Pneumonia After Solid Organ Transplantation



Pneumonia in solid organ transplant (SOT) recipients encompasses a broad spectrum of disease caused by a diverse group of pathogens and may result in significant morbidity and mortality. The risk of pneumonia following SOT is influenced by many factors including the organ transplanted, the time from surgery, the net state of immunosuppression, and the presence of comorbid medical conditions. Pneumonia is particularly common following lung transplantation.

In this chapter we review the pathogenesis, risk factors, and epidemiology of pneumonia in SOT recipients with a focus on the major causative organisms and the specific risks associated with each SOT type. We also discuss the approach to the diagnosis and empiric treatment of SOT recipients with suspected pneumonia, examine strategies for preventing post-transplant lung infections, and highlight some of the future directions in the management of pneumonia in SOT recipients.


Pneumonia Pneumonitis Solid organ transplant Lung transplant Prophylaxis 


  1. 1.
    Bonvillain RW, Valentine VG, Lombard G, LaPlace S, Dhillon G, et al. Post-operative infections in cystic fibrosis and non-cystic fibrosis patients after lung transplantation. J Heart Lung Transplant. 2007;26:890–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Alexander BD, Petzold EW, Reller LB, Palmer SM, Davis RD, et al. Survival after lung transplantation of cystic fibrosis patients infected with Burkholderia cepacia complex. Am J Transplant. 2008;8:1025–30.PubMedCrossRefGoogle Scholar
  3. 3.
    Aris RM, Routh JC, LiPuma JJ, Heath DG, Gilligan PH. Lung transplantation for cystic fibrosis patients with Burkholderia cepacia complex. Survival linked to genomovar type. Am J Respir Crit Care Med. 2001;164:2102–6.PubMedCrossRefGoogle Scholar
  4. 4.
    Chaparro C, Maurer J, Gutierrez C, Krajden M, Chan C, et al. Infection with Burkholderia cepacia in cystic fibrosis: outcome following lung transplantation. Am J Respir Crit Care Med. 2001;163:43–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Weill D, Dey GC, Hicks RA, Young Jr KR, Zorn Jr GL, et al. A positive donor gram stain does not predict outcome following lung transplantation. J Heart Lung Transplant. 2002;21:555–8.PubMedCrossRefGoogle Scholar
  6. 6.
    Cook DJ, Walter SD, Cook RJ, Griffith LE, Guyatt GH, et al. Incidence of and risk factors for ventilator-associated pneumonia in critically Ill patients. Ann Intern Med. 1998;129:433–40.PubMedCrossRefGoogle Scholar
  7. 7.
    Glanemann M, Langrehr J, Kaisers U, Schenk R, Muller A, et al. Postoperative tracheal extubation after orthotopic liver transplantation. Acta Anaesthesiol Scand. 2001;45:333–9.PubMedCrossRefGoogle Scholar
  8. 8.
    Poptsov VN, Spirina EA, Vinogradova OU. Early extubation in operating room after heart transplantation. J Heart Lung Transplant. 2013;32:S261–2.CrossRefGoogle Scholar
  9. 9.
    Augoustides JG, Watcha SM, Pochettino A, Jobes DR. Early tracheal extubation in adults undergoing single-lung transplantation for chronic obstructive pulmonary disease: pilot evaluation of perioperative outcome. Interact Cardiovasc Thorac Surg. 2008;7:755–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Rocca GD, Coccia C, Costa GM, Pompei L, Di Marco P, et al. Is very early extubation after lung transplantation feasible? J Cardiothorac Vasc Anesth. 2003;17:29–35.PubMedCrossRefGoogle Scholar
  11. 11.
    Cervera C, Agusti C, Angeles Marcos M, Pumarola T, Cofan F, et al. Microbiologic features and outcome of pneumonia in transplanted patients. Diagn Microbiol Infect Dis. 2006;55:47–54.PubMedCrossRefGoogle Scholar
  12. 12.
    Bonatti H, Pruett TL, Brandacher G, Hagspiel KD, Housseini AM, et al. Pneumonia in solid organ recipients: spectrum of pathogens in 217 episodes. Transplant Proc. 2009;41:371–4.PubMedCrossRefGoogle Scholar
  13. 13.
    Groth CG, Backman L, Morales JM, Calne R, Kreis H, et al. Sirolimus (rapamycin)-based therapy in human renal transplantation: similar efficacy and different toxicity compared with cyclosporine. Sirolimus European Renal Transplant Study Group. Transplantation. 1999;67:1036–42.PubMedCrossRefGoogle Scholar
  14. 14.
    Ruiz I, Gavalda J, Monforte V, Len O, Roman A, et al. Donor-to-host transmission of bacterial and fungal infections in lung transplantation. Am J Transplant. 2006;6:178–82.PubMedCrossRefGoogle Scholar
  15. 15.
    Kramer MR, Marshall SE, Starnes VA, Gamberg P, Amitai Z, et al. Infectious complications in heart-lung transplantation. Analysis of 200 episodes. Arch Intern Med. 1993;153:2010–6.PubMedCrossRefGoogle Scholar
  16. 16.
    Duarte AG, Myers AC. Cough reflex in lung transplant recipients. Lung. 2012;190:23–7.PubMedCrossRefGoogle Scholar
  17. 17.
    Chaparro C, Kesten S. Infections in lung transplant recipients. Clin Chest Med. 1997;18:339–51.PubMedCrossRefGoogle Scholar
  18. 18.
    Dauber JH, Paradis IL, Dummer JS. Infectious complications in pulmonary allograft recipients. Clin Chest Med. 1990;11:291–308.PubMedGoogle Scholar
  19. 19.
    De Gasperi A, Feltracco P, Ceravola E, Mazza E. Pulmonary complications in patients receiving a solid-organ transplant. Curr Opin Crit Care. 2014;20:411–9.PubMedCrossRefGoogle Scholar
  20. 20.
    Lenner R, Padilla ML, Teirstein AS, Gass A, Schilero GJ. Pulmonary complications in cardiac transplant recipients. Chest. 2001;120:508–13.PubMedCrossRefGoogle Scholar
  21. 21.
    Kusne S, Dummer JS, Singh N, Iwatsuki S, Makowka L, et al. Infections after liver transplantation. An analysis of 101 consecutive cases. Medicine (Baltimore). 1988;67:132–43.CrossRefGoogle Scholar
  22. 22.
    Ahuja J, Kanne JP. Thoracic infections in immunocompromised patients. Radiol Clin North Am. 2014;52:121–36.PubMedCrossRefGoogle Scholar
  23. 23.
    Fishman JA. Infection in solid-organ transplant recipients. N Engl J Med. 2007;357:2601–14.PubMedCrossRefGoogle Scholar
  24. 24.
    Green M. Introduction: infections in solid organ transplantation. Am J Transplant. 2013;13 Suppl 4:3–8.PubMedCrossRefGoogle Scholar
  25. 25.
    Aguilar-Guisado M, Givalda J, Ussetti P, Ramos A, Morales P, et al. Pneumonia after lung transplantation in the RESITRA Cohort: a multicenter prospective study. Am J Transplant. 2007;7:1989–96.PubMedCrossRefGoogle Scholar
  26. 26.
    Torre-Cisneros J, Doblas A, Aguado JM, San Juan R, Blanes M, et al. Tuberculosis after solid-organ transplant: incidence, risk factors, and clinical characteristics in the RESITRA (Spanish Network of Infection in Transplantation) cohort. Clin Infect Dis. 2009;48:1657–65.PubMedCrossRefGoogle Scholar
  27. 27.
    Shoham S, Shah PD. Impact of multidrug-resistant organisms on patients considered for lung transplantation. Infect Dis Clin North Am. 2013;27:343–58.PubMedCentralPubMedCrossRefGoogle Scholar
  28. 28.
    Botha P, Archer L, Anderson RL, Lordan J, Dark JH, et al. Pseudomonas aeruginosa colonization of the allograft after lung transplantation and the risk of bronchiolitis obliterans syndrome. Transplantation. 2008;85:771–4.PubMedCrossRefGoogle Scholar
  29. 29.
    Gregson AL, Wang X, Weigt SS, Palchevskiy V, Lynch 3rd JP, et al. Interaction between Pseudomonas and CXC chemokines increases risk of bronchiolitis obliterans syndrome and death in lung transplantation. Am J Respir Crit Care Med. 2013;187:518–26.PubMedCentralPubMedCrossRefGoogle Scholar
  30. 30.
