Prophylactic measures in the solid-organ recipient before transplantation.
Pretransplant screening affords an important opportunity to detect and treat preexisting active infection in the solid-organ transplant recipient. In this article, pretransplant strategies for preventing infections after solid-organ transplantation are reviewed. In addition to the search for active preexisting infection in the transplant candidate, immunization remains a cornerstone of preventive practice. Because there is a suboptimal response to vaccinations in patients who are receiving immunosuppressive therapy, as well as in patients with end-stage organ dysfunction, standard immunization of the transplant candidate should be updated as early as possible in the course of the illness, including pneumococcal, influenza, and hepatitis B vaccines. Liver transplant candidates should receive hepatitis A vaccine, and children should receive Haemophilus influenzae type B conjugate vaccine. All nonimmune pretransplant patients should be considered candidates for the varicella vaccine. The management of special risk groups is discussed in detail.
Avery
R K
RK
Department of Infectious Diseases, Cleveland Clinic Foundation, Cleveland, OH, USA. averyr@ccf.org
Ljungman
P
P
D000328:Adult; D002648:Child; D003141:Communicable Diseases / Q000276:immunology*; D005260:Female; D006801:Humans; D008297:Male; D016377:Organ Transplantation; D012307:Risk Factors; D014181:Transplantation Immunology; D014612:Vaccines
D014612:Vaccines