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Viruses
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Opportunistic Viral Infections in Organ Transplant Recipients
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Opportunistic Viral Infections in Organ Transplant Recipients

A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "Animal Viruses".

Deadline for manuscript submissions: closed (15 July 2021) | Viewed by 13565

Special Issue Editor

Prof. Dr. Nina Singh

E-Mail Website
Guest Editor
Professor of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
Interests: cytomegalovirus; CMV immunology and clinical trials for prevention in transplant recipients; human herpes virus-6

Special Issue Information

Dear Colleagues,

Opportunistic viruses have long been recognized as significant pathogens in organ transplant recipients. The field of organ transplantation has been profoundly affected by rapidly evolving covid-19 pandemic. Specific areas of uncertainty include the impact of host immune response and the role of immunomodulatory approaches, including vaccines. Despite advances in the management strategies, CMV continues to have a negative impact after organ transplantation. As precision medicine gains momentum, integration of data from antiviral trials, monoclonal antibodies, vaccines, adoptive T-cell therapies, and innovative testing platforms are frameworks to optimize CMV prevention and treatment. Promising graft and patient survival rates with HIV-HIV transplantation have implications relevant for expansion of donor pool to include HIV-infected individuals. This Special Issue focuses on topical developments that include, but are not limited to topical developments in characteristics of infection, outcomes, innovations in diagnosis, antiviral therapies and immune-based technologies for major opportunistic viral infections in organ transplant recipients.

Prof. Dr. Nina Singh
Guest Editor

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Keywords

  • Covid-19
  • cytomegalovirus
  • human immunodeficiency virus
  • respiratory virus infections
  • organ transplantation
  • antiviral therapies
  • vaccines
  • host defense

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Published Papers (5 papers)

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Research

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10 pages, 572 KiB  
Article
Cytomegalovirus Serostatus and Functional Impairment in Liver Transplant Recipients in the Current Era
by Nina Singh and Marilyn M. Wagener
Viruses 2021, 13(8), 1519; https://doi.org/10.3390/v13081519 - 1 Aug 2021
Viewed by 2138
Abstract
Background: Whether donor (D+) or recipient (R+) cytomegalovirus (CMV) seropositivity is associated with functional impairment in liver transplant recipients is not known. Methods: Patients included adult liver transplant recipients in the Organ Procurement and Transplantation Network database transplanted over a five-year period from [...] Read more.
Background: Whether donor (D+) or recipient (R+) cytomegalovirus (CMV) seropositivity is associated with functional impairment in liver transplant recipients is not known. Methods: Patients included adult liver transplant recipients in the Organ Procurement and Transplantation Network database transplanted over a five-year period from 1 January 2014–31 December 2018. Functional status in the database was assessed using Karnofsky performance scale. A logistic regression model that controlled for potential confounders was used to examine the association of CMV serostatus and functional status. Variables significantly associated with functional status (p < 0.05) were then used to develop propensity score and propensity score matched analysis was conducted where each patient was compared with a matched-control with the same propensity score. Results: Among 30,267 adult liver transplant recipients, D+ or R+ patients had significantly lower functional status at last follow-up than the D-R- cohort (OR 0.88, 95% CI 0.80–0.96, p = 0.007). In propensity score matched model, D+ or R+ patients had significantly lower functional status than matched-controls (p = 0.009). D+ or R+ CMV serostatus (p = 0.018) and low functional level (p < 0.001) were also independently associated with infections as cause-of-death. Conclusions: D+ or R+ liver transplant recipients had lower functional status and higher risk of deaths due to infections. Future studies are warranted to examine the mechanistic basis of these findings in the setting of transplantation. Full article
(This article belongs to the Special Issue Opportunistic Viral Infections in Organ Transplant Recipients)
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11 pages, 833 KiB  
Article
Discontinuation of Passive Immunization Is Safe after Liver Transplantation for Combined HBV/HDV Infection
by Ramin Raul Ossami Saidy, Irina Sud, Franziska Eurich, Mustafa Aydin, Maximilian Paul Postel, Eva Maria Dobrindt, Johann Pratschke and Dennis Eurich
Viruses 2021, 13(5), 904; https://doi.org/10.3390/v13050904 - 13 May 2021
Cited by 5 | Viewed by 2097
Abstract
Patients after LT due to combined HBV/HDV infection are considered to be high-risk patients for recurrence of hepatitis B and D. To date, life-long prophylaxis with hepatitis B immunoglobulin (HBIG) and replication control with nucleos(t)ide analogs (NA) remains standard. We examined the course [...] Read more.
Patients after LT due to combined HBV/HDV infection are considered to be high-risk patients for recurrence of hepatitis B and D. To date, life-long prophylaxis with hepatitis B immunoglobulin (HBIG) and replication control with nucleos(t)ide analogs (NA) remains standard. We examined the course of 36 patients that underwent liver transplantation from 1989 to 2020 for combined HBV/HDV-associated end-stage liver disease in this retrospective study. Seventeen patients eventually discontinued HBIG therapy for various reasons. Their graft function, histopathological findings from routine liver biopsies and overall survival were compared with those that received an unaltered NA-based standard regimen combined with HBIG. The median follow-up was 204 and 227 months, respectively. The recurrence of HBV was 25% and did not differ between the groups of standard reinfection prophylaxis NA/HBIG (21.1%) and HBIG discontinuation (29.4%); (p = 0.56). No significant differences were found regarding the clinical course or histopathological aspects of liver tissue damage (inflammation, fibrosis, steatosis) between these two groups. Overall, and adjusted survival did not differ between the groups. Discontinuation of HBIG in stable patients after LT for combined HBV/HDV did not lead to impaired overall survival or higher recurrence rate of HBV/HDV infection in this long-term follow-up. Therefore, the recommendation of the duration of HBG administration must be questioned. The earliest time of discontinuation remains unclear. Full article
(This article belongs to the Special Issue Opportunistic Viral Infections in Organ Transplant Recipients)
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Review

