Posttransplant Complications and Comorbidities

  • Lara Danziger-Isakov
  • Flor M. Munoz
  • Michele Estabrook
Reference work entry
Part of the Organ and Tissue Transplantation book series (OTT)


Infectious complications cause significant acute morbidity and mortality after pediatric lung transplantation. With the lung graft in direct communication with the environment, it is susceptible to a variety of bacterial, fungal, and viral pathogens. Appreciation for pretransplant risk factors in addition to perioperative and posttransplant exposures is necessary to anticipate, diagnose, and treat infections in this population. Further, epidemiologic associations between infection and chronic allograft dysfunction have been reported and suggest consequences of infectious events may have substantial impact.


Bacteria Cytomegalovirus Infectious complication Nontubercular mycobacteria Pediatric lung transplantation Respiratory virus 


  1. Aguilar-Guisado M et al (2007) Pneumonia after lung transplantation in the RESITRA cohort: a multicenter prospective study. Am J Transplant 7(8):1989–1996PubMedCrossRefGoogle Scholar
  2. Alexander BD, Tapson VF (2001) Infectious complications of lung transplantation. Transpl Infect Dis 3(3):128–137PubMedCrossRefGoogle Scholar
  3. American Academy of Pediatrics Committee on Infectious Diseases, American Academy of Pediatrics Bronchiolitis Guidelines Committee (2014) Updated guidance for palivizumab prophylaxis among infants and young children at increased risk of hospitalization for respiratory syncytial virus infection. Pediatrics 134(2):e620–e638CrossRefGoogle Scholar
  4. Andes DR et al (2016) The epidemiology and outcomes of invasive Candida infections among organ transplant recipients in the United States: results of the Transplant-Associated Infection Surveillance Network (TRANSNET). Transpl Infect Dis 18(6):921–931PubMedCrossRefGoogle Scholar
  5. Asberg A et al (2007) Oral valganciclovir is noninferior to intravenous ganciclovir for the treatment of cytomegalovirus disease in solid organ transplant recipients. Am J Transplant 7(9):2106–2113PubMedCrossRefGoogle Scholar
  6. Ascioglu S et al (2002) Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: an international consensus. Clin Infect Dis 34(1):7–14PubMedCrossRefGoogle Scholar
  7. Assi M et al (2013) Histoplasmosis after solid organ transplant. Clin Infect Dis 57(11):1542–1549PubMedPubMedCentralCrossRefGoogle Scholar
  8. Avery RK (2011) Antifungal prophylaxis in lung transplantation. Semin Respir Crit Care Med 32(6):717–726PubMedCrossRefGoogle Scholar
  9. Avery RK et al (2013) Strategies for safe living after solid organ transplantation. Am J Transplant 13(Suppl 4):304–310PubMedCrossRefGoogle Scholar
  10. Benden C et al (2013) The registry of the International Society for Heart and Lung Transplantation: sixteenth official pediatric lung and heart-lung transplantation report – 2013; focus theme: age. J Heart Lung Transplant 32(10):989–997PubMedCrossRefGoogle Scholar
  11. Bratzler DW et al (2013) Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm 70(3):195–283PubMedCrossRefGoogle Scholar
  12. Brizendine KD et al (2011) Antifungal prophylaxis in solid organ transplant recipients. Expert Rev Anti-Infect Ther 9(5):571–581PubMedCrossRefGoogle Scholar
  13. Bryant JM et al (2013) Whole-genome sequencing to identify transmission of Mycobacterium abscessus between patients with cystic fibrosis: a retrospective cohort study. Lancet 381(9877):1551–1560PubMedPubMedCentralCrossRefGoogle Scholar
  14. Burguete SR et al (2013) Lung transplant infection. Respirology 18(1):22–38PubMedCrossRefGoogle Scholar
  15. Chalermskulrat W et al (2006) Non-tuberculous mycobacteria in end stage cystic fibrosis: implications for lung transplantation. Thorax 61(6):507–513PubMedPubMedCentralCrossRefGoogle Scholar
  16. Chavez-Bueno S et al (2007) Intravenous palivizumab and ribavirin combination for respiratory syncytial virus disease in high-risk pediatric patients. Pediatr Infect Dis J 26(12):1089–1093PubMedCrossRefGoogle Scholar
