Infections and solid organ transplant rejection

A cause-and-effect relationship?

Research output: Contribution to journalReview article

110 Citations (Scopus)

Abstract

Although evidence is far from being conclusive, several studies have suggested that infections could trigger rejection in different transplant settings. In this review we examine the evidence linking cytomegalovirus (CMV), adenovirus, enterovirus, parvovirus, and herpes simplex virus infections to the vasculopathy leading to cardiac allograft rejection, the association between CMV and chronic kidney, lung, and liver graft rejection, and the association of human herpesvirus 6 reactivation with CMV-related disease in kidney and liver transplant recipients. We also review the numerous antiviral prophylactic or pre-emptive treatments in use to control CMV infection, and suggest that they do not limit immune reactions leading to graft rejection or lower the risk of developing post-transplantation atherosclerosis in allograft recipients. Finally, we emphasise the need for prospective, international studies to clarify the role of infections in transplant rejection, to look at virus-to-virus interactions, and to establish specific therapeutic strategies. Such strategies must not rely exclusively on expensive antiviral agents but also on vaccination or other, innovative approaches, such as the use of agents able to inhibit the activity of natural killer cells, which might have an important role in acute allograft rejection.

Original languageEnglish
Pages (from-to)539-549
Number of pages11
JournalLancet Infectious Diseases
Volume2
Issue number9
DOIs
Publication statusPublished - Sep 2002
Externally publishedYes

Fingerprint

Graft Rejection
Cytomegalovirus
Allografts
Transplants
Antiviral Agents
Infection
Viruses
Human Herpesvirus 6
Parvovirus
Enterovirus
Cytomegalovirus Infections
Kidney Diseases
Virus Diseases
Simplexvirus
Adenoviridae
Natural Killer Cells
Liver Diseases
Atherosclerosis
Vaccination
Transplantation

ASJC Scopus subject areas

  • Infectious Diseases

Cite this

Infections and solid organ transplant rejection : A cause-and-effect relationship? / Cainelli, Francesca; Vento, Sandro.

In: Lancet Infectious Diseases, Vol. 2, No. 9, 09.2002, p. 539-549.

Research output: Contribution to journalReview article

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