2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T706,Cytomegalovirus (CMV) infection remains one of the most prevalent and consequential post solid organ transplant (SOT) infections. Treatment is often challenging, especially when dealing with refractory and resistant CMV infections. We performed a retrospective multicenter cohort study of SOT recipients with clinically significant CMV infection (csCMVi) during 2010-2016. The primary outcome was early refractory CMV infection and secondary outcomes were drug resistance, CMV recurrence, and mortality. Analysis was done with Kaplan-Meier, univariable logistic regression analysis, and multivariable Cox regression. We included 145 SOT recipients with csCMVi, majority were liver transplant (49%). Most common induction was an anti-IL-2 antibody (43.9%). The majority (n = 82; 56.5%) were CMV D+/R- mismatch and presented asymptomatic infection (50.3%). After the initial 3 weeks of antiviral therapy, 13 (8.9%) patients had probable refractory csCMVi; most of them (10 [76.9%]) were CMV D+/R- mismatch. Longer time after transplant had lower risk (OR 0.68; CI 0.48-0.95, p = 0.029) while lower absolute lymphocyte count (ALC) had a higher risk of early refractory csCMVi (OR 1.54; CI 1.01-2.44, p = 0.048). Drug-resistant csCMVi occurred in 7 patients (4.8%); a high initial CMV DNA level was associated with resistant csCMVi (OR 2.00; CI 1.08-3.93, p = 0.031). 25 patients (17.2%) experienced recurrent csCMVi within 6 months. 30 patients (20.7%) died; refractory, resistant or recurrent CMV infections were not associated with mortality. Refractory csCMVi is associated with a low ALC and an earlier onset after transplant. Resistant csCMVi is associated with high initial CMV DNA levels. Recurrence of csCMVi is common and potentially associated with low ALC at the end of antiviral treatment.31:Tadf,ABSTRACT Background Cytomegalovirus (CMV) infection remains one of the most prevalent and consequential post solid organ transplant (SOT) infections. Treatment is often challenging, especially when dealing with refractory and resistant CMV infections. Methods We performed a retrospective multicenter cohort study of SOT recipients with clinically significant CMV infection (csCMVi) during 2010–2016. The primary outcome was early refractory CMV infection and secondary outcomes were drug resistance, CMV recurrence, and mortality. Analysis was done with Kaplan‐Meier, univariable logistic regression analysis, and multivariable Cox regression. Results We included 145 SOT recipients with csCMVi, majority were liver transplant (49%). Most common induction was an anti‐IL‐2 antibody (43.9%). The majority ( n = 82; 56.5%) were CMV D+/R‐ mismatch and presented asymptomatic infection (50.3%). After the initial 3 weeks of antiviral therapy, 13 (8.9%) patients had probable refractory csCMVi; most of them (10 [76.9%]) were CMV D+/R‐ mismatch. Longer time after transplant had lower risk (OR 0.68; CI 0.48–0.95, p = 0.029) while lower absolute lymphocyte count (ALC) had a higher risk of early refractory csCMVi (OR 1.54; CI 1.01–2.44, p = 0.048). Drug‐resistant csCMVi occurred in 7 patients (4.8%); a high initial CMV DNA level was associated with resistant csCMVi (OR 2.00; CI 1.08–3.93, p = 0.031). 25 patients (17.2%) experienced recurrent csCMVi within 6 months. 30 patients (20.7%) died; refractory, resistant or recurrent CMV infections were not associated with mortality. Conclusion Refractory csCMVi is associated with a low ALC and an earlier onset after transplant. Resistant csCMVi is associated with high initial CMV DNA levels. Recurrence of csCMVi is common and potentially associated with low ALC at the end of antiviral treatment. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Solid Organ Transplant: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Solid Organ Transplant (condition). Clinician-written summaries and actionable practice insights. Updated daily.\",\"url\":\"https://www.reachrx.ai/hub/tag/condition/Solid%20Organ%20Transplant\",\"breadcrumb\":{\"@type\":\"BreadcrumbList\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https://www.reachrx.ai\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Research Hub\",\"item\":\"https://www.reachrx.ai/hub\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Conditions\",\"item\":\"https://www.reachrx.ai/hub/tag/condition\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"Solid Organ Transplant\",\"item\":\"https://www.reachrx.ai/hub/tag/condition/Solid%20Organ%20Transplant\"}]}}"}}]],["$","$L2f",null,{"title":"Solid Organ Transplant: Research & Clinical Takeaways","description":"Discover peer-reviewed research on Solid Organ Transplant with concise clinician summaries and next-step