  17. Chernenko SM et al (2006) Mycobacterium abscessus infections in lung transplant recipients: the international experience. J Heart Lung Transplant 25(12):1447–1455PubMedCrossRefGoogle Scholar
  18. Chmiel C et al (2008) Ganciclovir/valganciclovir prophylaxis decreases cytomegalovirus-related events and bronchiolitis obliterans syndrome after lung transplantation. Clin Infect Dis 46(6):831–839PubMedCrossRefGoogle Scholar
  19. Chong PP et al (2015) Epidemiology of invasive fungal infections in lung transplant recipients on long-term azole antifungal prophylaxis. Clin Transpl 29(4):311–318CrossRefGoogle Scholar
  20. Choong CK et al (2006) Bronchial airway anastomotic complications after pediatric lung transplantation: incidence, cause, management, and outcome. J Thorac Cardiovasc Surg 131(1):198–203PubMedCrossRefGoogle Scholar
  21. Danziger-Isakov L, Mark Baillie G (2009) Hematologic complications of anti-CMV therapy in solid organ transplant recipients. Clin Transpl 23(3):295–304CrossRefGoogle Scholar
  22. Danziger-Isakov LA et al (2003a) Variability in standard care for cytomegalovirus prevention in pediatric lung transplantation: survey of eight pediatric lung transplant programs. Pediatr Transplant 7:469–473PubMedCrossRefGoogle Scholar
  23. Danziger-Isakov LA et al (2005) Epidemiology of bloodstream infections in the first year after pediatric lung transplantation. Pediatr Infect Dis J 24(4):324–330PubMedCrossRefGoogle Scholar
  24. Danziger-Isakov LA et al (2003b) Cytomegalovirus viremia associated with death or retransplantation in pediatric lung-transplant recipients. Transplantation 75(9):1538–1543PubMedCrossRefGoogle Scholar
  25. Danziger-Isakov LA et al (2008) Increased mortality after pulmonary fungal infection within the first year after pediatric lung transplantation. J Heart Lung Transplant 27(6):655–661PubMedPubMedCentralCrossRefGoogle Scholar
  26. Danziger-Isakov LA et al (2009) The risk, prevention, and outcome of cytomegalovirus after pediatric lung transplantation. Transplantation 87(10):1541–1548PubMedPubMedCentralCrossRefGoogle Scholar
  27. de Bruyn G et al (2004) Invasive pneumococcal infections in adult lung transplant recipients. Am J Transplant 4(8):1366–1371PubMedCrossRefGoogle Scholar
  28. Doan ML et al (2007) Treatment of adenovirus pneumonia with cidofovir in pediatric lung transplant recipients. J Heart Lung Transplant 26(9):883–889PubMedCrossRefGoogle Scholar
  29. Doligalski CT et al (2014) Epidemiology of invasive mold infections in lung transplant recipients. Am J Transplant 14(6):1328–1333PubMedPubMedCentralCrossRefGoogle Scholar
  30. Finlen Copeland CA et al (2011) Long-term efficacy and safety of 12 months of valganciclovir prophylaxis compared with 3 months after lung transplantation: a single-center, long-term follow-up analysis from a randomized, controlled cytomegalovirus prevention trial. J Heart Lung Transplant 30(9):990–996PubMedCrossRefGoogle Scholar
  31. Florescu DF et al (2013) Adenovirus in solid organ transplantation. Am J Transplant 13(Suppl 4):206–211PubMedCrossRefGoogle Scholar
  32. Glanville AR et al (2005) Intravenous ribavirin is a safe and cost-effective treatment for respiratory syncytial virus infection after lung transplantation. J Heart Lung Transplant 24(12):2114–2119PubMedCrossRefGoogle Scholar
  33. Gottlieb J et al (2009) Impact of graft colonization with gram-negative bacteria after lung transplantation on the development of bronchiolitis obliterans syndrome in recipients with cystic fibrosis. Respir Med 103(5):743–749PubMedCrossRefGoogle Scholar
  34. Gottlieb J et al (2016) ALN-RSV01 for prevention of bronchiolitis obliterans syndrome after respiratory syncytial virus infection in lung transplant recipients. J Heart Lung Transplant 35(2):213–221PubMedCrossRefGoogle Scholar
  35. Gregson AL (2016) Infectious triggers of chronic lung allograft dysfunction. Curr Infect Dis Rep 18(7):21PubMedCrossRefGoogle Scholar