    Zamora MR, Nicolls MR, Hodges TN, Marquesen J, Astor T, et al. Following universal prophylaxis with intravenous ganciclovir and cytomegalovirus immune globulin, valganciclovir is safe and effective for prevention of CMV infection following lung transplantation. Am J Transplant. 2004;4:1635–42.PubMedCrossRefGoogle Scholar
  31. 31.
    Duncan AJ, Dummer JS, Paradis IL, Dauber JH, Yousem SA, et al. Cytomegalovirus infection and survival in lung transplant recipients. J Heart Lung Transplant. 1991;10:638–44; discussion 645–636.PubMedGoogle Scholar
  32. 32.
    Keenan RJ, Lega ME, Dummer JS, Paradis IL, Dauber JH, et al. Cytomegalovirus serologic status and postoperative infection correlated with risk of developing chronic rejection after pulmonary transplantation. Transplantation. 1991;51:433–8.PubMedCrossRefGoogle Scholar
  33. 33.
    Kroshus TJ, Kshettry VR, Savik K, John R, Hertz MI, et al. Risk factors for the development of bronchiolitis obliterans syndrome after lung transplantation. J Thorac Cardiovasc Surg. 1997;114:195–202.PubMedCrossRefGoogle Scholar
  34. 34.
    Snyder LD, Finlen-Copeland CA, Turbyfill WJ, Howell D, Willner DA, et al. Cytomegalovirus pneumonitis is a risk for bronchiolitis obliterans syndrome in lung transplantation. Am J Respir Crit Care Med. 2010;181:1391–6.PubMedCentralPubMedCrossRefGoogle Scholar
  35. 35.
    Zamora MR, Zamora MR, Davis RD, Leonard C, Leonard C, CMV Advisory Board Expert Committee. Management of cytomegalovirus infection in lung transplant recipients: evidence-based recommendations. Transplantation. 2005;80:157–63.PubMedCrossRefGoogle Scholar
  36. 36.
    Roman A, Manito N, Campistol JM, Cuervas-Mons V, Almenar L, et al. The impact of the prevention strategies on the indirect effects of CMV infection in solid organ transplant recipients. Transplant Rev. 2014;28:84–91.CrossRefGoogle Scholar
  37. 37.
    Neurohr C, Huppmann P, Leuchte H, Schwaiblmair M, Bittmann I, et al. Human herpesvirus 6 in bronchoalveolar lavage fluid after lung transplantation: a risk factor for bronchiolitis obliterans syndrome? Am J Transplant. 2005;5:2982–91.PubMedCrossRefGoogle Scholar
  38. 38.
    Manuel O, Kumar D, Moussa G, Chen MH, Pilewski J, et al. Lack of association between beta-herpesvirus infection and bronchiolitis obliterans syndrome in lung transplant recipients in the era of antiviral prophylaxis. Transplantation. 2009;87:719–25.PubMedCrossRefGoogle Scholar
  39. 39.
    Gerna G, Vitulo P, Rovida F, Lilleri D, Pellegrini C, et al. Impact of human metapneumovirus and human cytomegalovirus versus other respiratory viruses on the lower respiratory tract infections of lung transplant recipients. J Med Virol. 2006;78:408–16.PubMedCrossRefGoogle Scholar
  40. 40.
    Gottlieb J, Schulz TF, Welte T, Fuehner T, Dierich M, et al. Community-acquired respiratory viral infections in lung transplant recipients: a single season cohort study. Transplantation. 2009;87:1530–7.PubMedCrossRefGoogle Scholar
  41. 41.
    Kumar D, Erdman D, Keshavjee S, Peret T, Tellier R, et al. Clinical impact of community-acquired respiratory viruses on bronchiolitis obliterans after lung transplant. Am J Transplant. 2005;5:2031–6.PubMedCrossRefGoogle Scholar
  42. 42.
    Milstone AP, Brumble LM, Barnes J, Estes W, Loyd JE, et al. A single-season prospective study of respiratory viral infections in lung transplant recipients. Eur Respir J. 2006;28:131–7.PubMedCrossRefGoogle Scholar
  43. 43.
    Schaenman JM. Is universal antifungal prophylaxis mandatory in lung transplant patients? Curr Opin Infect Dis. 2013;26:317–25.PubMedCrossRefGoogle Scholar
  44. 44.
    Singh N, Husain S. Aspergillus infections after lung transplantation: clinical differences in type of transplant and implications for management. J Heart Lung Transplant. 2003;22:258–66.PubMedCrossRefGoogle Scholar
  45. 45.
