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Donor-derived infections (DDIs); Organ transplantation; Transplant guidelines; AST Infectious Diseases Community; Pre-transplant screening; Perioperative management

Introduction

Donor-derived infections (DDIs) pose significant risks to organ transplant recipients, potentially leading to graft failure or even mortality. With the increasing volume of organ transplants performed globally, identifying and managing the risks associated with infectious diseases in donors is critical. This article presents guidelines from the American Society of Transplantation's (AST) Infectious Diseases Community of Practice, which have been developed to address the unique challenges posed by DDIs in organ transplantation [1]. These guidelines aim to assist healthcare professionals in minimizing the risk of transmission of infections from donor to recipient and ensuring optimal transplant outcomes.

Methodology

The development of these guidelines involved a comprehensive literature review, expert consensus, and data from organ transplant centers and infectious disease specialists. Key steps in the methodology include:

Literature review: A systematic review of peer-reviewed articles, case studies, and clinical guidelines related to donor-derived infections in organ transplantation [2, 3]. Contributions from infectious disease specialists, transplant surgeons, and epidemiologists to provide a consensus on best practices. Recommendations: Based on evidence and expert opinion, the guidelines offer practical recommendations for pre-transplant screening, infection prevention, diagnosis, and post-transplant monitoring.

Results and Discussion

Pre-Transplant screening: Recommendations for comprehensive screening of both living and deceased donors for infectious agents, including HIV, hepatitis B, hepatitis C, and other opportunistic pathogens. Perioperative management guidelines stress the importance of infection control during the transplant procedure, including the use of prophylactic antimicrobials and maintaining sterile environments [4].

Post-Transplant monitoring: Strategies for ongoing monitoring of recipients for signs of infection, including regular laboratory tests, imaging studies, and clinical evaluations. The guidelines also address management protocols for detecting and treating infections post-transplant [5-8]. Key pathogens the guidelines provide detailed approaches to managing infections from bacteria, fungi, viruses, and parasites, with a focus on high-risk pathogens like CMV, EBV, and fungal species.

Discussion

DDIs remain a significant concern in organ transplantation despite advances in screening and infection management. The guidelines outlined by the AST Infectious Diseases Community of Practice offer a comprehensive, evidence-based approach to mitigating these risks [9]. Key discussions focus on the balance between maximizing organ utilization and minimizing infection risk, as well as the importance of individualized care for transplant recipients [10]. The guidelines also highlight the need for international collaboration in DDI surveillance and research, as well as the integration of newer technologies such as molecular diagnostics and genomic testing in infection detection.

Conclusion

Donor-derived infections represent a critical challenge in the field of organ transplantation. The AST guidelines offer a robust framework for preventing, detecting, and managing these infections. Implementing these best practices can significantly reduce the risk of DDIs, thereby improving patient outcomes and transplant success. Continued research and collaboration among transplant centers, infectious disease specialists, and public health authorities are vital to further improving DDI management and ensuring the safety of transplant recipients.

Acknowledgement

None

Conflict of Interest

None

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