  36. Griffith DE et al (2007) An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med 175(4):367–416PubMedCrossRefGoogle Scholar
  37. Gupta MR et al (2009) Clinical spectrum of gram-positive infections in lung transplantation. Transpl Infect Dis 11(5):424–431PubMedCrossRefGoogle Scholar
  38. Hadjiliadis D et al (2007) Survival of lung transplant patients with cystic fibrosis harboring panresistant bacteria other than Burkholderia cepacia, compared with patients harboring sensitive bacteria. J Heart Lung Transplant 26(8):834–838PubMedCrossRefGoogle Scholar
  39. Hirche TO et al (2014) Practical guidelines: lung transplantation in patients with cystic fibrosis. Pulm Med 2014:621342PubMedPubMedCentralCrossRefGoogle Scholar
  40. Hosseini-Moghaddam SM, Husain S (2010) Fungi and molds following lung transplantation. Semin Respir Crit Care Med 31(2):222–233PubMedCrossRefGoogle Scholar
  41. Huang HC et al (2011) Non-tuberculous mycobacterium infection after lung transplantation is associated with increased mortality. J Heart Lung Transplant 30(7):790–798PubMedPubMedCentralCrossRefGoogle Scholar
  42. Humar A, Michaels M (2006) American Society of Transplantation recommendations for screening, monitoring and reporting of infectious complications in immunosuppression trials in recipients of organ transplantation. Am J Transplant 6(2):262–274PubMedCrossRefGoogle Scholar
  43. Husain S et al (2004) Prospective assessment of Platelia Aspergillus galactomannan antigen for the diagnosis of invasive aspergillosis in lung transplant recipients. Am J Transplant 4(5):796–802PubMedCrossRefGoogle Scholar
  44. Husain S et al (2011) A 2010 working formulation for the standardization of definitions of infections in cardiothoracic transplant recipients. J Heart Lung Transplant 30(4):361–374PubMedCrossRefGoogle Scholar
  45. Husni RN et al (1998) Cytomegalovirus infection is a risk factor for invasive aspergillosis in lung transplant recipients. Clin Infect Dis 26(3):753–755PubMedCrossRefGoogle Scholar
  46. Keating MR, Daly JS (2013) Nontuberculous mycobacterial infections in solid organ transplantation. Am J Transplant 13(Suppl 4):77–82PubMedCrossRefGoogle Scholar
  47. Kim YJ et al (2012) Cytomegalovirus infection and ganciclovir resistance caused by UL97 mutations in pediatric transplant recipients. Transpl Infect Dis 14(6):611–617PubMedCrossRefGoogle Scholar
  48. Knoll BM et al (2012) Non-tuberculous mycobacterial infection among lung transplant recipients: a 15-year cohort study. Transpl Infect Dis 14(5):452–460PubMedCrossRefGoogle Scholar
  49. Kotton CN et al (2013) Updated international consensus guidelines on the management of cytomegalovirus in solid-organ transplantation. Transplantation 96(4):333–360PubMedCrossRefGoogle Scholar
  50. Kumar D et al (2009) Cell-mediated immunity to predict cytomegalovirus disease in high-risk solid organ transplant recipients. Am J Transplant 9(5):1214–1222PubMedCrossRefGoogle Scholar
  51. Kumar D et al (2010) Outcomes from pandemic influenza A H1N1 infection in recipients of solid-organ transplants: a multicentre cohort study. Lancet Infect Dis 10(8):521–526PubMedPubMedCentralCrossRefGoogle Scholar
  52. Leen AM et al (2009) Cytotoxic T lymphocyte therapy with donor T cells prevents and treats adenovirus and Epstein-Barr virus infections after haploidentical and matched unrelated stem cell transplantation. Blood 114(19):4283–4292PubMedPubMedCentralCrossRefGoogle Scholar
  53. Lehrnbecher T et al (2016) Galactomannan, beta-D-Glucan, and polymerase chain reaction-based assays for the diagnosis of invasive fungal disease in pediatric cancer and hematopoietic stem cell transplantation: a systematic review and meta-analysis. Clin Infect Dis 63(10):1340–1348PubMedCrossRefGoogle Scholar
  54. Lewis RE (2011) Current concepts in antifungal pharmacology. Mayo Clin Proc 86(8):805–817PubMedPubMedCentralCrossRefGoogle Scholar