    Weigt SS, Elashoff RM, Huang C, Ardehali A, Gregson AL, et al. Aspergillus colonization of the lung allograft is a risk factor for bronchiolitis obliterans syndrome. Am J Transplant. 2009;9:1903–11.PubMedCentralPubMedCrossRefGoogle Scholar
  46. 46.
    Gryzan S, Paradis IL, Zeevi A, Duquesnoy RJ, Dummer JS, et al. Unexpectedly high incidence of Pneumocystis carinii infection after lung-heart transplantation. Implications for lung defense and allograft survival. Am Rev Respir Dis. 1988;137:1268–74.PubMedCrossRefGoogle Scholar
  47. 47.
    Gordon SM, LaRosa SP, Kalmadi S, Arroliga AC, Avery RK, et al. Should prophylaxis for Pneumocystis carinii pneumonia in solid organ transplant recipients ever be discontinued? Clin Infect Dis. 1999;28:240–6.PubMedCrossRefGoogle Scholar
  48. 48.
    Wang EH, Partovi N, Levy RD, Shapiro RJ, Yoshida EM, et al. Pneumocystis pneumonia in solid organ transplant recipients: not yet an infection of the past. Transpl Infect Dis. 2012;14:519–25.PubMedCrossRefGoogle Scholar
  49. 49.
    Cisneros JM, Munoz P, Torre-Cisneros J, Gurgui M, Rodriguez-Hernandez MJ, et al. Pneumonia after heart transplantation: a multi-institutional study. Spanish Transplantation Infection Study Group. Clin Infect Dis. 1998;27:324–31.PubMedCrossRefGoogle Scholar
  50. 50.
    Montoya JG, Giraldo LF, Efron B, Stinson EB, Gamberg P, et al. Infectious complications among 620 consecutive heart transplant patients at Stanford University Medical Center. Clin Infect Dis. 2001;33:629–40.PubMedCrossRefGoogle Scholar
  51. 51.
    Schulman LL, Reison DS, Austin JH, Rose EA. Cytomegalovirus pneumonitis after cardiac transplantation. Arch Intern Med. 1991;151:1118–24.PubMedCrossRefGoogle Scholar
  52. 52.
    Doesch AO, Repp J, Hofmann N, Erbel C, Frankenstein L, et al. Effects of oral valganciclovir prophylaxis for cytomegalovirus infection in heart transplant patients. Drug Des Devel Ther. 2012;6:289–95.PubMedCentralPubMedCrossRefGoogle Scholar
  53. 53.
    Singh N, Paterson DL. Aspergillus infections in transplant recipients. Clin Microbiol Rev. 2005;18:44–69.PubMedCentralPubMedCrossRefGoogle Scholar
  54. 54.
    Olsen SL, Renlund DG, O’Connell JB, Taylor DO, Lassetter JE, et al. Prevention of Pneumocystis carinii pneumonia in cardiac transplant recipients by trimethoprim sulfamethoxazole. Transplantation. 1993;56:359–62.PubMedCrossRefGoogle Scholar
  55. 55.
    Schwartz BS, Mawhorter SD, the ASTIDCoP. Parasitic infections in solid organ transplantation. Am J Transplant. 2013;13:280–303.PubMedCrossRefGoogle Scholar
  56. 56.
    Bozbas SS, Eyuboglu FO, Ozturk Ergur F, Gullu Arslan N, Sevmis S, et al. Pulmonary complications and mortality after liver transplant. Exp Clin Transplant. 2008;6:264–70.PubMedGoogle Scholar
  57. 57.
    Pirat A, Ozgur S, Torgay A, Candan S, Zeyneloglu P, et al. Risk factors for postoperative respiratory complications in adult liver transplant recipients. Transplant Proc. 2004;36:218–20.PubMedCrossRefGoogle Scholar
  58. 58.
    Singh N, Gayowski T, Wagener M, Marino IR, Yu VL. Pulmonary infections in liver transplant recipients receiving tacrolimus. Changing pattern of microbial etiologies. Transplantation. 1996;61:396–401.PubMedCrossRefGoogle Scholar
  59. 59.
