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The Impact of Infection on Chronic Allograft Dysfunction and Allograft Survival After Solid Organ Transplantation.

  • Martin-Gandul C Transplantation Center, University Hospital and University of Lausanne, Lausanne, Switzerland.
  • Mueller NJ Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
  • Pascual M Transplantation Center, University Hospital and University of Lausanne, Lausanne, Switzerland.
  • Manuel O Transplantation Center, University Hospital and University of Lausanne, Lausanne, Switzerland.
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  • 2015-10-17
Published in:
  • American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. - 2015
bronchiolitis obliterans (BOS)
chronic allograft nephropathy
complication: infectious
editorial/personal viewpoint
graft survival
infection and infectious agents
infectious disease
organ transplantation in general
viral
Allografts
Anti-Infective Agents
Graft Rejection
Graft Survival
Humans
Infections
Organ Transplantation
Prognosis
English Infectious diseases after solid organ transplantation (SOT) are a significant cause of morbidity and reduced allograft and patient survival; however, the influence of infection on the development of chronic allograft dysfunction has not been completely delineated. Some viral infections appear to affect allograft function by both inducing direct tissue damage and immunologically related injury, including acute rejection. In particular, this has been observed for cytomegalovirus (CMV) infection in all SOT recipients and for BK virus infection in kidney transplant recipients, for community-acquired respiratory viruses in lung transplant recipients, and for hepatitis C virus in liver transplant recipients. The impact of bacterial and fungal infections is less clear, but bacterial urinary tract infections and respiratory tract colonization by Pseudomonas aeruginosa and Aspergillus spp appear to be correlated with higher rates of chronic allograft dysfunction in kidney and lung transplant recipients, respectively. Evidence supports the beneficial effects of the use of antiviral prophylaxis for CMV in improving allograft function and survival in SOT recipients. Nevertheless, there is still a need for prospective interventional trials assessing the potential effects of preventive and therapeutic strategies against bacterial and fungal infection for reducing or delaying the development of chronic allograft dysfunction.
Language
  • English
Open access status
bronze
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Persistent URL
https://sonar.ch/global/documents/54039
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