  55. Li L et al (2012) Oral versus inhaled ribavirin therapy for respiratory syncytial virus infection after lung transplantation. J Heart Lung Transplant 31(8):839–844PubMedCrossRefGoogle Scholar
  56. Liu M et al (2010) Long-term impact of respiratory viral infection after pediatric lung transplantation. Pediatr Transplant 14(3):431–436PubMedPubMedCentralCrossRefGoogle Scholar
  57. Liu M et al (2009a) Respiratory viral infections within one year after pediatric lung transplant. Transpl Infect Dis 11(4):304–312PubMedCrossRefGoogle Scholar
  58. Liu M et al (2009b) Fungal infections in pediatric lung transplant recipients: colonization and invasive disease. J Heart Lung Transplant 28(11):1226–1230PubMedPubMedCentralCrossRefGoogle Scholar
  59. Ljungman P et al (2017) Definitions of cytomegalovirus infection and disease in transplant patients for use in clinical trials. Clin Infect Dis 64(1):87–91PubMedCrossRefGoogle Scholar
  60. Lobo LJ et al (2015) Pan-resistant Achromobacter xylosoxidans and Stenotrophomonas maltophilia infection in cystic fibrosis does not reduce survival after lung transplantation. Transplantation 99(10):2196–2202PubMedCrossRefGoogle Scholar
  61. Luong ML et al (2011) Comparison of an Aspergillus real-time polymerase chain reaction assay with galactomannan testing of bronchoalvelolar lavage fluid for the diagnosis of invasive pulmonary aspergillosis in lung transplant recipients. Clin Infect Dis 52(10):1218–1226PubMedCrossRefGoogle Scholar
  62. Manuel O et al (2013a) RNA respiratory viruses in solid organ transplantation. Am J Transplant 13(Suppl 4):212–219PubMedCrossRefGoogle Scholar
  63. Manuel O et al (2013b) Assessment of cytomegalovirus-specific cell-mediated immunity for the prediction of cytomegalovirus disease in high-risk solid-organ transplant recipients: a multicenter cohort study. Clin Infect Dis 56(6):817–824PubMedCrossRefGoogle Scholar
  64. Manuel O et al (2009) Methicillin-resistant Staphylococcus aureus infection after lung transplantation: 5-year review of clinical and molecular epidemiology. J Heart Lung Transplant 28(11):1231–1236PubMedCrossRefGoogle Scholar
  65. Marino E, Gallagher JC (2010) Prophylactic antifungal agents used after lung transplantation. Ann Pharmacother 44(3):546–556PubMedCrossRefGoogle Scholar
  66. Martin-Gandul C et al (2015) The impact of infection on chronic allograft dysfunction and allograft survival after solid organ transplantation. Am J Transplant 15(12):3024–3040PubMedCrossRefGoogle Scholar
  67. Martin M et al (2010) Incidence and characterization of cytomegalovirus resistance mutations among pediatric solid organ transplant patients who received valganciclovir prophylaxis. J Clin Virol 47(4):321–324PubMedCrossRefGoogle Scholar
  68. Mawhorter S, Yamani MH (2008) Hypogammaglobulinemia and infection risk in solid organ transplant recipients. Curr Opin Organ Transplant 13(6):581–585PubMedGoogle Scholar
  69. Mead L et al (2014) Antifungal prophylaxis in pediatric lung transplantation: an international multicenter survey. Pediatr Transplant 18(4):393–397PubMedCrossRefGoogle Scholar
  70. Metras D et al (1999) Lung infections in pediatric lung transplantation: experience in 49 cases. Eur J Cardiothorac Surg 15(4):490–494PubMedCrossRefGoogle Scholar
  71. Mitsani D et al (2010) Cytomegalovirus disease among donor-positive/recipient-negative lung transplant recipients in the era of valganciclovir prophylaxis. J Heart Lung Transplant 29(9):1014–1020PubMedCrossRefGoogle Scholar
  72. Monforte V et al (2001) Nebulized amphotericin B prophylaxis for Aspergillus infection in lung transplantation: study of risk factors. J Heart Lung Transplant 20(12):1274–1281PubMedCrossRefGoogle Scholar
  73. Neofytos D et al (2010) Epidemiology and outcome of invasive fungal infections in solid organ transplant recipients. Transpl Infect Dis 12(3):220–229PubMedCrossRefGoogle Scholar
  74. Neofytos D et al (2013) Epidemiology, risk factors, and outcomes of Clostridium difficile infection in kidney transplant recipients. Transpl Infect Dis 15(2):134–141PubMedCrossRefGoogle Scholar
