How prevalent are opportunistic infections due to immunosuppression after solid organ transplantation?

Updated: Jan 04, 2016
  • Author: Bethany Pellegrino, MD; Chief Editor: Mary C Mancini, MD, PhD, MMM  more...
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Answer

Answer

Opportunistic infections remain an important risk to the immunocompromised patient despite the use of prophylactic measures. Exposure to viruses such as Epstein-Barr virus (EBV), cytomegalovirus (CMV), herpes simplex virus, and human papillomavirus place the donor at risk for infection and, potentially, later malignancy.

The incidence of CMV has been reduced with the use of antiviral prophylaxis in the first 3 months posttransplant; preemptive monitoring and initiation of treatment in the case of significant viremia after discontinuation of prophylaxis remains to be proven as a strategy for reducing the risk of late-onset CMV disease. [18] The cause of death of approximately 27% of patients who die with a functioning graft is related to infectious or malignant complications. [19] This highlights the question of the appropriate amount of immunosuppression required to balance the aspects of graft function with complications related to therapy.


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