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16 pages, 342 KiB  
Review
Respiratory Viruses in Solid Organ Transplant Recipients
by Roni Bitterman and Deepali Kumar
Viruses 2021, 13(11), 2146; https://doi.org/10.3390/v13112146 - 25 Oct 2021
Cited by 6 | Viewed by 2596
Abstract
Solid organ transplantation is often lifesaving, but does carry an increased risk of infection. Respiratory viral infections are one of the most prevalent infections, and are a cause of significant morbidity and mortality, especially among lung transplant recipients. There is also data to [...] Read more.
Solid organ transplantation is often lifesaving, but does carry an increased risk of infection. Respiratory viral infections are one of the most prevalent infections, and are a cause of significant morbidity and mortality, especially among lung transplant recipients. There is also data to suggest an association with acute rejection and chronic lung allograft dysfunction in lung transplant recipients. Respiratory viral infections can appear at any time post-transplant and are usually acquired in the community. All respiratory viral infections share similar clinical manifestations and are all currently diagnosed using nucleic acid testing. Influenza has good treatment options and prevention strategies, although these are hampered by resistance to neuraminidase inhibitors and lower vaccine immunogenicity in the transplant population. Other respiratory viruses, unfortunately, have limited treatments and preventive methods. This review summarizes the epidemiology, clinical manifestations, therapies and preventive measures for clinically significant RNA and DNA respiratory viruses, with the exception of SARS-CoV-2. This area is fast evolving and hopefully the coming decades will bring us new antivirals, immunologic treatments and vaccines. Full article
(This article belongs to the Special Issue Opportunistic Viral Infections in Organ Transplant Recipients)
10 pages, 274 KiB  
Review
Viral Enteritis in Solid-Organ Transplantation
by Anum Abbas, Andrea J. Zimmer and Diana Florescu
Viruses 2021, 13(10), 2019; https://doi.org/10.3390/v13102019 - 7 Oct 2021
Cited by 12 | Viewed by 3034
Abstract
Solid organ transplant recipients are at increased risk for infections due to chronic immunosuppression. Diarrhea is a commonly encountered problem post transplantation, with infectious causes of diarrhea being a frequent complication. Viral infections/enteritides in solid organ transplant recipients often result from frequently encountered [...] Read more.
Solid organ transplant recipients are at increased risk for infections due to chronic immunosuppression. Diarrhea is a commonly encountered problem post transplantation, with infectious causes of diarrhea being a frequent complication. Viral infections/enteritides in solid organ transplant recipients often result from frequently encountered pathogens in this population such as cytomegalovirus, adenovirus, and norovirus. However, several emerging viral pathogens are increasingly being recognized as more sensitive diagnostic techniques become available. Treatment is often limited to supportive care and reduction in immunosuppression, though antiviral therapies mayplay a role in the treatment in certain diseases. Viral enteritis is an important entity that contributes to morbidity and mortality in transplant recipients. Full article
(This article belongs to the Special Issue Opportunistic Viral Infections in Organ Transplant Recipients)
19 pages, 316 KiB  
Review
A Review of Treatment and Prevention of Coronavirus Disease 2019 among Solid Organ Transplant Recipients
by Deanna J. Buehrle, Robert R. Sutton, Erin L. McCann and Aaron E. Lucas
Viruses 2021, 13(9), 1706; https://doi.org/10.3390/v13091706 - 27 Aug 2021
Cited by 10 | Viewed by 2837
Abstract
Therapeutic management of solid organ transplant (SOT) recipients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), may challenge healthcare providers given a paucity of clinical data specific to this cohort. Herein, we summarize and review [...] Read more.
Therapeutic management of solid organ transplant (SOT) recipients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), may challenge healthcare providers given a paucity of clinical data specific to this cohort. Herein, we summarize and review the studies that have formed the framework for current COVID-19 consensus management guidelines. Our review focuses on COVID-19 treatment options including monoclonal antibody products, antiviral agents such as remdesivir, and immunomodulatory agents such as corticosteroids, interleukin inhibitors, and kinase inhibitors. We highlight the presence or absence of clinical data of these therapeutics related to the SOT recipient with COVID-19. We also describe data surrounding COVID-19 vaccination of the SOT recipient. Understanding the extent and limitations of observational and clinical trial data for the prevention and treatment of COVID-19 specific to the SOT population is crucial for optimal management. Although minimal data exist on clinical outcomes among SOT recipients treated with varying COVID-19 therapeutics, reviewing these agents and the studies that have led to their inclusion or exclusion in clinical management of COVID-19 highlights the need for further studies of these therapeutics in SOT patients with COVID-19. Full article
(This article belongs to the Special Issue Opportunistic Viral Infections in Organ Transplant Recipients)
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