Selda HANÇERLİ TÖRÜN, Manolya ACAR, Nuran SALMAN, Ayper SOMER

Çocuk Solid Organ Nakli Enfeksiyonları

Solid organ nakli SON son dönem böbrek, karaciğer, kalp ve akciğer hastalıklarında dünyada 30 yılı aşkın süredir başarıyla uygulanmaktadır. Enfeksiyonlar SON yapılan çocuklarda önemli bir morbidite ve mortalite nedeni olmaktadır. Bu derlemede, SON yapılan çocuklarda sık görülen enfeksiyon sendromlarının ve etken patojenlerin tanımlanması, enfeksiyonun zamanlaması ve risk faktörle- rinin saptanması ve koruyucu önlemerin rehberler eşliğin- de ele alınması amaçlanmıştır.

Anahtar Kelimeler:

Solid organ nakli, pediatri, enfeksiyon

Infections Related to Solid Organ Transplantations in Children

The use of solid organ transplantation SOT has been suc- cessfully performed for end-stage disease of the kidneys, liver, heart and lungs for nearly 30 years. Infections are important causes of morbidity and mortality in children undergoing solid organ transplantation. This review aimed to identify risk factors for and timing of infections, to desc- ribe the common infectious syndromes and pathogens seen in children undergoing solid organ transplantation, and to review preventive strategies according to the guidelines.

Keywords:

