Solid-organ transplant patient

Figure 39-17 In situ hybridization (iSH) for the Epstein-Barr virus (EBV). ISH hybridization for EBV shows numerous positive signals (dark-blue spots) for EBV using the EBER-I probe.The tissue sample was obtained from a solid-organ transplant patient who developed widespread nodal and extranoda masses.The positive reaction for EBV In this assay supports a diagnosis of posttransplant lymphoproliferative disease. (See Color Plate 6.)...

Ferreira-Gonzalez A, Fisher RA, Weymouth LA, Langley MR, Wolfe L, WiUdnson DS, et al. Clinical utility of a quantitative polymerase chain reaction for diagnosis of cytomegalovirus disease in solid organ transplant patients. Transplantation 1999 68 991-6. 

Humar A, Kumar D, Boivin G, Caliendo AM. Cytomegalovirus (CMV) viral load kinetics to predict recurrent disease in solid organ transplant patients with CMV disease. J Infect Dis 2002 186 829-33. 

Partovi, N. Chan, W. Nimmo, C.R. Evaluation of a patient education program for solid organ transplant patients. Can. J. Hosp. Pharm. 1995, 48 (2), 72-78. 

Topical therapy with clotrimazole or nystatin for 7 days is usually adequate for treating mucocutaneous candidiasis in most solid-organ transplant patients. Use of topical therapy will reduce the number of systemic drugs that these patients receive and hence minimize the risk of drug-drug interactions. Failure to respond to topical agents warrants the use of fluconazole. Low-dose amphotericin B 5-10 mg daily for 7 to 10 days is reserved for the unusual cases of treatment failure. 

FIGURE 120-2. Timetable for the occurrence of infections in HSCT and solid organ-transplant patients. IV = intravenous UTI = urinary tract infection. 

Optimizing nutritional status of pediatric solid organ transplant patients pre- and post-transplantation can improve outcomes and reduce morbidity. 

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