guidance.","papers":[{"doi":"10.1016/j.ajt.2026.07.033","pmid":"42632426","title":"Vaccination and Safe Living Strategies for Solid Organ Transplant Candidates and Recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice","journal_title":"American Journal of Transplantation","journal_issn":"1600-6135","published_at":"2026-08-22T00:00:00.000Z","url":"https://doi.org/10.1016/j.ajt.2026.07.033","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-28T06:25:18.773Z","updated_at":"2026-08-28T06:25:18.773Z","tags":[{"paper_doi":"10.1016/j.ajt.2026.07.033","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.033","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.033","tag_type":"condition","value":"Immunocompromised State","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.033","tag_type":"condition","value":"Solid Organ Transplant","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.033","tag_type":"generic","value":"COVID-19 vaccine","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.033","tag_type":"generic","value":"hepatitis B vaccine","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.033","tag_type":"generic","value":"meningococcal vaccine","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.033","tag_type":"generic","value":"pneumococcal vaccine","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.033","tag_type":"generic","value":"recombinant zoster vaccine","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.033","tag_type":"generic","value":"RSV vaccine","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.033","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.033","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.033","tag_type":"modality","value":"Vaccine","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.033","tag_type":"study_design","value":"Clinical Practice Guideline","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.033","tag_type":"warning","value":"Level of evidence assigned as 7 (expert opinion/guideline) due to the nature of the publication; individual recommendations within the guideline may be supported by varying levels of underlying evidence.","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.033","tag_type":"warning","value":"No sample size applicable — this is a guideline document, not a primary study.","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.033","tag_type":"warning","value":"Study design labeled as 'Clinical Practice Guideline'; no randomization or control group applies.","value_numeric":null}],"summaries":{"what_studied":"Updated AST IDCOP guidelines on vaccination (routine, travel, and live-attenuated vaccines) and non-pharmacological safe living strategies for solid organ transplant (SOT) candidates and recipients, incorporating evidence since the 2019 guidelines.","key_result":"Key updates include: new vaccine recommendations for COVID-19 and RSV; newer formulations of pneumococcal, meningococcal, and hepatitis B vaccines; expanded age indications for recombinant zoster vaccine; and accumulating evidence supporting select live-attenuated vaccines in post-transplant pediatric and young adult patients under certain conditions.","limitations":"Guideline document based on evidence review rather than a primary clinical trial; many recommendations may rely on observational or limited data given the immunocompromised population studied.","practice_takeaway":"Review and update vaccination status in all SOT candidates before transplant and before any travel; for post-transplant patients, consider live-attenuated vaccines only in select pediatric and young adult cases, and counsel patients on food, water, pet, and sexual activity safety as part of routine care."}},{"doi":"10.1093/cid/ciag507","pmid":"42624500","title":"Infective Endocarditis in Solid Organ and Haematopoietic Stem Cell Transplant Recipients (E-IPA Study): a propensity-score-matched retrospective cohort study","journal_title":"Clinical Infectious Diseases","journal_issn":"1058-4838","published_at":"2026-08-21T00:00:00.000Z","url":"https://doi.org/10.1093/cid/ciag507","source_score":28,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-04T06:22:17.190Z","updated_at":"2026-09-04T06:22:17.190Z","tags":[{"paper_doi":"10.1093/cid/ciag507","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1093/cid/ciag507","tag_type":"category","value":"Infectious Diseases","value_numeric":null},{"paper_doi":"10.1093/cid/ciag507","tag_type":"condition","value":"Haematopoietic Stem Cell Transplant","value_numeric":null},{"paper_doi":"10.1093/cid/ciag507","tag_type":"condition","value":"Infective Endocarditis","value_numeric":null},{"paper_doi":"10.1093/cid/ciag507","tag_type":"condition","value":"Solid Organ Transplant","value_numeric":null},{"paper_doi":"10.1093/cid/ciag507","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1093/cid/ciag507","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1093/cid/ciag507","tag_type":"modality","value":"Antimicrobial Therapy","value_numeric":null},{"paper_doi":"10.1093/cid/ciag507","tag_type":"sample_size","value":"n=1835","value_numeric":1835},{"paper_doi":"10.1093/cid/ciag507","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/cid/ciag507","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1093/cid/ciag507","tag_type":"warning","value":"SOT and HSCT recipients are analysed together, which may obscure important differences between these populations.","value_numeric":null},{"paper_doi":"10.1093/cid/ciag507","tag_type":"warning","value":"Study is set entirely in France; pathogen distribution and outcomes may differ in other healthcare settings.","value_numeric":null},{"paper_doi":"10.1093/cid/ciag507","tag_type":"warning","value":"Total sample size of n=1,835 reflects all included participants (262 transplant + 1,573 controls); the matched subcohort size is not specified in the abstract and may be smaller.","value_numeric":null}],"summaries":{"what_studied":"This multicentre retrospective cohort study across 27 French hospitals characterised infective endocarditis (IE) in solid organ transplant (SOT) and haematopoietic stem cell transplant (HSCT) recipients (n=262) and compared clinical/microbiological features and mortality with propensity-score-matched non-transplant controls (n=1,573) from 2007–2023.","key_result":"Transplant recipients had a distinct pathogen profile — more *Enterococcus* spp., coagulase-negative staphylococci, non-HACEK Gram-negative bacilli, and fungal IE than matched controls (p<0.001). SOT/HSCT status was independently associated with higher 1-year all-cause mortality (adjusted HR 1.69, 95% CI 1.05–2.72; p=0.029), but not 90-day mortality.","limitations":"Retrospective design limits causal inference. Only definite/possible IE cases were included, which may undercount atypical presentations common in immunocompromised hosts. Heterogeneity across transplant types (SOT vs. HSCT) and immunosuppression regimens was not fully disentangled.","practice_takeaway":"In transplant recipients with suspected IE, broaden empirical coverage to include *Enterococcus*, coagulase-negative staphylococci, Gram-negative bacilli, and fungi — especially within the first year post-transplant. Counsel patients and teams that 1-year mortality risk is ~70% higher than in non-transplant IE patients."}},{"doi":"10.1007/s40121-026-01379-4","pmid":"42377765","title":"Burden of Respiratory Syncytial Virus Infection in Immunocompromised Adults: A Systematic Review of the Evidence From High-Income Countries","journal_title":"Infectious Diseases and Therapy","journal_issn":"2193-8229","published_at":"2026-06-30T00:00:00.000Z","url":"https://doi.org/10.1007/s40121-026-01379-4","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-06T13:36:13.268Z","updated_at":"2026-07-06T13:36:13.268Z","tags":[{"paper_doi":"10.1007/s40121-026-01379-4","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1007/s40121-026-01379-4","tag_type":"category","value":"Infectious Diseases","value_numeric":null},{"paper_doi":"10.1007/s40121-026-01379-4","tag_type":"condition","value":"Hematopoietic Stem Cell Transplant","value_numeric":null},{"paper_doi":"10.1007/s40121-026-01379-4","tag_type":"condition","value":"Immunocompromising Conditions","value_numeric":null},{"paper_doi":"10.1007/s40121-026-01379-4","tag_type":"condition","value":"Respiratory Syncytial Virus Infection","value_numeric":null},{"paper_doi":"10.1007/s40121-026-01379-4","tag_type":"condition","value":"Solid Organ Transplant","value_numeric":null},{"paper_doi":"10.1007/s40121-026-01379-4","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1007/s40121-026-01379-4","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1007/s40121-026-01379-4","tag_type":"modality","value":"Immunosuppressive Therapy","value_numeric":null},{"paper_doi":"10.1007/s40121-026-01379-4","tag_type":"sample_size","value":"n=36","value_numeric":36},{"paper_doi":"10.1007/s40121-026-01379-4","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s40121-026-01379-4","tag_type":"study_design","value":"Systematic Review","value_numeric":null},{"paper_doi":"10.1007/s40121-026-01379-4","tag_type":"warning","value":"Hospitalization and ICU ranges are broad due to inter-study heterogeneity; no pooled estimates were calculable from the abstract alone.","value_numeric":null},{"paper_doi":"10.1007/s40121-026-01379-4","tag_type":"warning","value":"Sample size tag reflects number of included studies (n=36), not individual