Infection in the Transplant Recipient

Nancy L. Stitt, RN, BSN

April 03, 2003

The Role of Vaccination

Immunization has long been a cornerstone of preventive health practices in the United States. And yet, vaccine-preventable diseases continue to constitute a significant threat to solid organ transplant recipients. Although recommended guidelines for vaccination have been widely disseminated, it is estimated that up to 71% of pediatric transplant recipients are not adequately immunized against preventable childhood and other diseases at the time of transplantation.^[47] Vaccination of pediatric transplant candidates and recipients deserves special attention because the immunologic response to vaccines is better before transplantation, transplant recipients cannot receive live vaccines, and immunization after transplantation may precipitate or potentiate rejection. Recommendations for vaccination and immunization of children within the context of SOT have recently been summarized.^[31]

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Cite this: Infection in the Transplant Recipient - Medscape - Apr 03, 2003.

Table 1. Table 1. Treatment Regimens for HSV Infection in Transplant Recipients[29]
Indication	Drug and Dosage
Initial genital infection	Acyclovir 400 mg PO 5 times daily or valacyclovir 1 g PO 3 times daily, for 10 days
Recurrent genital infection	Acyclovir 400 mg PO 5 times daily or valacyclovir 1 g PO 2 times daily, for 5 days
Suppression of recurrent genital infection	Acyclovir 400 mg PO 2 or 3 times daily or valacyclovir 1 g PO once daily
Herpes labialis	Penciclovir 1% topically every 2 h for 4 days or acyclovir 400 mg PO 5 times daily for 5 days
Encephalitis	Acyclovir 10-15 mg/kg IV every 8 h for 14-21 days

Table 2. Treatment Regimens for Varicella Infection in Transplant Recipients ^[29]
Indication	Drug and Dosage
Varicella	Acyclovir 10 mg/kg IV every 8 h for 7-10 days
Zoster	Valacyclovir 1 g PO 3 times daily or acyclovir 800 mg PO 5 times daily for 7 days or acyclovir 10 mg/kg IV every 8 h for 7 days

Table 3. Treatment Regimens for CMV Infection in Transplant Recipients[29]
Indication	Drug and Dosage
Prophylaxis	Ganciclovir, 5 mg/kg IV 2 times daily, then 1 g 3 times daily to complete 3 months; valacyclovir 2 g PO 4 times daily for 3 months
Treatment	Ganciclovir 5 mg/kg IV 2 times daily for 14 days, then 1 g 3 times daily to complete 6 weeks

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