Infections after uterus transplantation

Uterus transplantation has revolutionized the approach of uterine factor infertility. The restricted duration of exposure of immunosuppressive drugs to originally immunocompetent healthy women should control the increased infection risk. Considering the relative small number of uterus transplantations performed so far, the relative risk to contract especially severe and/or opportunistic infections remains uncertain. The surgical procedure and the presence of commensal vaginal flora shift the focus in the uterus transplant recipients toward targeted antimicrobial prophylaxis with particular attention to fungal infections. An analysis of the published data so far suggests that infections per se can contribute to graft loss, which is a rather unique feature for solid organ transplant recipients. Also of interest is the occurrence of CMV infection considering the risk of transfection during pregnancy, especially after relatively early embryo transfer. Adding up to prophylaxis by valganciclovir, the risk of CMV should possibly be contained by avoiding both allocation of CMV-positive cadaveric donors to CMV-negative recipients and the use of polyclonal induction. Recommendations and guidelines should be developed taking into account the current knowledge in the field of infectious diseases after transplantation while integrating outcome data from a joint registry set up by the International Society of Uterus Transplantation (ISUTx).

ISBN:9783319941622

Jaar van publicatie:2020

Toegankelijkheid:Closed