (2003)

    Article  CAS  PubMed  Google Scholar 

  2. Asberg, A., Humar, A., Rollag, H., et al.: Oral valganciclovir is noninferior to intravenous ganciclovir for the treatment of cytomegalovirus disease in solid organ transplant recipients. Am. J. Transplant. 7(9), 2106–2113 (2007)

    Article  CAS  PubMed  Google Scholar 

  3. Bohl, D.L., Brennan, D.C.: BK virus nephropathy and kidney transplantation. Clin. J. Am. Soc. Nephrol. 2 Suppl 1, S36–S46 (2007)

    Google Scholar 

  4. Brennan, D.C.: Cytomegalovirus in renal transplantation. J. Am. Soc. Nephrol. 12(4), 848–855 (2001)

    CAS  PubMed  Google Scholar 

  5. Caillard, S., Agodoa, L.Y., Bohen, E.M., Abbott, K.C.: Myeloma, Hodgkin disease, and lymphoid leukemia after renal transplantation: characteristics, risk factors and prognosis. Transplantation 81(6), 888–895 (2006)

    Article  PubMed  Google Scholar 

  6. Cruzado, J.M., Gil-Vernet, S., Ercilla, G., et al.: Hepatitis C virus-associated membranoproliferative glomerulonephritis in renal allografts. J. Am. Soc. Nephrol. 7(11), 2469–2475 (1996)

    CAS  PubMed  Google Scholar 

  7. Farrugia, E., Schwab, T.R.: Management and prevention of cytomegalovirus infection after renal transplantation. Mayo Clin. Proc. 67(9), 879–890 (1992)

    CAS  PubMed  Google Scholar 

  8. Fishman, J.A.: Pneumocystis carinii and parasitic infections in transplantation. Infect. Dis. Clin. N. Am. 9(4), 1005–1044 (1995)

    CAS  Google Scholar 

  9. Fishman, J.A., Rubin, R.H.: Infection in organ-transplant recipients. N Engl J. Med. 338(24), 1741–1751 (1998)

    Article  CAS  PubMed  Google Scholar 

  10. Khoury, J.A., Storch, G.A., Bohl, D.L., et al.: Prophylactic versus preemptive oral valganciclovir for the management of cytomegalovirus infection in adult renal transplant recipients. Am. J. Transplant. 6(9), 2134–2143 (2006)

    Article  CAS  PubMed  Google Scholar 

  11. Kubak, B., Maree, C.L., Pegues, D., Hwang, A.: Infections in kidney transplantation. Handbook of kidney transplantation 4th ed. Ed Danovitch G, 2004. Lippincott Williams & Wilkins, Philadelphia

    Google Scholar 

  12. Morales, J.M.: Hepatitis C virus infection and renal disease after renal transplantation. Transplant. Proc. 36(3), 760–762 (2004)

    Article  CAS  PubMed  Google Scholar 

  13. Nalesnik, M.A., Makowka, L., Starzl, T.E.: The diagnosis and treatment of posttransplant lymphoproliferative disorders. Curr. Probl. Surg. 25(6), 367–472 (1988)

    Article  CAS  PubMed  Google Scholar 

  14. Penn, I.: Cancers complicating organ transplantation. N Engl J. Med. 323(25), 1767–1769 (1990)

    Article  CAS  PubMed  Google Scholar 

  15. Roth, D., Cirocco, R., Zucker, K., et al.: De novo membranoproliferative glomerulonephritis in hepatitis C virus-infected renal allograft recipients. Transplantation 59(12), 1676–1682 (1995)

    Article  CAS  PubMed  Google Scholar 

  16. Rubin, R.H.: Infectious disease complications of renal transplantation. Kidney Int. 44(1), 221–236 (1993)

    Article  CAS  PubMed  Google Scholar 

  17. Swinnen, L.J., Costanzo-Nordin, M.R., Fisher, S.G., et al.: Increased incidence of lymphoproliferative disorder after immunosuppression with the monoclonal antibody OKT3 in cardiac-transplant recipients. N Engl J. Med. 323(25), 1723–1728 (1990)

    Article  CAS  PubMed  Google Scholar 

  18. Waldman, M., Kopp, J.B.: Parvovirus-B19-associated complications in renal transplant recipients. Nat. Clin. Pract. Nephrol. 3(10), 540–550 (2007)

    Article  PubMed  Google Scholar 

  19. Winston, D.J., Emmanouilides, C., Busuttil, R.W.: Infections in liver transplant recipients. Clin. Infect. Dis. 21, 1077–1089 (1995). quiz 1090–1071

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Daniel C. Brennan .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Springer Berlin Heidelberg

About this chapter

Cite this chapter

Ghoussoub, R., Brennan, D.C. (2009). Clinical Aspects of Infection. In: Liapis, H., Wang, H. (eds) Pathology of Solid Organ Transplantation. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-79343-4_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-79343-4_3

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-79342-7

  • Online ISBN: 978-3-540-79343-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics