Infections in lung transplanted patients: A review

Dettori, Marco; Riccardi, Niccolò; Canetti, Diana; Antonello, Roberta Maria; Piana, Andrea; Palmieri, Alessandra; Castiglia, Paolo; Azara, Antonio; Masia, Maria Dolores; Porcu, Arianna; Ginesu, Giorgio Carlo; Cossu, Monica; Conti, Maurizio; Pirina, Pietro; Fois, Alessandro Giuseppe; Maida, I.; Madeddu, Giordano; Babudieri, Sergio; Saderi, Laura; Sotgiu, Giovanni

doi:10.1016/j.pulmoe.2022.04.010

Cited by 9 publications

(11 citation statements)

References 136 publications

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“…Particularly, CMV is associated with chronic allograft dysfunction and BOS, affecting long-term survival in lung transplant recipients ( 12 ). Lung transplant recipients are additionally prone to community-acquired respiratory viruses (CARVs), comprising mainly of influenza virus, parainfluenza virus, rhinovirus, metapneumovirus, adenovirus, coronavirus, and respiratory syncytial virus ( 15 ). These pathogens are associated with lower respiratory tract infections and can induce acute/chronic rejection in the recipient ( 15 ).…”

Section: Infectious Diseases and Lung Transplantation In Japanmentioning

confidence: 99%

“…Lung transplant recipients are additionally prone to community-acquired respiratory viruses (CARVs), comprising mainly of influenza virus, parainfluenza virus, rhinovirus, metapneumovirus, adenovirus, coronavirus, and respiratory syncytial virus ( 15 ). These pathogens are associated with lower respiratory tract infections and can induce acute/chronic rejection in the recipient ( 15 ). In particular, CARVs are known to be risk factors for BOS, death from BOS, and death ( 54 - 56 ).…”

Section: Infectious Diseases and Lung Transplantation In Japanmentioning

confidence: 99%

“…In particular, CARVs are known to be risk factors for BOS, death from BOS, and death ( 54 - 56 ). Prevention based on hand hygiene and respiratory precautions is vital due to the scarcity of available vaccines against these agents, apart from influenza virus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ( 15 ). Recently, however, a new vaccine has shown promise against RSV, which may have potential benefits in these vulnerable populations ( 15 , 57 ).…”

Section: Infectious Diseases and Lung Transplantation In Japanmentioning

confidence: 99%

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The effect of infectious diseases on lung transplantation in Japan

Kitaura,

Okamoto

2024

J Thorac Dis

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Lung transplantation in Japan is an increasingly accessible treatment option for end-stage lung disease; however, the lack of donor organs is a persisting challenge. Five- and 10-year survival rates of lung transplant recipients in Japan are comparable, if not superior, to international standards. The outcomes of lung transplantation in Japan are likely affected by multiple factors. Infectious disease complications are a significant burden to transplant recipients and account for approximately 30% of recipient mortality in Japan, presenting a major challenge in peri-transplant management. Herein, we explore the current status of infectious disease epidemiology, available evidence surrounding infectious diseases in lung transplantation, and potentially influential factors pertinent to lung transplantation outcomes in Japan. Although infection remains the major cause of morbidity and mortality associated with lung transplantation in Japan, there is limited data and evidence. Despite some uncertainties, publicly available data suggests a low rate of antimicrobial resistance in Gram-negative bacteria and a distinct set of endemic pathogens that recipients may encounter. As a countermeasure against the burden of infectious diseases, 8 out of 10 transplant centers in Japan have a dedicated infectious diseases department. Despite these efforts, specific surveillance, prevention, and management are indispensable to improving post-transplantation infectious disease management. We accordingly lay out potential areas for improving infectious disease-related outcomes among lung transplant recipients in Japan.

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Section: Infectious Diseases and Lung Transplantation In Japanmentioning

confidence: 99%

Section: Infectious Diseases and Lung Transplantation In Japanmentioning

confidence: 99%

Section: Infectious Diseases and Lung Transplantation In Japanmentioning

confidence: 99%

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The effect of infectious diseases on lung transplantation in Japan

Kitaura,

Okamoto

2024

J Thorac Dis

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“…This predisposes them to hospital-acquired infections, aspiration pneumonia, central line-associated bloodstream infections (CLABSI), and urinary catheter-associated infections. The proposed timeline represents three overlapping periods of risk: within the first month of transplantation, 1 to 6 months post-transplantation, and more than 6 months after transplantation [ 13 ].…”

Section: Pre-lung Transplantmentioning

confidence: 99%

Prevention and Management of Infections in Lung Transplant Recipients

Fayyaz,

Raja,

Natori

2023

JCM

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Anti-rejection medications are essential in preventing organ rejection amongst solid organ transplant recipients; however, these agents also cause profound immunosuppression, predisposing lung transplant recipients (LTRs) to infectious complications. The timely management including prevention, diagnosis, and treatment of such infectious complications is vital to prevent significant morbidity and mortality in solid organ transplant recipients and allograft dysfunction. LTRs are inundated with microbes that may be recognized as commensals in hosts with intact immune systems. Bacterial infections are the most common ones, followed by viral pathogens. Indications of a brewing infectious process may be subtle. Hence, the importance of adapting vigilance around isolated hints through symptomatology and signs is pivotal. Signals to suggest an infectious process, such as fever and leukocytosis, may be dampened by immunosuppressive agents. One must also be vigilant about drug interactions of antibiotics and immunosuppressive agents. Treatment of infections can become challenging, as antimicrobials can interact with immunosuppressive agents, and antimicrobial resistance can surge under antimicrobial pressure. Transplant infectious disease physicians work in concert with transplant teams to obtain specimens for diagnostic testing and follow through with source control when possible. This heavily impacts medical decisions and fosters a multidisciplinary approach in management. Furthermore, the reduction of immunosuppression, although it augments the risk of allograft rejection, is as crucial as the initiation of appropriate antimicrobials when it comes to the management of infections.

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“…Besides, transplantation recipients are exposed to risk factors of infection, including the use of immunosuppressive agents, such as tacrolimus, more invasive operations, and prolonged ICU stay. 8 , 9 Therefore, the incidence of infection and colonization after lung transplantation increased, including a variety of multidrug-resistant (MDR) bacterial infections. It was reported that infections were frequent with high incidence among 2761 recipients of solid organ transplant (SOT), and bacteria predominated, including Enterobacteriaceae, Pseudomonas aeruginosa (PA), and Enterococcus spp.…”

Section: Introductionmentioning

confidence: 99%

Ceftazidime/Avibactam for the Treatment of Carbapenem-Resistant Pseudomonas aeruginosa Infection in Lung Transplant Recipients

Chen¹,

Liang²,

Ding³

et al. 2023

IDR

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Background Experience of ceftazidime-avibactam (CAZ/AVI) for carbapenem-resistant Pseudomonas aeruginosa (CRPA) infection in recipients after lung transplantation (LT) is relatively limited. Methods A retrospective observational study was conducted on lung transplant recipients receiving CAZ/AVI therapy for CRPA infection. The primary outcomes were the 14-day and 30-day mortality. The secondary outcomes were clinical cure and microbiological cure. Results Among 183 LT recipients, a total of 15 recipients with CRPA infection who received CAZ/AVI therapy were enrolled in this study. The mean age of recipients was 54 years and 73.3% of recipients were male. The median time from infection onset to initiation of CAZ/AVI treatment was 4 days (IQR, 3–7) and the mean duration of CAZ/AVI therapy was 10 days. CAZ/AVI was mainly administered as monotherapy in LT recipients (80%). Among these eligible recipients, 14-day and 30-day mortality were 6.7% and 13.3%, respectively. The clinical cure and microbiological cure rates of CAZ/AVI therapy were 53.3% and 60%, respectively. Three recipients (20%) experienced recurrent infection. In addition, the mean lengths of ICU stay and hospital stay were 24 days and 35 days, respectively, among LT recipients. Conclusion CAZ/AVI may be an alternative and promising regimen for CRPA eradiation in lung transplant recipients.

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Infections in lung transplanted patients: A review

Cited by 9 publications

References 136 publications

The effect of infectious diseases on lung transplantation in Japan

The effect of infectious diseases on lung transplantation in Japan

Prevention and Management of Infections in Lung Transplant Recipients

Ceftazidime/Avibactam for the Treatment of Carbapenem-Resistant Pseudomonas aeruginosa Infection in Lung Transplant Recipients

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