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Diagnostic and therapeutic approach to infectious diseases in solid organ transplant recipients

Jean-François Timsit, Romain Sonneville, Andre C Kalil, Matteo Bassetti, Ricard Ferrer, Samir Jaber, Fanny Lanternier, Charles-Edouard Luyt, Flavia Machado, Malgorzata Mikulska, Laurent Papazian, Fréderic Pène, Garyphalia Poulakou, Claudio Viscoli, Michel Wolff, Lara Zafrani, Christian Van Delden
Intensive Care Medicine 2019, 45 (5): 573-591

PURPOSE: Prognosis of solid organ transplant (SOT) recipients has improved, mainly because of better prevention of rejection by immunosuppressive therapies. However, SOT recipients are highly susceptible to conventional and opportunistic infections, which represent a major cause of morbidity, graft dysfunction and mortality.

METHODS: Narrative review.

RESULTS: We cover the current epidemiology and main aspects of infections in SOT recipients including risk factors such as postoperative risks and specific risks for different transplant recipients, key points on anti-infective prophylaxis as well as diagnostic and therapeutic approaches. We provide an up-to-date guide for management of the main syndromes that can be encountered in SOT recipients including acute respiratory failure, sepsis or septic shock, and central nervous system infections as well as bacterial infections with multidrug-resistant strains, invasive fungal diseases, viral infections and less common pathogens that may impact this patient population.

CONCLUSION: We provide state-of the art review of available knowledge of critically ill SOT patients with infections.


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