Emerging Transplant Infections. Clinical Challenges and Implications

Part I: General introduction

• 1. Infectious Diseases - impact of infections on transplant morbidity/mortality, data on ID impact on outcomes, and important role of Infectious Disease providers in the transplant team
• 2. Intro to Solid Organ Transplant
• 3. Intro to Stem Cell Transplantation
• 4. General concepts
• 5. Hospital epi / InfControl issues
• 6. Antibiotic Stewardship for transplant ID
• 7. Prophylaxis in the era of emerging new infectious pathogens
• 8. Pre-transplant evaluation of patients with MDRO infection/colonization
• 9. Pre-transplant screening of patients with epidemiologic & geographic risk factors for infection exposure
• 10. Safe living post-transplant
• 11. Vaccination
• 12. Travel medicine and the Transplant Recipient - Infection Avoidance & Management of the Returning Traveler with Fever including Transplant Tourism
• 13. Changing definition of Immunosuppression - Biologics, Monoclonal Antibodies - what infections will emerge as a result and how do we prevent them?

Part II: Bacterial Infections Introduction

• 14. Multidrug Resistant Organisms including Extended Spectrum Beta Lactamase Producing Organisms & Carbapenemase Resistant Enterobacteriaceae
• 15. Mycobacterium tuberculosis
• 16. Rapidly Growing Nontuberculous Mycobacteria
• 17. Slow Growing Nontuberculous Mycobacteria - M. Chimaera
• 18. Nocardia
• 19. Mycoplasma / Ureaplasma
• 20. Pseudomonas including Pseudomonas pseudomallei
• 21. Acinetobacter
• 22. Burkholderia
• 23. Clostridia Difficile

Part III: Viral Infections Introduction

• 24. Cytomegalovirus
• 25. Herpes Simplex
• 26. Varicella Zoster
• 27. Epstein Barr Virus including PTLD
• 28. HHV6, HHV7, HHV8
• 29. BK VIrus
• 30. Influenza
• 31. Respiratory Syncytial Virus
• 32. Respiratory viruses including parainfluenza, metapneumovirus, rhinovirus, enterovirus, coronaviruses (MERS CoV & SARS)
• 33. Adenovirus
• 34. HIV
• 35. Hepatitis A & E
• 36. Hepatitis B & D
• 37. Hepatitis C
• 38. West Nile Virus
• 39. Dengue, Chikungunya, & Zika
• 40. Yellow Fever
• 41. Viral Encephalitides including Rabies & Lymphocytic Choriomeningitis Virus

Part IV: Fungal Infections Introduction

• 42. Candida
• 43. Aspergillus
• 44. Mucorales
• 45. Non-Aspergillus Molds esp. Phaeohyphomycoses
• 46. Cryptococcus including gatti
• 47. Pneumocystis
• 48. Endemic molds - coccidioidomycosis, histoplasmosis, blastomycosis, paracoccidioidomycosis

Part V: Parasitic Infections Introduction

• 49. Toxoplasmosis
• 50. Strongyloidiasis
• 51. Chagas disease
• 52. Leishmaniasis
• 53. Malaria
• 54. Entamoeba histolytica
• 55. Intestinal Parasites including Cryptosporidium, Cyclospora, Microsporidia, Blastocystis hominis, Isospora, Giardia
• 56. Acanthamoeba, Naegleria, & Balamuthia

Part VI: Emerging Clinical Challenges

• 57. Ventricular Assist Devices/ECMO/Cardiac Support
• 58. Infection in Vascular Composite Allografts

Part VII: Considering Emerging Infections in Differential Diagnosis

• 59. Rash
• 60. Eye infections
• 61. Pulmonary
• 62. Diarrhea
• 63. Encephalitis & Delerium
• 64. Cytopenias including Anemia and Neutropenic Fever

The field of transplant medicine has evolved significantly since the first kidney transplant was performed in 1954. Innovations in transplant immunosuppression have lowered the risk of organ rejection so that infectious complications are now the leading cause of hospitalization and mortality after solid organ transplant. Infection is also cited as the leading cause of non-relapse mortality after stem cell transplantation. As transplant centers have recognized the importance of transplant specific expertise in patient outcomes, the field of transplant infectious diseases has expanded into a recognized and highly valued subspecialty. International growth in solid organ and stem cell transplantation has outpaced access to such expertise, with some centers employing microbiology laboratory directors and transplant nephrologists as their lead infectious diseases consultants. This has been a particular challenge as the use of novel immunosuppressive regimens in new geographic and immigrant populations have fueled the emergence of new infection syndromes, with the initial presentation sometimes occurring in this most vulnerable patient population.

This digital-first book is designed to meet the needs of practitioners engaged in transplant infectious disease practice who need more depth than they are able to find in UpToDate. It provides an overview of emerging infectious disease challenges with clinically relevant information regarding the epidemiology, diagnosis, management, and prevention of infections in solid organ and stem cell transplant recipients. Each chapter focuses on a clinical syndrome or pathogen with new or emerging implications for transplant patients.

Given the rapidly evolving nature of emerging infections and topics in transplant infections, no resource has been published on these increasingly notorious issues; this this text is written by top, global experts who regularly update the material to ensure that readers will always have access to the most cutting edge material available.

The editorial team consists of three experienced leaders in the field, all of whom have a strong record of scholarship and publication, as well as an international reputation. All three have focused their academic careers on emerging infectious diseases in transplantation, including a current and a past president of various infectious diseases and transplantation societies. The editors are also experienced reviewers and authors who have collaborated on multiple previous projects. All are committed to this project as a unique opportunity to make an important contribution to their field.

Author Information

Michele I. Morris, M.D., FACP, FIDSA, FAST
Professor of Clinical Medicine
Director, Immunocompromised Host Service
Division of Infectious Diseases
University of Miami Miller School of Medicine
1120 N.W. 14th St., Suite 842 (R-21)
Miami, FL 33136

Camille Nelson Kotton MD, FIDSA, FAST
Clinical Director, Transplant and Immunocompromised Host Infectious Diseases
Infectious Diseases Division
Massachusetts General Hospital
Harvard Medical School
55 Fruit Street, Cox 5
Boston, MA 02114 USA

Dr Cameron R.Wolfe MBBS(Hons), MPH, FIDSA
Associate Professor of Medicine
Transplant Infectious Disease
DUMC #102359, Rm 159,
Hanes House, Trent Drive
Durham, NC, 27710

Michele I. Morris, M.D., FACP, FIDSA, FAST is an Associate Professor of Clinical Medicine in the Division of Infectious Diseases at the University of Miami Miller School of Medicine in Miami, Florida. She is Director of the Immunocompromised Host Section, providing consultation services to hematology/oncology patients and solid organ and stem cell transplant recipients at Jackson Memorial Hospital and Sylvester Cancer Center. She is currently President of the international Transplantation Society Transplant Infectious Diseases section. She has published over 50 papers and 5 book chapters. In addition to being an active academic clinician, she has been the principal investigator in over 25 clinical trials. Her clinical research focuses on the diagnosis and management of invasive fungal and mycobacterial infections and the prevention and treatment of transplant-related infectious diseases with a focus on tropical and transplant donor-derived infections.