patients—patient-level N was not reported in the abstract.","value_numeric":null},{"paper_doi":"10.1007/s40121-026-01379-4","tag_type":"warning","value":"The full text content extracted from the PDF corresponds to the 2025 STIKO (German Standing Committee on Vaccination) immunization guidelines, not the systematic review described in the abstract. The abstract and structured summary are based solely on the provided abstract metadata, as the full text of the systematic review was not present in the extracted content.","value_numeric":null}],"summaries":{"what_studied":"This systematic literature review (2000–2024) summarized the burden of RSV infection in immunocompromised adults in high-income countries, covering incidence, hospitalization, ICU admission, mechanical ventilation, and mortality across solid organ transplant (SOT), hematopoietic stem cell transplant (HSCT), and other immunocompromising conditions.","key_result":"Across 36 included studies, RSV infection led to high rates of hospitalization (37.5–87.5% in lung transplant; 37.7–68.0% in any SOT; 30.3–83.9% in HSCT recipients), ICU admission (11.7% lung; 3.9–17.9% any SOT; 4.8–29.8% HSCT), and mechanical ventilation (0.0–10.4% lung; 3.9–14.3% any SOT; 2.7–29.8% HSCT). Degree of immunosuppression—driven by anti-rejection regimens, corticosteroid dosing, and adjunctive agents—was identified as a key risk modifier.","limitations":"Most studies were observational and retrospective; only 4 of 36 were conducted outside Europe or the USA, limiting generalizability. RSV diagnostic methods varied across studies, potentially affecting incidence estimates. No pooled meta-analysis was performed, so ranges reflect study heterogeneity rather than precise effect sizes.","practice_takeaway":"Clinicians caring for lung or stem cell transplant recipients should recognize RSV as a major cause of severe respiratory illness requiring hospitalization and ICU care. Vaccination and preventive strategies should be prioritized in this group, and immunosuppression level should be weighed as a key risk factor when assessing RSV severity."}},{"doi":"10.1093/ofid/ofag391","pmid":null,"title":"Incidence of RSV-Acute Respiratory Infection in Adults 18-64 years with High-Risk Conditions: A Prospective Community-based Surveillance Study","journal_title":"Open Forum Infectious Diseases","journal_issn":"2328-8957","published_at":"2026-06-29T00:00:00.000Z","url":"https://doi.org/10.1093/ofid/ofag391","source_score":11,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-07-13T17:42:42.444Z","updated_at":"2026-07-13T17:42:42.444Z","tags":[{"paper_doi":"10.1093/ofid/ofag391","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag391","tag_type":"category","value":"Infectious Diseases","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag391","tag_type":"condition","value":"Acute Respiratory Infection","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag391","tag_type":"condition","value":"Asthma","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag391","tag_type":"condition","value":"Chronic Kidney Disease","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag391","tag_type":"condition","value":"Congenital Immunodeficiency","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag391","tag_type":"condition","value":"Lower Respiratory Tract Disease","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag391","tag_type":"condition","value":"Respiratory Syncytial Virus Infection","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag391","tag_type":"condition","value":"Solid Organ Transplant","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag391","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag391","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag391","tag_type":"modality","value":"Epidemiological Surveillance","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag391","tag_type":"sample_size","value":"n=3375","value_numeric":3375},{"paper_doi":"10.1093/ofid/ofag391","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag391","tag_type":"study_design","value":"Prospective Cohort Study","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag391","tag_type":"warning","value":"Impact flag 'practice_changing' applied because findings extend established RSV vaccine indications to younger high-risk adults, but formal guideline changes would require regulatory or advisory body review.","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag391","tag_type":"warning","value":"Level of evidence assigned as 2 (prospective cohort); no randomization was performed, so causal inferences are limited.","value_numeric":null},{"paper_doi":"10.1093/ofid/ofag391","tag_type":"warning","value":"The total sample size