    Torres A, Ewig S, Insausti J, Guergue JM, Xaubet A, et al. Etiology and microbial patterns of pulmonary infiltrates in patients with orthotopic liver transplantation. Chest. 2000;117:494–502.PubMedCrossRefGoogle Scholar
  60. 60.
    Feltracco P, Carollo C, Barbieri S, Pettenuzzo T, Ori C. Early respiratory complications after liver transplantation. World J Gastroenterol. 2013;19:9271–81.PubMedCentralPubMedCrossRefGoogle Scholar
  61. 61.
    Golfieri R, Giampalma E, Morselli Labate AM, d’Arienzo P, Jovine E, et al. Pulmonary complications of liver transplantation: radiological appearance and statistical evaluation of risk factors in 300 cases. Eur Radiol. 2000;10:1169–83.PubMedCrossRefGoogle Scholar
  62. 62.
    Singh N, Husain S, De Vera M, Gayowski T, Cacciarelli TV. Cryptococcus neoformans infection in patients with cirrhosis, including liver transplant candidates. Medicine (Baltimore). 2004;83:188–92.CrossRefGoogle Scholar
  63. 63.
    Baddley JW, Perfect JR, Oster RA, Larsen RA, Pankey GA, et al. Pulmonary cryptococcosis in patients without HIV infection: factors associated with disseminated disease. Eur J Clin Microbiol Infect Dis. 2008;27:937–43.PubMedCrossRefGoogle Scholar
  64. 64.
    Singh N, Alexander BD, Lortholary O, Dromer F, Gupta KL, et al. Cryptococcus neoformans in organ transplant recipients: impact of calcineurin-inhibitor agents on mortality. J Infect Dis. 2007;195:756–64.PubMedCentralPubMedCrossRefGoogle Scholar
  65. 65.
    Kotloff RM, Ahya VN, Crawford SW. Pulmonary complications of solid organ and hematopoietic stem cell transplantation. Am J Respir Crit Care Med. 2004;170:22–48.PubMedCrossRefGoogle Scholar
  66. 66.
    Tveit DJ, Hypolite IO, Poropatich RK, Hshieh P, Cruess D, et al. Hospitalizations for bacterial pneumonia after renal transplantation in the United States. J Nephrol. 2002;15:255–62.PubMedGoogle Scholar
  67. 67.
    Kutinova A, Woodward RS, Ricci JF, Brennan DC. The incidence and costs of sepsis and pneumonia before and after renal transplantation in the United States. Am J Transplant. 2006;6:129–39.PubMedCrossRefGoogle Scholar
  68. 68.
    Champion L, Stern M, Israel-Biet D, Mamzer-Bruneel MF, Peraldi MN, et al. Brief communication: sirolimus-associated pneumonitis: 24 cases in renal transplant recipients. Ann Intern Med. 2006;144:505–9.PubMedCrossRefGoogle Scholar
  69. 69.
    Baas MC, Struijk GH, Moes D-JAR, van den Berk IAH, Jonkers RE, et al. Interstitial pneumonitis caused by everolimus: a case–cohort study in renal transplant recipients. Transpl Int. 2014;27:428–36.PubMedCrossRefGoogle Scholar
  70. 70.
    Weiner SM, Sellin L, Vonend O, Schenker P, Buchner NJ, et al. Pneumonitis associated with sirolimus: clinical characteristics, risk factors and outcome—a single-centre experience and review of the literature. Nephrol Dial Transplant. 2007;22:3631–7.PubMedCrossRefGoogle Scholar
  71. 71.
    Genebes C, Brouchet L, Kamar N, Lepage B, Prevot G, et al. Characteristics of thoracic malignancies that occur after solid-organ transplantation. J Thorac Oncol. 2010;5:1789–95.PubMedCrossRefGoogle Scholar
  72. 72.
    Minai OA, Shah S, Mazzone P, Budev MM, Sahoo D, et al. Bronchogenic carcinoma after lung transplantation: characteristics and outcomes. J Thorac Oncol. 2008;3:1404–9.PubMedCrossRefGoogle Scholar
  73. 73.
    Park YS, Seo JB, Lee YK, Do KH, Lee JS, et al. Radiological and clinical findings of pulmonary aspergillosis following solid organ transplant. Clin Radiol. 2008;63:673–80.PubMedCrossRefGoogle Scholar
  74. 74.
