Young Brittany A, Hanson Kimberly E, Gomez Carlos A
Department of Pathology, University of Utah, Salt Lake City, UT, USA.
Associated Regional and University Pathologists Laboratories (ARUP), Salt Lake City, UT, USA.
Curr Infect Dis Rep. 2019 Nov 26;21(12):52. doi: 10.1007/s11908-019-0704-7.
The infectious complications of transplantation can have devastating consequences for patients. Early and accurate diagnosis is essential to good outcomes. This review describes recent advances in pathogen-directed diagnostic testing and discusses the role of new methods for transplant infectious diseases.
Several molecular assays have been introduced into clinical practice in recent years. When the results of rapid testing are linked to patient-specific interventions, improved outcomes can be realized. Syndromic testing along with metagenomic next-generation sequencing (mNGS) represents novel approaches to infection diagnosis. However, the optimal use of these tests for transplant patients along with an overall assessment of cost-effectiveness demands further study. Molecular diagnostics are revolutionizing transplant care. Clinicians need to be aware of the current diagnostic landscape and have a working knowledge of the nuances related to test performance, result interpretation, and cost.
移植的感染性并发症可给患者带来毁灭性后果。早期准确诊断对良好预后至关重要。本综述描述了病原体导向诊断检测的最新进展，并讨论了移植传染病新方法的作用。
近年来，几种分子检测方法已应用于临床实践。当快速检测结果与针对患者的干预措施相结合时，可实现更好的预后。症状性检测与宏基因组下一代测序（mNGS）代表了感染诊断的新方法。然而，这些检测方法在移植患者中的最佳应用以及成本效益的全面评估仍需进一步研究。分子诊断正在彻底改变移植护理。临床医生需要了解当前的诊断情况，并对与检测性能、结果解释和成本相关的细微差别有实际的认识。