of the non-HRC comparator group is not specified in the abstract; the n=3,375 figure reflects only the HRC cohort, so overall study N is likely larger but indeterminate from available text.","value_numeric":null}],"summaries":{"what_studied":"A multi-state, prospective community cohort of U.S. adults aged 18–64 years (n=3,375 with high-risk conditions [HRCs] plus a comparator group without HRCs) followed October 2022–September 2024 to estimate incidence and attack rates of RSV acute respiratory infection (ARI) and RSV lower respiratory tract disease (LRTD) by HRC status and age group.","key_result":"Adults with ≥1 HRC had RSV-ARI incidence of 17.9 vs. 14.8 per 1,000 person-years (no HRC), and RSV-LRTD incidence of 10.0 vs. 5.7 per 1,000 person-years. Having ≥1 HRC was associated with 62% higher RSV-LRTD risk after adjustment; among adults aged 18–49 with HRCs, RSV-LRTD incidence was 9.6 vs. 4.3 per 1,000 person-years (117% increased risk). Asthma, congenital immunodeficiency, immunosuppressive medication use, solid organ transplant, and chronic kidney disease drove the highest LRTD burden.","limitations":"- Total sample size of the non-HRC comparator group is not reported, limiting full interpretation of between-group comparisons.\n- Community-based surveillance may undercount cases if mild RSV illness goes untested.\n- Only two RSV seasons observed; year-to-year variability in RSV circulation may affect generalizability.","practice_takeaway":"Clinicians should recognize that working-age adults (especially those aged 18–49) with asthma, immunosuppression, solid organ transplant, or chronic kidney disease carry a substantially elevated RSV-LRTD burden—comparable in magnitude to older adults—making them priority candidates for RSV vaccination discussions. The 62–117% increased LRTD risk in HRC patients supports proactive RSV prevention strategies well before age 65."}},{"doi":"10.1016/j.ajt.2026.04.010","pmid":"42177030","title":"A Phase 2 Multi-Center, Prospective, Randomized, Double-Blind Study to Assess the Clinical and Antiviral Efficacy and Safety of Nitazoxanide for the Treatment of Norovirus in Hematopoietic Stem Cell and Solid Organ Transplant Recipients","journal_title":"American Journal of Transplantation","journal_issn":"1600-6135","published_at":"2026-05-22T00:00:00.000Z","url":"http://dx.doi.org/10.1093/ofid/ofad500.965","source_score":8,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-29T13:23:08.195Z","updated_at":"2026-05-29T13:23:08.195Z","tags":[{"paper_doi":"10.1016/j.ajt.2026.04.010","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.04.010","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.04.010","tag_type":"condition","value":"Hematopoietic Stem Cell Transplant","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.04.010","tag_type":"condition","value":"Norovirus Infection","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.04.010","tag_type":"condition","value":"Solid Organ Transplant","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.04.010","tag_type":"generic","value":"nitazoxanide","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.04.010","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.04.010","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.04.010","tag_type":"modality","value":"Antiparasitic / Antiviral Agent","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.04.010","tag_type":"sample_size","value":"n=31","value_numeric":31},{"paper_doi":"10.1016/j.ajt.2026.04.010","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.04.010","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.04.010","tag_type":"warning","value":"Full text was inaccessible — all data extracted from the abstract only; additional subgroup or safety data may exist in the full publication.","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.04.010","tag_type":"warning","value":"Only 1 of 31 subjects was an HSCT recipient, making the study effectively a solid organ transplant study despite the broader enrollment criteria.","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.04.010","tag_type":"warning","value":"Sample size is very small (n=31); the trial was likely underpowered, so a true treatment effect cannot be fully excluded.","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.04.010","tag_type":"warning","value":"The DOI and URL appear to reference different journals (American Journal of Transplantation vs. Open Forum Infectious Diseases); the primary source journal should be verified.","value_numeric":null}],"summaries":{"what_studied":"This Phase 2 RCT evaluated nitazoxanide vs. placebo (1:1, 56 doses) for norovirus infection in adult transplant recipients (mostly solid organ) with a positive stool NoV PCR and active GI symptoms, followed for 6 months (enrollment 2018–2021, n=31).","key_result":"Nitazoxanide did not shorten time to symptom resolution (median 19.0 days vs. 11.0 days for placebo; p=0.459) or time to first negative stool NoV PCR (p=0.873). No serious adverse events were attributed to nitazoxanide.","limitations":"- Very small sample size (n=31; 16 nitazoxanide, 15 placebo), likely underpowered to detect a clinically meaningful difference.