Infections in transplant recipients

Infections in transplant recipients

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]

Overview

Organ transplant recipients are susceptible to infection due to their generalized immunosuppressed state. Furthermore, the allograft organ (e.g., lung) has increased susceptibility due to its direct communication with the environment.

Pathophysiology

• The immunosuppressive therapy related to the transplantation depresses the cell mediated immunity and blunt the antibody response making them more susceptible to the infections.
• They are most prone during the early post transplantation period and less immunosuppressed at the later stage when the immunotherapy is withdrawn.
• The presence of metabolic abnormalities, damage to muco-cutaneous membranes and devices like catheters and IV lines make the patient more prone to infections.
• Post transplantation period is classified to three time frames namely first month, second through six months and beyond six months (late post transplant period). The patient is most susceptible to specific type of infections in each period. The type of infections is mainly influenced by environmental factors, level of immunosupression and surgical factors.

• During the first month, most infections are due to complications of surgery such as urinary tract infections, sepsis, pneumonia and wound infections. It includes bacterial and fungal infections.

Post Transplant Infected Biloma

• Post liver transplantation, infected fluid collections can develop intrahepatic and parahepatic regions and they are called as biloma.

Prevention

• Evaluation of pretransplantation infection and counseling to prevent post transplant infections are done as a routine before any transplantation.

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