  75. Neoh CF et al (2011) Antifungal prophylaxis in lung transplantation-A world-wide survey. Am J Transplant 11(2):361–366PubMedCrossRefGoogle Scholar
  76. Orens JB et al (2006) International guidelines for the selection of lung transplant candidates: 2006 update – a consensus report from the Pulmonary Scientific Council of the International Society for Heart and Lung Lransplantation. J Heart Lung Transplant 25(7):745–755PubMedCrossRefGoogle Scholar
  77. Palmer SM et al (2010) Extended valganciclovir prophylaxis to prevent cytomegalovirus after lung transplantation: a randomized, controlled trial. Ann Intern Med 152(12):761–769PubMedCrossRefGoogle Scholar
  78. Pang XL et al (2009) Interlaboratory comparison of cytomegalovirus viral load assays. Am J Transplant 9(2):258–268PubMedCrossRefGoogle Scholar
  79. Pappas PG et al (2016) Clinical practice guideline for the Management of Candidiasis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis 62(4):e1–50PubMedCrossRefGoogle Scholar
  80. Parada MT et al (2010) Early and late infections in lung transplantation patients. Transplant Proc 42(1):333–335PubMedCrossRefGoogle Scholar
  81. Pasqualotto AC et al (2010) Diagnosis of invasive aspergillosis in lung transplant recipients by detection of galactomannan in the bronchoalveolar lavage fluid. Transplantation 90(3):306–311PubMedCrossRefGoogle Scholar
  82. Patel R, Paya CV (1997) Infections in solid-organ transplant recipients. Clin Microbiol Rev 10(i):86–124PubMedPubMedCentralGoogle Scholar
  83. Patterson TF et al (2016) Practice guidelines for the diagnosis and Management of Aspergillosis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis 63(4):e1–e60PubMedPubMedCentralCrossRefGoogle Scholar
  84. Peghin M et al (2016) 10 years of prophylaxis with nebulized liposomal amphotericin B and the changing epidemiology of Aspergillus spp. infection in lung transplantation. Transpl Int 29(1):51–62PubMedCrossRefGoogle Scholar
  85. Pelaez A et al (2009) Efficacy of oral ribavirin in lung transplant patients with respiratory syncytial virus lower respiratory tract infection. J Heart Lung Transplant 28(1):67–71PubMedPubMedCentralCrossRefGoogle Scholar
  86. Qvist T et al (2013) Nontuberculous mycobacterial disease is not a contraindication to lung transplantation in patients with cystic fibrosis: a retrospective analysis in a Danish patient population. Transplant Proc 45(1):342–345PubMedCrossRefGoogle Scholar
  87. Ranganathan K et al (2009) Cytomegalovirus immunoglobulin decreases the risk of cytomegalovirus infection but not disease after pediatric lung transplantation. J Heart Lung Transplant 28(10):1050–1056PubMedPubMedCentralCrossRefGoogle Scholar
  88. Razonable RR (2013) Human herpesviruses 6, 7 and 8 in solid organ transplant recipients. Am J Transplant 13(Suppl 3):67–77. quiz 77-68PubMedCrossRefGoogle Scholar
  89. Razonable RR et al (2013) Cytomegalovirus in solid organ transplantation. Am J Transplant 13(Suppl 4):93–106PubMedCrossRefGoogle Scholar
  90. Robertson J et al (2009) Hypogammaglobulinemia: incidence, risk factors, and outcomes following pediatric lung transplantation. Pediatr Transplant 13(6):754–759PubMedCrossRefGoogle Scholar
  91. Ruttmann E et al (2006) Combined CMV prophylaxis improves outcome and reduces the risk for bronchiolitis obliterans syndrome (BOS) after lung transplantation. Transplantation 81(10):1415–1420PubMedCrossRefGoogle Scholar
  92. Rychert J et al (2014) Multicenter comparison of laboratory performance in cytomegalovirus and Epstein-Barr virus viral load testing using international standards. Clin Transpl 28(12):1416–1423CrossRefGoogle Scholar
  93. Shields RK et al (2012) Staphylococcus aureus Infections in the early period after lung transplantation: epidemiology, risk factors, and outcomes. J Heart Lung Transplant 31(11):1199–1206PubMedCrossRefGoogle Scholar
  94. Shoham S, Shah PD (2013) Impact of multidrug-resistant organisms on patients considered for lung transplantation. Infect Dis Clin N Am 27(2):343–358CrossRefGoogle Scholar
