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Harrison's Principles of Internal Medicine, 18e
| Part 8. Infectious Diseases > Section 3. Clinical Syndromes. Health Care–Associated Infections > |
Chapter 132. Infections in Transplant Recipients
Sections: Infections in Transplant Recipients: Introduction, Infections in Hematopoietic Stem Cell Transplant Recipients, Infections in Solid Organ Transplant Recipients, Vaccination of Transplant Recipients, Further Readings.
Topics Discussed: immunocompromised host, infection in; infection in solid organ transplant recipients; pathogenesis of infection; transplantation.
Excerpt:"This chapter considers aspects of infection unique to patients receiving transplanted organs. The evaluation of infections in transplant recipients involves consideration of both the donor and the recipient of the transplanted organ. Two central issues are of paramount importance: (1) Infectious agents (particularly viruses, but also bacteria, fungi, and parasites) can be introduced into the recipient by the donor organ. (2) Treatment of the recipient with medicine to prevent rejection can suppress normal immune responses, greatly increasing susceptibility to infection. Thus, what might have been a latent or asymptomatic infection in an immunocompetent donor or in the recipient prior to therapy can become a life-threatening problem when the recipient becomes immunosuppressed. The pretransplantation evaluation of each patient should be guided by an analysis of both (1) what infections the recipient is currently harboring, since organisms that exist in a state of latency or dormancy before the procedure may cause fatal disease when the patient receives immunosuppressive treatment; and (2) what organisms are likely to be transmitted by the donor organ, particularly those to which the recipient may be naïve.A variety of organisms have been transmitted by organ transplantation..."
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