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RNA respiratory viral infections in solid organ transplant recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice.
Clin Transplant. 2019 09; 33(9):e13511.CT

Abstract

These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of RNA respiratory viral infections in the pre- and post-transplant period. Viruses reviewed include influenza, respiratory syncytial virus (RSV), parainfluenza, rhinovirus, human metapneumovirus (hMPV), and coronavirus. Diagnosis is by nucleic acid testing due to improved sensitivity, specificity, broad range of detection of viral pathogens, automatization, and turnaround time. Respiratory viral infections may be associated with acute rejection and chronic lung allograft dysfunction in lung transplant recipients. The cornerstone of influenza prevention is annual vaccination and in some cases antiviral prophylaxis. Treatment with neuraminidase inhibitors and other antivirals is reviewed. Prevention of RSV is limited to prophylaxis with palivizumab in select children. Therapy of RSV upper or lower tract disease is controversial but may include oral or aerosolized ribavirin in some populations. There are no approved vaccines or licensed antivirals for parainfluenza, rhinovirus, hMPV, and coronavirus. Potential management strategies for these viruses are given. Future studies should include prospective trials using contemporary molecular diagnostics to understand the true epidemiology, clinical spectrum, and long-term consequences of respiratory viruses as well as to define preventative and therapeutic measures.

Authors+Show Affiliations

Infectious Diseases Service and Transplantation Center, University Hospital and University of Lausanne, Lausanne, Switzerland.Division of Pediatric Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30817023

Citation

Manuel, Oriol, et al. "RNA Respiratory Viral Infections in Solid Organ Transplant Recipients: Guidelines From the American Society of Transplantation Infectious Diseases Community of Practice." Clinical Transplantation, vol. 33, no. 9, 2019, pp. e13511.
Manuel O, Estabrook M, American Society of Transplantation Infectious Diseases Community of Practice. RNA respiratory viral infections in solid organ transplant recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019;33(9):e13511.
Manuel, O., & Estabrook, M. (2019). RNA respiratory viral infections in solid organ transplant recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clinical Transplantation, 33(9), e13511. https://doi.org/10.1111/ctr.13511
Manuel O, Estabrook M, American Society of Transplantation Infectious Diseases Community of Practice. RNA Respiratory Viral Infections in Solid Organ Transplant Recipients: Guidelines From the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019;33(9):e13511. PubMed PMID: 30817023.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - RNA respiratory viral infections in solid organ transplant recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. AU - Manuel,Oriol, AU - Estabrook,Michele, AU - ,, Y1 - 2019/03/22/ PY - 2019/01/28/received PY - 2019/02/12/accepted PY - 2019/3/1/pubmed PY - 2020/10/2/medline PY - 2019/3/1/entrez KW - antibiotic prophylaxis KW - antibiotic: antiviral KW - guidelines KW - infection and infectious agents KW - viral: influenza SP - e13511 EP - e13511 JF - Clinical transplantation JO - Clin Transplant VL - 33 IS - 9 N2 - These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of RNA respiratory viral infections in the pre- and post-transplant period. Viruses reviewed include influenza, respiratory syncytial virus (RSV), parainfluenza, rhinovirus, human metapneumovirus (hMPV), and coronavirus. Diagnosis is by nucleic acid testing due to improved sensitivity, specificity, broad range of detection of viral pathogens, automatization, and turnaround time. Respiratory viral infections may be associated with acute rejection and chronic lung allograft dysfunction in lung transplant recipients. The cornerstone of influenza prevention is annual vaccination and in some cases antiviral prophylaxis. Treatment with neuraminidase inhibitors and other antivirals is reviewed. Prevention of RSV is limited to prophylaxis with palivizumab in select children. Therapy of RSV upper or lower tract disease is controversial but may include oral or aerosolized ribavirin in some populations. There are no approved vaccines or licensed antivirals for parainfluenza, rhinovirus, hMPV, and coronavirus. Potential management strategies for these viruses are given. Future studies should include prospective trials using contemporary molecular diagnostics to understand the true epidemiology, clinical spectrum, and long-term consequences of respiratory viruses as well as to define preventative and therapeutic measures. SN - 1399-0012 UR - https://www.unboundmedicine.com/medline/citation/30817023/RNA_respiratory_viral_infections_in_solid_organ_transplant_recipients:_Guidelines_from_the_American_Society_of_Transplantation_Infectious_Diseases_Community_of_Practice_ L2 - https://doi.org/10.1111/ctr.13511 DB - PRIME DP - Unbound Medicine ER -