Solid-organ transplantation, complications

The introduction of CSA signiflcantly improved the outcomes of transplantation. Since its approval and widespread use, patient and graft survival rates have improved secondary to a lower incidence of acute rejection episodes and severe infectious complications. In heart transplant recipients, for example, 1 -year survival rates increased from 56% to 85%, and 5-year survival rates increased from 31% to 15%P The efficacy of CSA is well established in aU types of solid-organ transplants. Currently, CSA is approved for use in kidney, liver, and heart transplantation. 

TABLE 120—4. Infectious Complications after Bone Marrow and Solid Organ Transplantation Syndromes of Disease and Treatment Guidelines... 

Table 120-4 contains information on microbiology, clinical presentation, and treatment of infections in HSCT and solid-organ transplant recipients. Although opportunistic viral, fungal, and protozoal infections may occur commonly, bacterial infections remain the most frequent infectious complications after transplantation in all allograft recipients. 

Simon DM, Levin S. Infectious complications of solid organ transplantations. Infect Dis Clin North Am 2001 15 521-549. 

Concerns have been raised about the use of adjuvanted pandemic vaccines in patients with immune disorders, such as immunodeficiency, autoimmune disorders, and solid organ transplants. To date, postmarketing surveillance has not found evidence for causality of any adverse reactions in such patients. Viral infections, such as influenza, can lead to severe complications in immunocompromised patients. 

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