title: A retrospective study to describe the epidemiology and outcomes of opportunistic infections after abdominal organ transplantation.
abstract: BACKGROUND
  Most epidemiologic studies of opportunistic infections (OI) following abdominal organ transplantation are derived prior to the era of contemporary immunosuppression and prophylaxis. These studies suggest that most OI occur within the first 6 months post transplant.
  
  
  METHODS
  In this single-center, retrospective cohort study, we describe the epidemiology of OI in 359 consecutive abdominal organ transplant recipients, in the era of contemporary prophylaxis practices and alemtuzumab induction in kidney and simultaneous pancreas-kidney transplant recipients.
  
  
  RESULTS
  Ninety patients (25.1%) developed OI, with 53.3% of these occurring beyond 6 months. The most common OI were BK polyomavirus nephropathy (5.0%), cytomegalovirus (10.2%), varicella zoster virus (4.4%), and herpes simplex virus (1.1%), which typically occurred after discontinuation of antiviral prophylaxis, and Clostridium difficile infections (7.8%).
  
  
  CONCLUSIONS
  OI had no impact on patient or graft survival at 12 months post transplant. In the era of contemporary immunosuppression and prophylaxis, a significant proportion of OI occur beyond 6 months. Additional strategies may be important to reduce the incidence of such late-onset infections.
authors.affiliation: Northwestern University Transplant Outcomes Research Collaborative, Chicago, IL, USA.
authors.forename: Mia
authors.initials: M
authors.lastname: Helfrich
authors.affiliation: Northwestern University Transplant Outcomes Research Collaborative, Chicago, IL, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Dorschner
authors.affiliation: Northwestern University Transplant Outcomes Research Collaborative, Chicago, IL, USA.|Division of Organ Transplantation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Thomas
authors.affiliation: Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.|Division of Organ Transplantation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Valentina
authors.initials: V
authors.lastname: Stosor
authors.affiliation: Northwestern University Transplant Outcomes Research Collaborative, Chicago, IL, USA.|Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.|Division of Organ Transplantation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Michael G
authors.identifier: http://orcid.org/0000-0003-3347-9671
authors.initials: MG
authors.lastname: Ison
mesh_terms: D000328:Adult; D000368:Aged; D000074323:Alemtuzumab / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015994:Incidence; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D016035:Pancreas Transplantation / Q000009:adverse effects*; D012189:Retrospective Studies; D013997:Time Factors; D066027:Transplant Recipients / Q000706:statistics & numerical data
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D000074323:Alemtuzumab
keywords: abdominal organ transplant; alemtuzumab; opportunistic infections