Chest Infections After Lung Transplantation
| Autor: | Jens Gottlieb, Tobias Welte, Oana Joean |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
Graft Rejection
Pulmonary and Respiratory Medicine medicine.medical_specialty medicine.medical_treatment Infections Critical Care and Intensive Care Medicine Pneumocystis pneumonia medicine Humans Transplantation Homologous Lung transplantation Infection control Intensive care medicine Respiratory Tract Infections medicine.diagnostic_test business.industry Immunosuppression medicine.disease Transplantation Vaccination Pneumonia Bronchoalveolar lavage Cardiology and Cardiovascular Medicine business Immunosuppressive Agents Lung Transplantation |
| Zdroj: | Chest. 161:937-948 |
| ISSN: | 0012-3692 |
| DOI: | 10.1016/j.chest.2021.10.014 |
| Popis: | Despite substantial progress in the long-term follow-up strategies for lung transplant recipients, morbidity and mortality remain high mostly due to the elevated infectious risk and to the development of chronic lung allograft dysfunction. The high immunosuppressive levels necessary to prevent acute rejection and the graft's constant exposure to the environment come at the high price of frequent infectious complications. Moreover, some infectious agents have been shown to trigger acute rejection or chronic allograft dysfunction. A rapid diagnostic approach followed by an early treatment and follow-up strategy are of paramount importance. They are, however, challenging endeavors due to the vast spectrum of possible pathogens and to the discrete clinical features as a consequence of transplant recipients' impaired immune response. This review proposes a stratified diagnostic strategy, discusses the most relevant pathogens and the corresponding therapeutic approaches while also offering an insight in the infection prevention strategies: vaccination, prophylaxis, preemptive therapy, antibiotic stewardship. |
| Databáze: | OpenAIRE |
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