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供体来源的感染在实体器官移植受者中。

Donor-derived infections in solid organ transplant recipients.

机构信息

Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, Varese, Italy.

出版信息

Curr Opin Organ Transplant. 2023 Oct 1;28(5):384-390. doi: 10.1097/MOT.0000000000001094. Epub 2023 Aug 8.

Abstract

PURPOSE OF REVIEW

The potential for transmission of donor-derived infections (DDIs) is impossible to eliminate, but a thoughtful and systematic approach to donor evaluation can mitigate the risk. Prevention is a key issue and clinicians must maintain a high index of suspicion and remain vigilant in staying up to date on emerging infections. COVID-19 and Monkeypox have represented a new challenge for infectious disease screening and recommendations have been evolving, as knowledge in the field has grown. Additional considerations for pretransplant deceased donor screening include testing for neglected and endemic infectious diseases such as strongyloidiasis and HTLV 1/2. Molecular diagnostic tests have improved awareness on pathogenicity of mollicutes and fungi in the setting of DDIs. The aim of this review is to provide an update on the most recent literature on DDI with a special focus on these emerging hot topics.

RECENT FINDINGS

Donor screening for uncommon pathogens must be guided by knowledge of changing epidemiology of infectious disease and availability of new diagnostic methods.

SUMMARY

Appropriate screening, early recognition, timely reporting, close monitoring, and appropriate management are essential to help reducing the risk of emerging DDIs.

摘要

目的综述

供体来源感染(DDI)的传播风险无法完全消除,但通过对供体进行仔细、系统的评估,可以降低风险。预防是关键,临床医生必须保持高度怀疑,并随时了解新出现的感染,保持警惕。COVID-19 和猴痘给传染病筛查带来了新的挑战,随着该领域知识的不断发展,相关建议也在不断演变。对于移植前已故供体的筛查,还应考虑检测 neglected 和地方性传染病,如鞭虫病和 HTLV1/2。分子诊断检测提高了人们对 DDI 中柔膜体和真菌致病性的认识。本综述旨在提供最新的 DDI 文献综述,特别关注这些新兴的热点话题。

最近的发现

罕见病原体的供体筛查必须以了解传染病的不断变化的流行病学和新诊断方法的可用性为指导。

总结

适当的筛查、早期识别、及时报告、密切监测和适当的管理对于帮助降低新兴 DDI 的风险至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1caa/10597443/eb7e44a0a1b5/cootr-28-384-g001.jpg

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