Handbook of Kidney Transplantation by Gabriel M. Danovitch

Author:Gabriel M. Danovitch [Danovitch, Gabriel M.]
Language: eng
Format: azw3, epub, pdf
Publisher: Wolters Kluwer Health
Published: 2017-04-23T16:00:00+00:00

STRATEGY 10: PREVENT INFECTION

Infections in the late post-transplantation period are discussed in chapter 12 together with recommendations for routine immunization (Table 12.4). Routine prophylaxis for Pneumocystis jiroveci infections with trimethoprim-sulfamethoxazole is probably not warranted late after transplantation. The exception may be for patients who are receiving high doses of immunosuppression to treat rejection or for patients receiving sirolimus (see chapter 6, Part I). The same is true for cytomegalovirus (CMV) infection prophylaxis.

Influenza types A and B are likely to be at least as common, and probably more severe, in renal transplant patients as in the general population. Therefore, transplant recipients should receive annual influenza vaccination. Although vaccines are safe, they may be somewhat less effective in transplant recipients than in the general population because of the limitation in antibody response by immunosuppressant drugs. Nevertheless, the response to vaccination is high enough (50% to 100%) to warrant their use.

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