What is Solid Organ Transplant-Related infection?
Solid organs are defined as organs that have a solid consistency and are not hollow. These include the kidneys, liver, pancreas, spleen, heart, and lungs. Solid organ transplant-related infections are defined as infections encountered following a solid organ transplant. The risk of infection is increased after a transplant because of immunosuppressive medications. These medicines prevent your immune system from attacking the new organ, but they also decrease your body's capacity to fight infections. Kidney transplants are the most common solid organ transplant performed, followed by those of the liver, heart, lung, and others.
Why Do Infections Occur After a Solid Organ Transplant?
Beneficiaries of transplanted organs take immunosuppressive/anti-rejection medicines to suppress their immune system and prevent their body from rejecting the new organ. A suppressed immune system (one that has fewer white blood cells) increases your chances of getting infections and having difficulty fighting them. Anti-rejection medicines can also prevent your body from responding well to vaccines. You are most susceptible to infection immediately following a transplant when the degree of the immunosuppressive medicines is at its highest. However, the likelihood of infection continues even long after you have been discharged from the hospital, so it is essential to take preventive steps to ward off infection at home.
What are the Types of Infections Encountered After a Solid Organ Transplant?
Minor infections are common after a solid organ transplant. They can become serious if you have other chronic disorders that increase the risk of infection, including heart disease, diabetes, or lung disease.
In general, a solid organ transplant patient can get almost any type of infection caused by bacteria, viruses, fungi, and parasites, but certain infections are of particular concern. They include:
- Urinary tract infections
- Cryptococcal and other fungal infections
- Abdomen and biliary tract infections
- Hepatitis A, B, and C
- Pneumonia
- Encephalitis
- Meningitis
- Cytomegalovirus (CMV)
- Epstein-Barr virus (EBV or mononucleosis)
- Herpes
- Tuberculosis
- Severe acute respiratory syndrome (SARS)
- Human immunodeficiency virus (HIV)
- Syphilis
Infections are the topmost reason transplant patients are hospitalized in the first 2 years following the transplant. It is essential that you take measures to ward off infection and look for signs and symptoms of infection.
What are the Signs and Symptoms of Solid Organ Transplant-Related Infection?
Some of the signs and symptoms of solid organ transplant-related infection include:
- Fever higher than 100 degrees Fahrenheit or 38 degrees Celsius
- Problems with urination, including burning or pain, frequent urination, or constant urge
- Bloody, cloudy, or foul-smelling urine
- Nausea, vomiting, or diarrhea
- Pain, tenderness, swelling, or redness
- Flu-like symptoms (chills, sweats, aches, headache, or fatigue)
- Scratchy throat, sore throat, or pain while swallowing
- Persistent moist or dry cough that lasts more than 2 days
- Nasal congestion, sinus drainage, headaches, or tenderness along upper cheekbones
- Warm, red, or draining sore
- Nonhealing cut or wound
Diagnosis of Solid Organ Transplant-Related Infection
If an infection is suspected, your physician may order the following tests to establish the level of the infection and what is causing it. These include:
- Blood tests: A blood sample will be obtained to assist in detecting a specific microorganism.
- Chest X-ray: This may reveal spots on your lungs where the immune system is fighting an infection.
- Sputum test: A sample of mucus is obtained to check for the presence of microorganisms in a lab setting.
- Urine test: A sample of urine is obtained and examined under a microscope for the presence of microorganisms.
- Urine culture: A sample of urine is stored in an environment that encourages bacterial growth to help detect what the infectious agent is.
- Stool test: A stool sample is obtained from you to test for infection in the digestive tract.
Treatment for Solid Organ Transplant-Related Infection
After a solid organ transplant, you must strike a fine balance between preventing organ rejection and your body’s capacity to fight infection. Your immunosuppressant medications may make fighting infection more difficult, but your doctor can assist you to find the right balance to prevent serious infection.
If infections are mild, you will likely receive an antibiotic, antiviral, or antifungal medication. If the infection is more serious, your doctor may decrease your anti-rejection medication temporarily to enable your body to help in fighting the infection.
How Can You Prevent Transplant-Related Infection?
There are many ways you can take a proactive approach to control or prevent transplant-related infection. These include:
- Frequently washing your hands with soap and water/sanitizers
- Taking a daily bath
- Exercising daily to strengthen your body
- Brushing your teeth and gums thoroughly after each meal
- Using dental floss daily
- Protecting your skin from scratches, sores, or other irritation that may result in infection
- Refraining from using whirlpools, hot tubs, steam baths, or saunas
- Using sunscreen lotion with an SPF of 30 or higher
- Keeping your home clean and free from dust
- Avoiding crowded areas for at least 3 months
- Limiting visitors for the first few months to avoid the risk of transmission of cold or flu-like symptoms
- Reducing close exposure to pets as things such as pet dander may trigger an allergic reaction
What Other Precautions Should Be Taken to Prevent Solid Organ Transplant-Related Infection After leaving the Hospital?
To ensure that you stay as healthy as possible after the transplant, your physician may advise the following preventive treatment measures to avoid solid organ transplant-related infection. These include:
- Getting appropriate vaccinations, such as annual flu shot, Hepatitis A and B, tetanus, diphtheria, pertussis, and pneumonia vaccine
- Visiting your dentist at least twice a year
- Visiting your ophthalmologist (eye doctor) at least once a year
- Checking your armpits, neck, and groin area for new growth or lumps
- Men should have their prostate and PSA (prostate-specific antigen) checked every year
- Women should have monthly self-breast exams, as well as a pelvic exam with Pap smear and a mammogram every year, irrespective of age.