Solid organ transplantation, pediatrics, infection,

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Green m. Introduction: Infections in Solid Organ Transplantation. Am J Transplantation 2013; 13:3-8.
Green m, michaels m. Infections in pediatric solid organ transplant recipients. J Pediatric Infectious Diseases Society 2012;1(2):144-51.
https://doi.org/10.1093/jpids/pir001
Keough Wl, michaels mG. Infectious complications in pediatric solid organ transplantation. Pediatr Clin N Am 2003;50:1451-69.
https://doi.org/10.1016/S0031-3955(03)00126-3
Koo S, marty Fm, Baden lr. Infectious complicati- ons associated with immunomodulating biologic agents. Inf Dis Clin N Am 2010;24:285-306.
https://doi.org/10.1016/j.idc.2010.01.006
martin-Pena a, cordero E, Fijo J, et al. Prospective study of infectious complications in a cohort of pediat- ric renal transplant recipients. Pediatr Transplant 2009; 13:457-63.
https://doi.org/10.1111/j.1399-3046.2008.01019.x
Green m, covington S, Taranto S, et al. Donor- derived transmission events in 2013: a report of the Organ Procurement Transplant Network Ad Hoc Disease Transmission Advisory Committee. Transplantation 2015;99(2):282.
https://doi.org/10.1097/TP.0000000000000584
Humar a, Snydman D and the aST Infectious Diseases community of Practice. Cytomegalovirus in solid organ transplant recipients. Am J Transplant 2009;9(Suppl 4):S78-86.
https://doi.org/10.1111/j.1600-6143.2009.02897.x
Wagener mm, Yu Vl. Bacteremia in transplant reci- pients: a prospective study of demographics, etiologic agents, risk factors and outcomes. Am J Infect Control 1992;20:239-4.
https://doi.org/10.1016/S0196-6553(05)80197-X
Gorensek mJ, carey WD, Washington Ja, et al. Selective bowel decontamination with quinolones and nystatin reduces gram-negative and fungal infections in orthotopic liver transplant recipients. Cleve Clin J Med 1993; 60:139-44.
https://doi.org/10.3949/ccjm.60.2.139
Fox Bc, Sollinger HW, Belzer FO, et al. A prospecti- ve, randomized,double-blind study of trimethoprim- sulfamethoxazole for prophylaxis of infection in renal transplantation: clinical efficacy, absorption, trimethoprim-sulfamethoxazole effects on the microf- lora, and the costbenefit of prophylaxis. Am J Med 1990;89:255-74.
https://doi.org/10.1016/0002-9343(90)90337-D
Playford EG, Webster Sorell Tc, et al. Antifungal agents for preventing fungal infections in solid organ transplant recipients. Cochrane Database Syst Rev 2004;(3):CD004291
https://doi.org/10.1002/14651858.CD004291.pub2
Pappas PG, Kauffman ca, andes D, et al. Infectious Diseases Society of America Clinical practice guideli- nes for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis 2009;48(5):503.
https://doi.org/10.1086/596757
Kontoyiannis D, marr K, Park B, et al. Prospective surveillance for invasive fungal infections in hemato- poietic stem cell transplant recipients, 2001-2006: overview of the Transplant-Associated Infection Surveillance Network (TRANSNET) Database. Clin Infect Dis 2010;50:10911100.
https://doi.org/10.1086/651263
Vazquez Ja, marisa H et al. Invasive fungal infecti- ons in transplant recipients. Ther Adv Infect Dis 2013;1(3):8510.
https://doi.org/10.1177/2049936113491936
Fishman Ja. Prevention of infection caused by Pneumocystis carinii in transplant recipients. Clin Infect Dis 2001;33(8):1397.
https://doi.org/10.1086/323129
Schwartza BS, mawhorterb SD and the aST Infectious Diseases community of Practice. Parasitic Infections in Solid Organ Transplantation. Am J Transplantation 2013;13:280-303.
https://doi.org/10.1111/ajt.12120
Young J-aWD. Typical and atypical Mycobacterium infections after hematopoietic stem cell or solid organ transplantation. In: Bowden RA, Snydman DR, eds. Transplant infections. Philadelphia, PA: Wolters Kluwer/Lippincott Williams&Wilkins, 2010, pp. 195– 203.
Torre-cisneros J, Doblas a, aguado Jm, et al. Tuberculosis after solid-organ transplant: Incidence, risk factors, and clinical characteristics in the RESITRA (Spanish Network of Infection in Transplantation) cohort. Clin Infect Dis 2009;48:1657-65.
https://doi.org/10.1086/599035
aguado Jm, Torre-cisneros J, Fortun J, et al. Tuberculosis in solid-organ transplant recipients: Consensus statement of the group for the study of infection in transplant recipients (GESITRA) of the Spanish Society of Infectious Diseases and Clinical Microbiology. Clin Infect Dis 2009;48:1276-84.
https://doi.org/10.1086/597590
Subramaniana aK, morrisb mI and the aST Infectious diseases community of practice. Mycobacterium tuberculosis infections in solid organ transplantation. Am J Transplantation 2013;13:68-76.