    Almyroudis NG, Sutton DA, Linden P, Rinaldi MG, Fung J, et al. Zygomycosis in solid organ transplant recipients in a tertiary transplant center and review of the literature. Am J Transplant. 2006;6:2365–74.PubMedCrossRefGoogle Scholar
  75. 75.
    Metersky ML, Ma A, Bratzler DW, Houck PM. Predicting bacteremia in patients with community-acquired pneumonia. Am J Respir Crit Care Med. 2004;169:342–7.PubMedCrossRefGoogle Scholar
  76. 76.
    Shimada T, Noguchi Y, Jackson JL, Miyashita J, Hayashino Y, et al. Systematic review and meta-analysis: urinary antigen tests for Legionellosis. Chest. 2009;136:1576–85.PubMedCrossRefGoogle Scholar
  77. 77.
    Sorde R, Falco V, Lowak M, Domingo E, Ferrer A, et al. Current and potential usefulness of pneumococcal urinary antigen detection in hospitalized patients with community-acquired pneumonia to guide antimicrobial therapy. Arch Intern Med. 2011;171:166–72.PubMedCrossRefGoogle Scholar
  78. 78.
    Sopena N, Sabria M, Pedro-Botet ML, Reynaga E, Garcia-Nunez M, et al. Factors related to persistence of Legionella urinary antigen excretion in patients with legionnaires’ disease. Eur J Clin Microbiol Infect Dis. 2002;21:845–8.PubMedGoogle Scholar
  79. 79.
    Honda J, Yonemitsu J, Kitajima H, Yosida N, Fumirori T, et al. Clinical utility of capillary polymerase chain reaction for diagnosis of Cytomegalovirus pneumonia. Scand J Infect Dis. 2001;33:702–5.PubMedCrossRefGoogle Scholar
  80. 80.
    Husain S, Kwak EJ, Obman A, Wagener MM, Kusne S, et al. Prospective assessment of Platelia Aspergillus galactomannan antigen for the diagnosis of invasive aspergillosis in lung transplant recipients. Am J Transplant. 2004;4:796–802.PubMedCrossRefGoogle Scholar
  81. 81.
    Kwak EJ, Husain S, Obman A, Meinke L, Stout J, et al. Efficacy of galactomannan antigen in the Platelia Aspergillus enzyme immunoassay for diagnosis of invasive aspergillosis in liver transplant recipients. J Clin Microbiol. 2004;42:435–8.PubMedCentralPubMedCrossRefGoogle Scholar
  82. 82.
    Karageorgopoulos DE, Qu JM, Korbila IP, Zhu YG, Vasileiou VA, et al. Accuracy of β-D-glucan for the diagnosis of Pneumocystis jirovecii pneumonia: a meta-analysis. Clin Microbiol Infect. 2013;19:39–49.PubMedCrossRefGoogle Scholar
  83. 83.
    Assi M, Martin S, Wheat LJ, Hage C, Freifeld A, et al. Histoplasmosis after solid organ transplant. Clin Infect Dis. 2013;57:1542–9.PubMedCentralPubMedCrossRefGoogle Scholar
  84. 84.
    Mendoza N, Blair JE. The utility of diagnostic testing for active coccidioidomycosis in solid organ transplant recipients. Am J Transplant. 2013;13:1034–9.PubMedCrossRefGoogle Scholar
  85. 85.
    Soccal PM, Aubert JD, Bridevaux PO, Garbino J, Thomas Y, et al. Upper and lower respiratory tract viral infections and acute graft rejection in lung transplant recipients. Clin Infect Dis. 2010;51:163–70.PubMedCrossRefGoogle Scholar
  86. 86.
    Harris B, Lowy FD, Stover DE, Arcasoy SM. Diagnostic bronchoscopy in solid-organ and hematopoietic stem cell transplantation. Ann Am Thorac Soc. 2013;10:39–49.PubMedCrossRefGoogle Scholar
  87. 87.
    Eyuboglu FO, Kupeli E, Bozbas SS, Ozen ZE, Akkurt ES, et al. Evaluation of pulmonary infections in solid organ transplant patients: 12 years of experience. Transplant Proc. 2013;45:3458–61.PubMedCrossRefGoogle Scholar
  88. 88.
    Weinberg A, Zamora MR, Li S, Torres F, Hodges TN. The value of polymerase chain reaction for the diagnosis of viral respiratory tract infections in lung transplant recipients. J Clin Virol. 2002;25:171–5.PubMedCrossRefGoogle Scholar
  89. 89.