  95. Smibert O et al (2016) Mycobacterium abscessus complex - a particular challenge in the setting of lung transplantation. Expert Rev Anti-Infect Ther 14(3):325–333PubMedCrossRefGoogle Scholar
  96. Snyder LD et al (2011) Polyfunctional cytomegalovirus-specific immunity in lung transplant recipients receiving valganciclovir prophylaxis. Am J Transplant 11(3):553–560PubMedPubMedCentralCrossRefGoogle Scholar
  97. Speich R, van der Bij W (2001) Epidemiology and management of infections after lung transplantation. Clin Infect Dis 33(Suppl 1):S58–S65PubMedCrossRefGoogle Scholar
  98. Spivey JF et al (2007) Safety and efficacy of prolonged cytomegalovirus prophylaxis with intravenous ganciclovir in pediatric and young adult lung transplant recipients. Pediatr Transplant 11(3):312–318PubMedPubMedCentralCrossRefGoogle Scholar
  99. Valentine VG et al (2009) Effect of etiology and timing of respiratory tract infections on development of bronchiolitis obliterans syndrome. J Heart Lung Transplant 28(2):163–169PubMedCrossRefGoogle Scholar
  100. van Duin D, van Delden C (2013) Multidrug-resistant gram-negative bacteria infections in solid organ transplantation. Am J Transplant 13(Suppl 4):31–41PubMedCrossRefGoogle Scholar
  101. Vaudry W et al (2009) Valganciclovir dosing according to body surface area and renal function in pediatric solid organ transplant recipients. Am J Transplant 9(3):636–643PubMedCrossRefGoogle Scholar
  102. Vazquez R et al (2015) Invasive mold infections in lung and heart-lung transplant recipients: Stanford University experience. Transpl Infect Dis 17(2):259–266PubMedCrossRefGoogle Scholar
  103. Vu DL et al (2011) Respiratory viruses in lung transplant recipients: a critical review and pooled analysis of clinical studies. Am J Transplant 11(5):1071–1078PubMedCrossRefGoogle Scholar
  104. Weinberg A et al (2000) Comparison of PCR, antigenemia assay, and rapid blood culture for detection and prevention of cytomegalovirus disease after lung transplantation. J Clin Microbiol 38(2):768–772PubMedPubMedCentralGoogle Scholar
  105. Westall GP et al (2008) Linking CMV serostatus to episodes of CMV reactivation following lung transplantation by measuring CMV-specific CD8+ T-cell immunity. Am J Transplant 8(8):1749–1754PubMedCrossRefGoogle Scholar
  106. Yun JH et al (2015) Infections after lung transplantation: time of occurrence, sites, and microbiologic etiologies. Korean J Intern Med 30(4):506–514PubMedPubMedCentralCrossRefGoogle Scholar
  107. Zaidi S et al (2009) Mycobacterium abscessus in cystic fibrosis lung transplant recipients: report of 2 cases and risk for recurrence. Transpl Infect Dis 11(3):243–248PubMedCrossRefGoogle Scholar
  108. Zamora MR et al (2011) RNA interference therapy in lung transplant patients infected with respiratory syncytial virus. Am J Respir Crit Care Med 183(4):531–538PubMedCrossRefGoogle Scholar
  109. Zamora MR et al (2004) Following universal prophylaxis with intravenous ganciclovir and cytomegalovirus immune globulin, valganciclovir is safe and effective for prevention of CMV infection following lung transplantation. Am J Transplant 4(10):1635–1642PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Lara Danziger-Isakov
    • 1
    • 2
  • Flor M. Munoz
    • 3
    • 4
  • Michele Estabrook
    • 5
  1. 1.Division of Infectious Diseases/Department of PediatricsUniversity of CincinnatiCincinnatiUSA
  2. 2.Immunocompromised Infectious DiseasesCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  3. 3.Department of Pediatrics, Molecular Virology and MicrobiologyBaylor College of MedicineHoustonUSA
  4. 4.Transplant Infectious DiseasesTexas Children’s HospitalHoustonUSA
  5. 5.Division of Infectious Diseases/Department of PediatricsWashington University School of Medicine, St. Louis Children’s HospitalSt. LouisUSA

Section editors and affiliations

  • Samuel B Goldfarb
    • 1
  1. 1.The Children's Hospital of PhiladelphiaPhiladelphiaUSA

Personalised recommendations