title: The Impact of Infection on Chronic Allograft Dysfunction and Allograft Survival After Solid Organ Transplantation.
abstract: 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.
authors.affiliation: Transplantation Center, University Hospital and University of Lausanne, Lausanne, Switzerland.|Infectious Diseases Service, University Hospital and University of Lausanne, Lausanne, Switzerland.
authors.forename: C
authors.initials: C
authors.lastname: Martin-Gandul
authors.affiliation: Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: N J
authors.initials: NJ
authors.lastname: Mueller
authors.affiliation: Transplantation Center, University Hospital and University of Lausanne, Lausanne, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Pascual
authors.affiliation: Transplantation Center, University Hospital and University of Lausanne, Lausanne, Switzerland.|Infectious Diseases Service, University Hospital and University of Lausanne, Lausanne, Switzerland.
authors.forename: O
authors.initials: O
authors.lastname: Manuel
mesh_terms: D064591:Allografts; D000890:Anti-Infective Agents / Q000627:therapeutic use; D006084:Graft Rejection / Q000209:etiology* / Q000517:prevention & control; D006085:Graft Survival; D006801:Humans; D007239:Infections / Q000150:complications* / Q000503:physiopathology; D016377:Organ Transplantation / Q000009:adverse effects*; D011379:Prognosis
chemical_list: D000890:Anti-Infective Agents
keywords: bronchiolitis obliterans (BOS); chronic allograft nephropathy; complication: infectious; editorial/personal viewpoint; graft survival; infection and infectious agents; infectious disease; organ transplantation in general; viral