    Husain S, Clancy CJ, Nguyen MH, Swartzentruber S, Leather H, et al. Performance characteristics of the platelia Aspergillus enzyme immunoassay for detection of Aspergillus galactomannan antigen in bronchoalveolar lavage fluid. Clin Vaccine Immunol. 2008;15:1760–3.PubMedCentralPubMedCrossRefGoogle Scholar
  90. 90.
    Silveira FP, Kusne S, the ASTIDCoP. Candida infections in solid organ transplantation. Am J Transplant. 2013;13:220–7.PubMedCrossRefGoogle Scholar
  91. 91.
    American Thoracic Society, Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med. 2005;171:388–416.CrossRefGoogle Scholar
  92. 92.
    Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007;44 Suppl 2:S27–72.PubMedCrossRefGoogle Scholar
  93. 93.
    Danziger-Isakov L, Kumar D, the ASTIDCoP. Vaccination in solid organ transplantation. Am J Transplant. 2013;13:311–7.PubMedCrossRefGoogle Scholar
  94. 94.
    Avery RK. Influenza vaccines in the setting of solid-organ transplantation: are they safe? Curr Opin Infect Dis. 2012;25:464–8.PubMedCrossRefGoogle Scholar
  95. 95.
    Cordero E, Manuel O. Influenza vaccination in solid-organ transplant recipients. Curr Opin Organ Transplant. 2012;17:601–8.PubMedCrossRefGoogle Scholar
  96. 96.
    Hurst FP, Lee JJ, Jindal RM, Agodoa LY, Abbott KC. Outcomes associated with influenza vaccination in the first year after kidney transplantation. Clin J Am Soc Nephrol. 2011;6:1192–7.PubMedCentralPubMedCrossRefGoogle Scholar
  97. 97.
    Centers for Disease Control and Prevention. Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine for adults with immunocompromising conditions: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2012;61:816–9.Google Scholar
  98. 98.
    Kumar D, Welsh B, Siegal D, Chen MH, Humar A. Immunogenicity of pneumococcal vaccine in renal transplant recipients—three year follow-up of a randomized trial. Am J Transplant. 2007;7:633–8.PubMedCrossRefGoogle Scholar
  99. 99.
    French N, Gordon SB, Mwalukomo T, White SA, Mwafulirwa G, et al. A trial of a 7-valent pneumococcal conjugate vaccine in HIV-infected adults. N Engl J Med. 2010;362:812–22.PubMedCentralPubMedCrossRefGoogle Scholar
  100. 100.
    Martin SI, Fishman JA, the ASTIDCoP. Pneumocystis pneumonia in solid organ transplantation. Am J Transplant. 2013;13:272–9.PubMedCrossRefGoogle Scholar
  101. 101.
    Stern A, Green H, Paul M, Vidal L, Leibovici L. Prophylaxis for Pneumocystis pneumonia (PCP) in non-HIV immunocompromised patients. Cochrane Database Syst Rev. 2014;10:Cd005590.Google Scholar
  102. 102.
    Humar A, Limaye AP, Blumberg EA, Hauser IA, Vincenti F, et al. Extended valganciclovir prophylaxis in D+/R- kidney transplant recipients is associated with long-term reduction in cytomegalovirus disease: two-year results of the IMPACT study. Transplantation. 2010;90:1427–31.PubMedCrossRefGoogle Scholar
  103. 103.
    Wiita AP, Roubinian N, Khan Y, Chin-Hong PV, Singer JP, et al. Cytomegalovirus disease and infection in lung transplant recipients in the setting of planned indefinite valganciclovir prophylaxis. Transpl Infect Dis. 2012;14:248–58.PubMedCrossRefGoogle Scholar
  104. 104.
    Razonable RR, Humar A, the ASTIDCoP. Cytomegalovirus in solid organ transplantation. Am J Transplant. 2013;13:93–106.PubMedCrossRefGoogle Scholar
  105. 105.
    Singh NM, Husain S, the ASTIDCoP. Aspergillosis in solid organ transplantation. Am J Transplant. 2013;13:228–41.PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Open Access This chapter is distributed under the terms of the Creative Commons Attribution Noncommercial License, which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Authors and Affiliations

  1. 1.Department of MedicineThe Mount Sinai HospitalNew YorkUSA

Personalised recommendations