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Intra-abdominal infections in solid organ transplant recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice.
Clin Transplant. 2019 09; 33(9):e13595.CT

Abstract

This new guideline from the AST IDCOP reviews intra-abdominal infections (IAIs), which cause substantial morbidity and mortality among abdominal SOT recipients. Each transplant type carries unique risks for IAI, though peritonitis occurs in all abdominal transplant recipients. Biliary infections, bilomas, and intra-abdominal and intrahepatic abscesses are common after liver transplantation and are associated with the type of biliary anastomosis, the presence of vascular thrombosis or ischemia, and biliary leaks or strictures. IAIs after kidney transplantation include renal and perinephric abscesses and graft-site candidiasis, which is uncommon but may require allograft nephrectomy. Among pancreas transplant recipients, duodenal anastomotic leaks can have catastrophic consequences, and polymicrobial abscesses can lead to graft loss and death. Intestinal transplant recipients are at the highest risk for sepsis, infection due to multidrug-resistant organisms, and death from IAI, as the transplanted intestine is a contaminated, highly immunological, pathogen-rich organ. Source control and antibiotics are the cornerstone of the management of IAIs. Empiric antimicrobial regimens should be tailored to local susceptibility patterns and pathogens with which the patient is known to be colonized, with subsequent optimization once the results of cultures are reported.

Authors+Show Affiliations

Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.Departments of Pediatrics, Surgery & Clinical and Translational Science, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Division of Infectious Diseases, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

31102546

Citation

Haidar, Ghady, et al. "Intra-abdominal 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. e13595.
Haidar G, Green M, American Society of Transplantation Infectious Diseases Community of Practice. Intra-abdominal infections in solid organ transplant recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019;33(9):e13595.
Haidar, G., & Green, M. (2019). Intra-abdominal infections in solid organ transplant recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clinical Transplantation, 33(9), e13595. https://doi.org/10.1111/ctr.13595
Haidar G, Green M, American Society of Transplantation Infectious Diseases Community of Practice. Intra-abdominal Infections in Solid Organ Transplant Recipients: Guidelines From the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019;33(9):e13595. PubMed PMID: 31102546.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intra-abdominal infections in solid organ transplant recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. AU - Haidar,Ghady, AU - Green,Michael, AU - ,, Y1 - 2019/06/20/ PY - 2019/05/06/received PY - 2019/05/11/accepted PY - 2019/5/19/pubmed PY - 2020/8/19/medline PY - 2019/5/19/entrez KW - abscess KW - anastomotic leak KW - bacteremia KW - biloma KW - cholangitis KW - intestinal transplant KW - kidney transplant KW - liver transplant KW - pancreas transplant KW - rejection SP - e13595 EP - e13595 JF - Clinical transplantation JO - Clin Transplant VL - 33 IS - 9 N2 - This new guideline from the AST IDCOP reviews intra-abdominal infections (IAIs), which cause substantial morbidity and mortality among abdominal SOT recipients. Each transplant type carries unique risks for IAI, though peritonitis occurs in all abdominal transplant recipients. Biliary infections, bilomas, and intra-abdominal and intrahepatic abscesses are common after liver transplantation and are associated with the type of biliary anastomosis, the presence of vascular thrombosis or ischemia, and biliary leaks or strictures. IAIs after kidney transplantation include renal and perinephric abscesses and graft-site candidiasis, which is uncommon but may require allograft nephrectomy. Among pancreas transplant recipients, duodenal anastomotic leaks can have catastrophic consequences, and polymicrobial abscesses can lead to graft loss and death. Intestinal transplant recipients are at the highest risk for sepsis, infection due to multidrug-resistant organisms, and death from IAI, as the transplanted intestine is a contaminated, highly immunological, pathogen-rich organ. Source control and antibiotics are the cornerstone of the management of IAIs. Empiric antimicrobial regimens should be tailored to local susceptibility patterns and pathogens with which the patient is known to be colonized, with subsequent optimization once the results of cultures are reported. SN - 1399-0012 UR - https://www.unboundmedicine.com/medline/citation/31102546/Intra_abdominal_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.13595 DB - PRIME DP - Unbound Medicine ER -