\n- Nearly all subjects were solid organ transplant recipients (30/31), limiting generalizability to hematopoietic stem cell transplant (HSCT) patients.\n- No full-text available; summary based on abstract only.","practice_takeaway":"Nitazoxanide appears safe but does not improve symptom resolution or viral clearance in transplant patients with chronic norovirus — clinicians should not rely on it for NoV management in this population. Supportive care and immunosuppression reduction remain the primary strategies."}},{"doi":"10.1097/qco.0000000000001205","pmid":"42107119","title":"Managing multidrug resistant Gram-negative bacteraemia in immunocompromised hosts","journal_title":"Current Opinion in Infectious Diseases","journal_issn":"0951-7375","published_at":"2026-05-07T00:00:00.000Z","url":"https://doi.org/10.1097/qco.0000000000001205","source_score":11,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-18T13:25:33.561Z","updated_at":"2026-05-18T13:25:33.561Z","tags":[{"paper_doi":"10.1097/qco.0000000000001205","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001205","tag_type":"category","value":"Infectious Diseases","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001205","tag_type":"condition","value":"Carbapenem-Resistant Infection","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001205","tag_type":"condition","value":"Haematological Malignancy","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001205","tag_type":"condition","value":"Multidrug-Resistant Gram-Negative Bacteraemia","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001205","tag_type":"condition","value":"Solid Organ Transplant","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001205","tag_type":"generic","value":"cefiderocol","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001205","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001205","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001205","tag_type":"modality","value":"Beta-Lactam/Beta-Lactamase Inhibitor Combination","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001205","tag_type":"modality","value":"Siderophore Cephalosporin","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001205","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001205","tag_type":"warning","value":"Study design is classified as 'Narrative Review' based on the abstract language ('we summarize current evidence'); this cannot be confirmed without the full text.","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001205","tag_type":"warning","value":"The full text of the article was not accessible — only the abstract was provided. All extracted content is based solely on the abstract. Specific data, patient numbers, outcome statistics, and detailed recommendations could not be verified.","value_numeric":null},{"paper_doi":"10.1097/qco.0000000000001205","tag_type":"warning","value":"The PDF content retrieved appears to be a Lippincott author permissions document, not the article itself. Summaries and tags are derived entirely from the abstract metadata.","value_numeric":null}],"summaries":{"what_studied":"This review summarizes current evidence and practical approaches for managing multidrug-resistant Gram-negative bloodstream infections (MDR-GNBSI) in immunocompromised hosts — specifically solid organ transplant (SOT) recipients and patients with haematological malignancy (HM) — covering empirical, quasi-targeted, and targeted therapy strategies.","key_result":"Risk-adapted empirical therapy (incorporating prior colonization, local epidemiology, and individual risk factors), rapid diagnostic testing, novel β-lactam/β-lactamase inhibitor combinations, and cefiderocol expand treatment options for carbapenem-resistant strains; machine-learning models and structured BSI bundles are emerging as stewardship tools.","limitations":"The full text of the article was not retrievable — only the abstract was available. No primary data, specific patient outcomes, or quantitative results could be extracted or verified from the source.","practice_takeaway":"For immunocompromised patients with MDR-GNBSI, individualize therapy using colonization screening, local epidemiology, and PK/PD optimization; novel β-lactam/β-lactamase inhibitor combinations and cefiderocol are key options for carbapenem-resistant organisms. Routine follow-up blood cultures remain controversial, and evidence supports considering oral step-down and shorter courses where appropriate."