Viral Infections

Guest Editor: Emily Blumberg

Viral infections are a major source of morbidity and mortality following solid organ transplantation. These infections may be present in the recipient prior to transplant, acquired from the donor, or acquired via exposure in the posttransplant setting. Recent articles provide new insights into some of the major viral infections seen in transplant recipients, including cytomegalovirus, Epstein–Barr virus, human herpesvirus 8, polyomavirus, human T cell lymphotrophic virus 1/2 and influenza, expanding our understanding of risk factors and outcomes related to these viruses.

Additionally, high-profile transmissions of human immunodeficiency virus and hepatitis C have drawn attention to identification of donor risk factors associated with these infections with the goal of expanding our understanding of which donors would be most likely to transmit these blood-borne viruses to recipients.

The articles in this virtual issue highlight recent developments in viral infections, focusing on preventive measures including vaccination, immune-modulation, and identification of at-risk donors, as well as factors associated with more severe complications of infection. This issue features clinically relevant articles with the goal of expanding our understanding of why viral infections have such a significant impact on transplant outcomes.

References:

BK Virus

Dharnidharka VR, Cherikh WS, Neff R, Cheng Y, Abbott KC. Retransplantation after BK virus nephropathy in prior kidney transplant: An OPTN database analysis. Am J Transplant 2010; 10: 1312–1315.

Hardinger KL, Koch MJ, Bohl DJ, Storch GA, Brennan DC. BK-Virus and the impact of pre-emptive immunosuppression reduction: 5-year results. Am J Transplant 2010; 10: 407–415.

Cytomegalovirus

Bosch W, Heckman MG, Diehl NN, Shalev JA, Pungpapong S, Hellinger WC. Association of cytomegalovirus infection and disease with death and graft loss after liver transplant in high-risk recipients. Am J Transplant 2011; 11: 2181–2189.

Brennan DC, Legendre C, Patel D, et al. Cytomegalovirus incidence between everolimus versus mycophenolate in de novo renal transplants: Pooled analysis of three clinical trials. Am J Transplant 2011; 11: 2453–2462.

Couzi L, Helou S, Bachelet T, et al. High incidence of anticytomegalovirus drug resistance among D+R- kidney transplant recipients receiving preemptive therapy. Am J Transplant 2012; 12: 202–209.

Eid AJ, Arthurs SK, Deziel PJ, Wilhelm MP, Razonable RR. Clinical predictors of relapse after treatment of primary gastrointestinal cytomegalovirus disease in solid organ transplant recipients. Am J Transplant 2010; 10: 157–161.

Gala-Lopez BL, Senior PA, Koh A, et al. Late cytomegalovirus transmission and impact of T-depletion in clinical islet transplantation. Am J Transplant 2011; 11: 2708–2714.

Gerna G, Lilleri D, Chiesa A, et al. Virologic and immunologic monitoring of cytomegalovirus to guide preemptive therapy in solid organ transplantation. Am J Transplant 2011; 11: 2463–2471.

Helanterä I, Kyllönen L, Lautenschlager I, Salmela K, Koskinen P. Primary CMV infections are common in kidney transplant recipients after 6 months valganciclovir prophylaxis. Am J Transplant 2010; 10: 2026–2032.

Humar A, Lebranchu Y, Vincenti F, et al. The efficacy and safety of 200 days valganciclovir cytomegalovirus prophylaxis in high-risk kidney transplant recipients. Am J Transplant 2010; 10: 1228–1237.

Luan FL, Kommareddi M, Ojo AO. Impact of cytomegalovirus disease in D+R- kidney transplant patients receiving 6 months low-dose valganciclovir prophylaxis. Am J Transplant 2011; 11: 1936–1942.

Paraskeva M, Bailey M, Levvey BJ, et al. Cytomegalovirus replication within the lung allograft is associated with bronchiolitis obliterans. Am J Transplant 2011; 11: 2190–2196.

Patel N, Snyder LD, Finlen Copeland CA, Palmer SM. Is prevention the best treatment? CMV after lung transplantation. Am J Transplant 2012; 12: 539–544.

Snyder LD, Medinas R, Chan C, et al. Polyfunctional cytomegalovirus-specific immunity in lung transplant recipients receiving valganciclovir prophylaxis. Am J Transplant 2011; 11: 553–560.

HTLV

Kaul DR, Taranto S, Alexander C, et al. Donor screening for human T-cell lymphotrophic virus ½: Changing paradigms for changing testing capacity. Am J Transplant 2010; 10: 207–213.

EBV/PTLD

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 lymphomas. Am J Transplant 2012; 12: 682–693.

Dharnidharka VR, Lamb KE, Gregg JA, Meier-Kriesche H-U. Associations between EBV serostatus and organ transplant type in PTLD risk: An analysis of the SRTR national registry data in the United States. Am J Transplant 2012; 12: 976–983.

Nourse JP, Jones K, Gandhi MK. Epstein–Barr virus-related post-transplant lymphoproliferative disorders: Pathogenetic insights for targeted therapy. Am J Transplant 2011; 11: 888–895.

Donor Screening for and Transmission of Blood-Borne Viruses

Boyarsky BJ, Hall EC, Singer AL, Montgomery RA, Gebo KA, Segev DL. Estimating the potential pool of HIV-infected deceased organ donors in the United States. Am J Transplant 2011; 11: 1209–1217.

Ellingson K, Seem D, Nowicki M, Strong DM, Kuehnert MJ. Estimated risk of human immunodeficiency virus and hepatitis C virus infection among potential organ donors from 17 organ procurement organizations in the United States. Am J Transplant 2011; 11: 1201–1208.

Humar A, Morris M, Blumberg E, et al. Nucleic acid testing (NAT) of organ donors: Is the ‘best’ test the right test? A consensus conference report. Am J Transplant 2010; 10: 889–899.

Ison MG, Llata E, Conover CS, et al. Transmission of human immunodeficiency virus and hepatitis C virus from an organ donor to four transplant recipients. Am J Transplant 2011; 11: 1218–1225.

Kucirka LM, Sarathy H, Govindan P, et al. Risk of window period hepatitis-C infection in high infectious risk donors: Systematic review and meta-analysis. Am J Transplant 2011; 11: 1188–1200.

Kucirka LM, Sarathy H, Govindan P, et al. Risk of window period HIV infection in high infectious risk donors: Systematic review and meta-analysis. Am J Transplant 2011; 11: 1176–1187.

Kucirka LM, Singer AL, Ros RL, Montgomery RA, Dagher NN, Segev DL. Underutilization of hepatitis C-positive kidneys for hepatitis C-positive recipients. Am J Transplant 2010; 10: 1238–1246.

Influenza

Cordero E, Perez-Ordoñez A, Aydillo TA, et al. Therapy with m-TOR inhibitors decreases the response to the pandemic influenza A H1N1 vaccine in solid organ transplant recipients. Am J Transplant 2011; 11: 2205–2213.

Kumar D, Blumberg EA, Danziger-Isakov L, et al. Influenza vaccination in the organ transplant recipient: Review and summary recommendations. Am J Transplant 2011; 11: 2020–2030.

Ng BJH, Glanville AR, Snell G, et al. The impact of pandemic influenza A H1N1 2009 on Australian lung transplant recipients. Am J Transplant 2011; 11: 568–574.

HHV8

Pietrosi G, Vizzini G, Pipitone L, et al. Primary and reactivated HHV8 infection and disease after liver transplantation: A prospective study. Am J Transplant 2011; 11: 2715–2723.

Virtual Issue compiled online 12 June 2012.