ID-Transplant

Question 1

Solid organ transplant infection timing <1 month after transplant

Answer 1

Early period-less than one month: gram positives, nosocomial gram negative, C. diff, Candida infection, aspergillus, surgical site infection, nosocomial pneumonia, catheter related bacteremia, UTIs

*more hospital related stuff

Question 2

Solid organ transplant infection timing 1-6 months after transplant

Answer 2

CMV, EBV and associated lymphoproliferative disease, HSV, VZV, BK virus, PJP, Toxo, Nocarida, TB reactivation, fungal infections, Hep B and C

*highest risk for opportunisitic infection due to suppressed cell-mediated immunity (most common time for CMV reactivation!)

Question 3

Solid organ transplant infection timing greater than months after transplant

Answer 3

EBV and lymphoproliferativ e disease, VZV, CAP, UTIs, BK virus, CMV

*opportunitistic infections less common unless there is an increased episodes of rejection requiring high immunosuppression

Question 4

For HSCT, less than 30 days after getting the stuff or pre-engraftment period

Answer 4

Neutropenia, mucositis, graft-versus-host disease: HSV, GNs, strep epi, GI strep species, candida, aspergillus

Question 5

For HSCT, post engraftment 30-100 days

Answer 5

CMV respiratory and enteric viruses, EBV lymphoproliferative disease
aspergillus
PJP pneumonia
Candida

Question 6

For HSCT, after 100 days

Answer 6

CMV, VZV virus, encapsulated bacteria (pneumococcal), Aspergillus, PJP pneumonia

Question 7

SOT: Pneumococcal vaccination for transplants

Answer 7

Before: PCV + 8 weeks later… PPSV 23
After: 5 years after…. PPSV23

Question 8

HSCT: Pneumococcal vaccination

Answer 8

3-6 months after transplantation, 3-4 doses of PCV13

12 months after transplantation: 1 dose of PPSV 23

Question 9

SOT: Tdap

Answer 9

Complete series before transplant, including booster

Question 10

HSCT: Tdap

Answer 10

give 3 doses of Tdap 6 months after transplant

Question 11

SOT: MMR

Answer 11

Contraindicated after transplantation

Question 12

HSCT MMR:

Answer 12

24 months after transplantation: 1-2 doses if no GVHD Or immune suppression

Question 13

SOT: Hib

Answer 13

no recommendation

Question 14

HSCT: Hib

Answer 14

3 doses 6-12months after transplantation

Question 15

SOT: Hep B and Hep A

Answer 15

Complete series if not already immune

Question 16

HSCT: Hep B and Hep A

Answer 16

3 doses 6-12 months after transplant

Question 17

SOT: VZV after transplant

Answer 17

Contraindicated after transplantation!!!

Question 18

SOT: VZV before transplant

Answer 18

> 4 weeks before give VZV vaccine if not immune, >4 weeks before give zoster if meet traditional requirements

Question 19

HSCT: VZV

Answer 19

Give >4 weeks before transplant

and again 24 months after transplant