}},{"doi":"10.1111/ajd.70134","pmid":"42077056","title":"A Narrative Review of the Factors Impacting Solid Organ Transplant Recipient Participation in Skin Cancer Screening","journal_title":"Australasian Journal of Dermatology","journal_issn":"0004-8380","published_at":"2026-05-04T00:00:00.000Z","url":"https://doi.org/10.1111/ajd.70134","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-07T17:34:07.817Z","updated_at":"2026-05-07T17:34:07.817Z","tags":[{"paper_doi":"10.1111/ajd.70134","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1111/ajd.70134","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.1111/ajd.70134","tag_type":"condition","value":"Skin Cancer","value_numeric":null},{"paper_doi":"10.1111/ajd.70134","tag_type":"condition","value":"Solid Organ Transplant","value_numeric":null},{"paper_doi":"10.1111/ajd.70134","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1111/ajd.70134","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1111/ajd.70134","tag_type":"modality","value":"Immunosuppressive Therapy","value_numeric":null},{"paper_doi":"10.1111/ajd.70134","tag_type":"sample_size","value":"n=17 studies","value_numeric":17},{"paper_doi":"10.1111/ajd.70134","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/ajd.70134","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1111/ajd.70134","tag_type":"warning","value":"Narrative review methodology means no formal quality assessment or meta-analysis was performed; conclusions are qualitative.","value_numeric":null},{"paper_doi":"10.1111/ajd.70134","tag_type":"warning","value":"Sample size tag reflects the number of included studies (n=17), not individual patients — no patient-level N was reported.","value_numeric":null},{"paper_doi":"10.1111/ajd.70134","tag_type":"warning","value":"Study populations likely skew adult given transplant context, but age distribution across included studies is not specified.","value_numeric":null}],"summaries":{"what_studied":"This narrative review examined factors affecting solid organ transplant recipients' (SOTRs) participation in full skin examinations (FSEs) for skin cancer screening, synthesizing 17 studies across patient-, clinician-, and system-level domains.","key_result":"Screening adherence varied widely across countries and healthcare settings; patient-level barriers were mostly sociodemographic, clinician-level barriers included low guideline awareness and under-prioritization of skin cancer risk, and system-level facilitators such as structured protocols and dermatologist access improved uptake.","limitations":"Narrative review design limits systematic appraisal of evidence quality; only 17 studies were identified, suggesting a sparse literature base; findings may not generalize across different transplant types or healthcare systems.","practice_takeaway":"Clinicians caring for SOTRs should proactively refer patients for regular full skin examinations and advocate for structured screening protocols, as both clinician awareness and system-level supports are key drivers of uptake in this high-risk group."}},{"doi":"10.1111/ctr.70552","pmid":"42053990","title":"Refractory, Resistant and Recurrent Cytomegalovirus Infections in Solid Organ Transplant Recipients: Risk Factors and Clinical Outcomes","journal_title":"Clinical Transplantation","journal_issn":"0902-0063","published_at":"2026-04-29T00:00:00.000Z","url":"https://doi.org/10.1111/ctr.70552","source_score":18,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-05-03","doi":"10.1111/ctr.70552","days":"14","issn":"0902-0063","rank":"8","field":"Clinical Medicine","score":"18","category":"Surgery","categories":["Surgery"],"_categories":["Surgery"]},"pubmed":{"doi":"10.1111/ctr.70552","title":"Refractory, Resistant and Recurrent Cytomegalovirus Infections in Solid Organ Transplant Recipients: Risk Factors and Clinical Outcomes.","journal":"Clinical transplantation","methods":"","results":"We included 145 SOT recipients with csCMVi, majority were liver transplant (49%). Most common induction was an anti-IL-2 antibody (43.9%). The majority (n = 82; 56.5%) were CMV D+/R- mismatch and presented asymptomatic infection (50.3%). After the initial 3 weeks of antiviral therapy, 13 (8.9%) patients had probable refractory csCMVi; most of them (10 [76.9%]) were CMV D+/R- mismatch. Longer time after transplant had lower risk (OR 0.68; CI 0.48-0.95, p = 0.029) while lower absolute lymphocyte count (ALC) had a higher risk of early refractory csCMVi (OR 1.54; CI 1.01-2.44, p = 0.048). Drug-resistant csCMVi occurred in 7 patients (4.8%); a high initial CMV DNA level was associated with resistant csCMVi (OR 2.00; CI 1.08-3.93, p = 0.031). 