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Review
. 2021 Dec 1;26(6):646-653.
doi: 10.1097/MOT.0000000000000927.

Risk constellations, viral infections, and prophylaxis in uterine transplantation

Courtney E Harris  1 , Nicolas C Issa
Affiliations
Review

Risk constellations, viral infections, and prophylaxis in uterine transplantation

Courtney E Harris et al. Curr Opin Organ Transplant. .

Abstract

Purpose of review: Uterine transplantation (UTx) is a burgeoning new category of solid organ transplantation (SOT) that is practiced at several centers worldwide (first transplantation in 2013). Although there are still relatively low numbers of transplants (<75 published in literature), they are increasing in frequency and thus we attempt to discuss the current documented infections in this population as well as theoretical infectious risks and summarize prophylaxis and treatment strategies of centers current performing these procedures.

Recent findings: The most reported posttransplantation infection is not surprisingly urinary tract infections, with other documented infections including bacterial infections at site of graft (Enterococcus), herpes simplex virus, cytomegalovirus (CMV), human papillomavirus, Candida, and reportedly posttransplant lymphoproliferative disorder. The net state of immunosuppression and host factors (host colonization and serologic status of viral exposures) plays a significant role in infectious risk and with low numbers of infections documented, much of our guidance surrounding prophylaxis is inferred from SOT literature.

Summary: In this review, we give an overview of described infections in UTx and theoretical infectious risks, detailing how to tailor prophylaxis base on host risk, with specific focus that the goal of transplantation is completion of a successful pregnancy as the desired outcome. Special considerations should be given to pregnant recipients when managing infectious complications and further data collection and reporting regarding infectious complications is crucial to advance this field as numbers of transplantation continue to increase.

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References

    1. Fishman JA. Infection in organ transplantation. Am J Transplant 2017; 17:856–879.
    1. Richards EG, Farrell RM, Ricci S, et al. Uterus transplantation : state of the art in 2021. J Assist Reprod Gen 2021.
    1. Flyckt RL, Farrell RM, Perni UC, et al. Deceased donor uterine transplantation. Obstetrics Gynecol 2016; 128:837–842.
    1. Hoz RML, Morris MI. Infectious Diseases Community of Practice of the American Society of Transplantation. Tissue and blood protozoa including toxoplasmosis, Chagas disease, leishmaniasis, Babesia, Acanthamoeba, Balamuthia, and Naegleria in solid organ transplant recipients – Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant 2019; 33:e13546.
    1. Allen UD, Preiksaitis JK. AST Infectious Diseases Community of Practice. Posttransplant lymphoproliferative disorders, Epstein–Barr virus infection, and disease in solid organ transplantation: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant 2019; 33:e13652.

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