Fiore aE, Fry a, Shay D, Gubareva l, et al. Centers for Disease Control and Prevention (CDC) SOMMWR Antiviral agents for the treatment and chemoprophyla- xis of influenza --- recommendations of the Advisory Committee on Immunization Practices (ACIP). Recomm Rep 2011;60(1):1.
Karen c. lara a. David B. Cytomegalovirus infecti- on in pediatric solid organ transplant recipients: a focus on prevention Curr. Infect Dis Rep 2016;18:5.
Hodson Em, Jones ca, Webster ac, et al. Antiviral medications to prevent cytomegalovirus disease and early death in recipients of solid-organ transplants: a systematic review of randomised controlled trials. Lancet 2005;365(9477):2105.
https://doi.org/10.1016/S0140-6736(05)66553-1
munoz-Price lS, Slifkin m, ruthazer r, et al. The clinical impact of ganciclovir prophylaxis on the occur- rence of bacteremia in orthotopic liver transplant reci- pients. Clin Infect Dis 2004;39:1293-9.
https://doi.org/10.1086/425002
George mJ, Snydman Dr, Werner BG, et al. The independent role of cytomegalovirus as a risk factor for invasive fungal disease in orthotopic liver transplant recipients. Boston Center for Liver Transplantation CMVIG-Study Group. Cytogam, Med Immune, Inc. Gaithersburg, Maryland. Am J Med 1997;103:106-13.
https://doi.org/10.1016/S0002-9343(97)80021-6
Humar a, Gregson D, caliendo am, et al. Clinical utility of quantitative cytomegalovirus viral load deter- mination for predicting cytomegalovirus disease in liver transplant recipients. Transplantation 1999;68: 1305-11.
https://doi.org/10.1097/00007890-199911150-00015
Kliem V, Fricke l, Wollbrink T, Burg m, radermacher J, rohde F. Improvement in long-term renal graft survival due to CMV prophylaxis with oral ganciclovir: Results of a randomized clinical trial. Am J Transplant 2008;8:975-83.
https://doi.org/10.1111/j.1600-6143.2007.02133.x
Danziger-Isakov l, Bucavalas J. Current prevention strategies against cytomegalovirus in the studies in pediatric liver transplantation (SPLIT) centers. Am J Transplant 2014;14(8):1908-11.
https://doi.org/10.1111/ajt.12755
Kotton cN, Kumar D, caliendo am, et al. Updated international consensus guidelines on the management of cytomegalovirus in solid-organ transplantation. Transplantation 2013;96(4):333-60.
https://doi.org/10.1097/TP.0b013e31829df29d
razonablea rr, Humarb a and the aST Infectious Diseases community of Practice. Cytomegalovirus in solid organ transplantation. American Journal of Transplantation 2013;13:93-106.
lurain NS, chou S. Antiviral drug resistance of human cytomegalovirus. Clin Microbiol Rev 2010; 23: 689–712
https://doi.org/10.1128/CMR.00009-10
allen UD. The ABC of Epstein-Barr virus infections- Hot topics in infection and immunity in children. Adv Exp Med Biol 2005;568:25-39.
https://doi.org/10.1007/0-387-25342-4_3
caillard S, lamy FX, Quelen c, et al. Epidemiology of posttransplant lymphoproliferative disorders in adult kidney and kidney pancreas recipients: Report of the French registry and analysis of subgroups of lympho- mas. Am J Transplant 2012;12:682-93.
https://doi.org/10.1111/j.1600-6143.2011.03896.x
allena UD, Preiksaitisd JK and the aST Infectious Diseases community of Practice. Epstein-Barr virus and posttransplant lymphoproliferative disorder in solid organ transplantation. Am J Transplantation 2013;13:107-20.
Swerdlow SH, Webber Sa, Ferry Ja, et al. A post- transplant lymphoproliferative disorders. WHO classi- fication of tumors of haematopoietic and lymphoid tissues, 4th Ed. Lyons: International Agency for Research on Cancer/WHO, 2008
Opelz G, Daniel V, Naujokat c, et al. Effect of cyto- megalovirus prophylaxis with immunoglobulin or with antiviral drugs on posttransplant non-Hogkin lympho- ma: A multicentre retrospective analysis. Lancet Oncol 2007; 8:212-8.
https://doi.org/10.1016/S1470-2045(07)70040-2
Tsai DE, Douglas l, andreadis c, et al. EBV PCR in the diagnosis and monitoring of posttransplant lymphoproliferative disorder: Results of a two-arm prospective trial. Am J Transplant 2008;8:1016-24.
https://doi.org/10.1111/j.1600-6143.2008.02183.x
martin SI, Dodson B, Wheeler c, et al. Monitoring infection with Epstein-Barr Virus among seromismatch adult renal transplant recipients. Am J Transplant 2011;11:1058-63.
https://doi.org/10.1111/j.1600-6143.2011.03478.x
Parker a, Bowles K, Bradley a, et al. Diagnosis of post-transplant lymphoproliferative disorder in solid organ transplant recipients-BCSH and BTS Guidelines. Br J Haematol 2010;149:675-92.
https://doi.org/10.1111/j.1365-2141.2010.08161.x