Pancreas Irradiation for Treatment-Resistant Acute Cellular Rejection in a Severely Immunocompromised Pancreas after Kidney Transplant Recipient - Case Report.

Treating acute rejection of a pancreas transplant in a severely immunocompromised patient with viral opportunistic infection is challenging due to the balance of rescuing from rejection without worsening the morbidity of infection and prolonging the infection episode. We present a case involving a pancreas-after-kidney transplant in a patient with CMV high-risk discordance (donor positive/recipient negative) and chronic lymphopenia who developed difficult-to-treat CMV disease approximately six months after pancreas transplant. Following the withdrawal of the antimetabolite due to the persistent CMV DNAemia and lymphopenia, the patient experienced acute pancreas rejection without adequate and sustained response to treatment with steroids and Thymoglobulin.

Comparative Effectiveness of Outpatient COVID-19 Therapies in Solid Organ Transplant Recipients.

Background: Multiple outpatient therapies have been developed for COVID-19 in high-risk individuals, but solid organ transplant (SOT) recipients were not well represented in controlled clinical trials. To date, few comparative studies have evaluated outcomes between outpatient therapies in this population.

Methods: We performed a retrospective cohort study using de-identified administrative claims data from OptumLabs Data Warehouse.

Clinical utility of two-step hepatitis E virus IgM antibody testing in a low-prevalence setting: A 10-year retrospective multicenter study.

Background: Diagnostic uncertainty caused by the low positive predictive value of HEV-specific IgM antibody (Ab) testing in a low-prevalence setting. We investigated the utility of a two-step HEV IgM Ab testing approach for diagnosing HEV infection.

Methods: We retrospectively reviewed all adults who underwent HEV IgM Ab and/or HEV RNA testing from July 2013 through June 2023 at Mayo Clinic.

Shaping the Future of Infectious Diseases: The Journey to Promote Value, Opportunity, and Positive Messaging.

The field of infectious diseases (ID) offers a rewarding career path and is widely viewed as an essential subspecialty in medicine. However, in recent years, these positive aspects have been overshadowed by concerns surrounding low fellowship match rates, undercompensation, and burnout. The Infectious Diseases Society of America Fellowship Training Program Directors Committee met in 2023, discussed the future of ID as a specialty, and sought to develop strategies to highlight the value and opportunities of ID for future generations, as well as underscore the importance of and provide tools for positive messaging to trainees about the subspecialty.

Cytomegalovirus Infection After Solid Organ Transplantation: How I Use Cell-Mediated Immune Assays for Management.

Introduction: The pathogenesis and outcome of cytomegalovirus (CMV) infection after solid organ transplantation (SOT) reflects the interplay between viral replication and CMV-specific immunity. Despite advances in its diagnosis and treatment, CMV continues to cause significant morbidity after SOT. Since CMV is an opportunistic pathogen that occurs as a result of impaired pathogen-specific immunity, laboratory assays that measure CMV-specific immune responses may be useful in assisting clinicians in its management.