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    Screening of donors and recipients for infections prior to solid organ transplantation. Nanayakkara Deepa D,Schaenman Joanna Current opinion in organ transplantation PURPOSE OF REVIEW:This review is a brief overview of current guidelines on screening donors and candidates for bacterial, fungal, parasitic and viral infections prior to solid organ transplantation. The pretransplant period is an important time to evaluate infection exposure risk based on social history as well as to offer vaccinations. RECENT FINDINGS:One of the major changes in the past few years has been increased utilization of increased Public Health Service risk, HIV positive, and hepatitis C-positive donors. There has also been increased attention to donor and recipient risks for geographically associated infections, such as endemic fungal infections and flaviviruses. SUMMARY:Screening for donors and candidates prior to organ transplantation can identify and address infection risks. Diagnosing infections in a timely manner can help guide treatment and additional testing. Use of necessary prophylactic treatment in organ recipients can prevent reactivation of latent infections and improve posttransplant outcomes. 10.1097/MOT.0000000000000671
    Transmission of lymphocytic choriomeningitis virus by organ transplantation. Fischer Staci A,Graham Mary Beth,Kuehnert Matthew J,Kotton Camille N,Srinivasan Arjun,Marty Francisco M,Comer James A,Guarner Jeannette,Paddock Christopher D,DeMeo Dawn L,Shieh Wun-Ju,Erickson Bobbie R,Bandy Utpala,DeMaria Alfred,Davis Jeffrey P,Delmonico Francis L,Pavlin Boris,Likos Anna,Vincent Martin J,Sealy Tara K,Goldsmith Cynthia S,Jernigan Daniel B,Rollin Pierre E,Packard Michelle M,Patel Mitesh,Rowland Courtney,Helfand Rita F,Nichol Stuart T,Fishman Jay A,Ksiazek Thomas,Zaki Sherif R, The New England journal of medicine BACKGROUND:In December 2003 and April 2005, signs and symptoms suggestive of infection developed in two groups of recipients of solid-organ transplants. Each cluster was investigated because diagnostic evaluations were unrevealing, and in each a common donor was recognized. METHODS:We examined clinical specimens from the two donors and eight recipients, using viral culture, electron microscopy, serologic testing, molecular analysis, and histopathological examination with immunohistochemical staining to identify a cause. Epidemiologic investigations, including interviews, environmental assessments, and medical-record reviews, were performed to characterize clinical courses and to determine the cause of the illnesses. RESULTS:Laboratory testing revealed lymphocytic choriomeningitis virus (LCMV) in all the recipients, with a single, unique strain of LCMV identified in each cluster. In both investigations, LCMV could not be detected in the organ donor. In the 2005 cluster, the donor had had contact in her home with a pet hamster infected with an LCMV strain identical to that detected in the organ recipients; no source of LCMV infection was found in the 2003 cluster. The transplant recipients had abdominal pain, altered mental status, thrombocytopenia, elevated aminotransferase levels, coagulopathy, graft dysfunction, and either fever or leukocytosis within three weeks after transplantation. Diarrhea, peri-incisional rash, renal failure, and seizures were variably present. Seven of the eight recipients died, 9 to 76 days after transplantation. One recipient, who received ribavirin and reduced levels of immunosuppressive therapy, survived. CONCLUSIONS:We document two clusters of LCMV infection transmitted through organ transplantation. 10.1056/NEJMoa053240