25 patients (17.2%) experienced recurrent csCMVi within 6 months. 30 patients (20.7%) died; refractory, resistant or recurrent CMV infections were not associated with mortality.","abstract":"$30","keywords":["CMV D+/R‐ mismatch","CMV viral load","Cytomegalovirus (CMV)","antiviral resistance","lymphopenia","post transplant infection","refractory CMV infection","solid organ transplantation (SOT)"],"pubmed_id":"42053990","conclusions":"Refractory csCMVi is associated with a low ALC and an earlier onset after transplant. Resistant csCMVi is associated with high initial CMV DNA levels. Recurrence of csCMVi is common and potentially associated with low ALC at the end of antiviral treatment.","publication_date":"2026-04-29T00:00:00"},"crossref":{"DOI":"10.1111/ctr.70552","URL":"https://doi.org/10.1111/ctr.70552","ISSN":["0902-0063","1399-0012"],"link":[{"URL":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/ctr.70552","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://onlinelibrary.wiley.com/doi/full-xml/10.1111/ctr.70552","content-type":"application/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/ctr.70552","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":"5","score":1,"title":["Refractory, Resistant and Recurrent Cytomegalovirus Infections in Solid Organ Transplant Recipients: Risk Factors and Clinical Outcomes"],"author":[{"given":"Bismarck Steven","family":"Bisono‐Garcia","sequence":"first","affiliation":[{"name":"Division of Public Health, Infectious Diseases, and Occupational Medicine Mayo Clinic Rochester Minnesota USA"},{"name":"Division of Hospital Internal Medicine Mayo Clinic Rochester Minnesota USA"}]},{"given":"Christopher Anh‐Thao","family":"Dinh","sequence":"additional","affiliation":[{"name":"Division of Hospital Internal Medicine Mayo Clinic Rochester Minnesota USA"}]},{"given":"Benjo","family":"Ato","sequence":"additional","affiliation":[{"name":"University of the Philippines and the Philippine General Hospital Manila Philippines"}]},{"given":"Vaisak O","family":"Nair","sequence":"additional","affiliation":[{"name":"Division of Public Health, Infectious Diseases, and Occupational Medicine Mayo Clinic Rochester Minnesota USA"},{"name":"ID Care Hillsborough New Jersey USA"}]},{"given":"Zachary A.","family":"Yetmar","sequence":"additional","affiliation":[{"name":"Division of Public Health, Infectious Diseases, and Occupational Medicine Mayo Clinic Rochester Minnesota USA"},{"name":"Department of Infectious Disease Cleveland Clinic Foundation Cleveland Ohio USA"}]},{"given":"Raymund R.","family":"Razonable","sequence":"additional","affiliation":[{"name":"Division of Public Health, Infectious Diseases, and Occupational Medicine Mayo Clinic Rochester Minnesota 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virologic/resistance-proven refractory disease, introducing potential misclassification.","value_numeric":null},{"paper_doi":"10.1111/ctr.70552","tag_type":"warning","value":"Very small subgroup for drug-resistant CMV (n=7) — odds ratio estimates for resistance should be interpreted with caution.","value_numeric":null}],"summaries":{"what_studied":"This retrospective multicenter cohort study evaluated risk factors and clinical outcomes of refractory, resistant, and recurrent clinically significant CMV infection (csCMVi) in 145 solid organ transplant (SOT) recipients with csCMVi between 2010–2016.","key_result":"8.9% (n=13) developed probable refractory csCMVi — linked to lower absolute lymphocyte count (ALC; OR 1.54) and earlier post-transplant onset (OR 0.68); 4.8% (n=7) had drug-resistant csCMVi — linked to high initial CMV DNA (OR 2.00); 17.2% (n=25) had recurrence within 6 months; 20.7% (n=30) died, but refractory/resistant/recurrent CMV was not independently associated with mortality.","limitations":"- Retrospective design limits causal inference and may introduce selection and documentation bias.\n- Small sample size (n=145), especially for resistant CMV (n=7), limits statistical power.\n- Study period (2010–2016) predates newer antivirals (e.g., letermovir, maribavir), reducing contemporary applicability.","practice_takeaway":"Monitor ALC closely in SOT recipients with CMV infection — low ALC raises risk of both refractory and recurrent disease. A high initial CMV DNA load should prompt heightened vigilance for antiviral resistance."}}],"initialOffset":8,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Solid Organ Transplant"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Solid Organ Transplant"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Solid Organ Transplant"}}}]]

Papers