Letermovir should be first-line cytomegalovirus prophylaxis in lung transplant recipients.

Universal cytomegalovirus (CMV) prophylaxis is recommended for at-risk lung transplant recipients. Valganciclovir is currently the preferred first-line agent. Valganciclovir-related myelosuppression, however, can lead to drug discontinuation or reduction in anti-metabolite immunosuppression.

Severe Acute Liver Injury After Hepatotoxic Medication Initiation in Real-World Data.

Importance: Current approaches to classify the hepatotoxic potential of medications are based on cumulative case reports of acute liver injury (ALI), which do not consider the size of the exposed population. There is little evidence from real-world data (data relating to patient health status and/or the delivery of health care routinely collected from sources outside of a research setting) on incidence rates of severe ALI after initiation of medications, accounting for duration of exposure.

Objective: To identify the most potentially hepatotoxic medications based on real-world incidence rates of severe ALI and to examine how these rates compare with categorization based on case reports.

Hospitalizations for opportunistic infections following transplantation and associated risk factors: A national cohort study of Medicare beneficiaries.

Background: Opportunistic infections (OIs) are a significant cause of morbidity and mortality after organ transplantation, though data in the liver transplant (LT) population are limited.

Methods: We performed a retrospective cohort study of LT recipients between January 1, 2007 and Deceber 31, 2016 using Medicare claims data linked to the Organ Procurement and Transplantation Network database. Multivariable Cox regression models evaluated factors independently associated with hospitalizations for early (≤1 year post transplant) and late (>1 year) OIs, with a particular focus on immunosuppression.

COVID-19 in organ donors: An organ procurement organization perspective.

Background: The COVID-19 pandemic presented a significant challenge for Organ Procurement Organizations (OPOs) with the use of SARS-CoV-2 positive donors varying widely. This study used detailed single OPO data to determine the success of using SARS-CoV-2 positive donors.

Methods: We performed a retrospective cohort study including all SARS-CoV-2 positive donors referred to the Gift of Life OPO from January 1, 2021, to June 30, 2023.

Differences in Early Immunosuppressive Therapy Among Liver Retransplantation Recipients in a National Cohort.

Background: There is no unified consensus as to the preferred immunosuppression (IS) strategy following liver retransplantation (reLT).

Methods: This was a retrospective cohort study using the United Network for Organ Sharing database. Recipient, donor, and center characteristics associated with induction use and early maintenance IS regimen were described.

Attainment of target rifampicin concentrations in cerebrospinal fluid during treatment of tuberculous meningitis.

Objective: There is considerable uncertainty regarding the optimal use of rifampicin for the treatment of tuberculous (TB) meningitis. A pharmacokinetic modeling and simulation study of rifampicin concentrations in cerebrospinal fluid (CSF) during TB meningitis treatment was performed in this study.

Methods: Parameters for rifampicin pharmacokinetics in CSF were estimated using individual-level rifampicin pharmacokinetic data, and the model was externally validated in three separate patient cohorts.

Assessing Response to Therapy for Nontuberculous Mycobacterial Lung Disease: Quo Vadis?

Assessing progression of disease or response to treatment remains a major challenge in the clinical management of nontuberculous mycobacterial (NTM) infections of the lungs. Serial assessments of validated measures of treatment response address whether the current therapeutic approach is on track toward clinical cure, which remains a fundamental question for clinicians and patients during the course of NTM disease treatment. The 2015 NTM Research Consortium Workshop, which included a patient advisory panel, identified treatment response biomarkers as a priority area for investigation.

Tuberculous Meningitis in Children and Adults: New Insights for an Ancient Foe.

Purpose Of Review: Tuberculous meningitis is the most devastating manifestation of infection with Mycobacterium tuberculosis and represents a medical emergency. Approximately one half of tuberculous meningitis patients die or suffer severe neurologic disability. The goal of this review will be to review the pathogenic, clinical, and radiologic features of tuberculous meningitis and to highlight recent advancements in translational and clinical science.

Deaths Related to Nontuberculous Mycobacterial Infections in the United States, 1999-2014.

Rationale: Unlike tuberculosis, nontuberculous mycobacterial disease is not reportable to public health authorities in the United States, and the total burden of disease is uncertain.

Objectives: To estimate the mortality of nontuberculous mycobacterial disease in the United States over a 15-year period and to identify temporal trends.

Methods: The U.

Transfusion transmitted infections in solid organ transplantation.

While the risk of infectious disease transmission through blood transfusion has been greatly reduced as a result of improved screening methods, transfusion-transmissible infections remain a concern for transplant recipients, especially those receiving multiple transfusions. Although transfusion and transplant recipients are at risk for similar infections, the current reporting requirements for infections transmitted by transfusions and organ transplantation vary greatly and remain distinctly separate with no communication between reporting systems. This article reviews 23 past reports of transfusion-transmitted infections in organ recipients acquired through transfusions.

Viral load monitoring as a tool to reinforce adherence: a systematic review.

Objective: Viral load monitoring has been proposed as a tool to reinforce adherence, but outcomes have never been systematically assessed.

Design: A meta-analysis was conducted to systematically analyze the research on viral load monitoring as a tool to reinforce adherence. Viremic resuppression is defined here as a decrease in viral load beneath a particular threshold following viral load levels that have been elevated despite antiretroviral treatment.