2023
Rapid antimicrobial resistance detection methods for bloodstream infection in solid organ transplantation: Proposed clinical guidance, unmet needs, and future directions
Turbett S, Banach D, Bard J, Gandhi R, Letourneau A, Azar M. Rapid antimicrobial resistance detection methods for bloodstream infection in solid organ transplantation: Proposed clinical guidance, unmet needs, and future directions. Transplant Infectious Disease 2023, 25: e14113. PMID: 37594214, DOI: 10.1111/tid.14113.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsMeSH KeywordsAnti-Bacterial AgentsAnti-Infective AgentsCommunicable DiseasesDrug Resistance, BacterialHumansOrgan TransplantationSepsisTransplant RecipientsConceptsUnmet needSolid organ transplant recipientsOrgan transplant recipientsSolid organ transplantationTransplant infectious diseasesEffective antimicrobial therapyPositive blood culturesFast institutionSOT recipientsTransplant recipientsDiagnostic stewardshipBloodstream infectionsAntimicrobial therapyBlood culturesClinical guidanceOrgan transplantationConsensus conferenceClinical practiceInfectious diseasesClinical microbiologyAmerican SocietyTransplantationResistance detectionBacterial resistanceRecipientsCurrent Concepts in the Diagnosis and Management of Pneumocystis Pneumonia in Solid Organ Transplantation
Trubin P, Azar M. Current Concepts in the Diagnosis and Management of Pneumocystis Pneumonia in Solid Organ Transplantation. Infectious Disease Clinics Of North America 2023, 37: 617-640. PMID: 37142510, DOI: 10.1016/j.idc.2023.03.005.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsMeSH KeywordsHumansImmunocompromised HostOrgan TransplantationPneumocystis cariniiPneumonia, PneumocystisTrimethoprim, Sulfamethoxazole Drug CombinationConceptsSolid organ transplant recipientsOrgan transplant recipientsFirst-choice agentsSolid organ transplantationAppropriate clinical contextTransplant recipientsInterstitial pneumoniaTrimethoprim-sulfamethoxazoleOptimal treatmentPneumocystis pneumoniaOrgan transplantationInfection manifestsPrevention strategiesNucleic acid amplificationDiagnostic testingRadiographic imagingTissue samplingClinical contextLung fluidCurrent conceptsHost susceptibilityPneumoniaAcid amplificationTreatmentProphylaxis
2022
A consensus conference to define the utility of advanced infectious disease diagnostics in solid organ transplant recipients
Azar MM, Turbett S, Gaston D, Gitman M, Razonable R, Koo S, Hanson K, Kotton C, Silveira F, Banach DB, Basu SS, Bhaskaran A, Danziger-Isakov L, Bard JD, Gandhi R, Hanisch B, John TM, John A, Letourneau AR, Luong M, Maron G, Miller S, Prinzi A, Schwartz I, Simner P, Kumar D, Group O. A consensus conference to define the utility of advanced infectious disease diagnostics in solid organ transplant recipients. American Journal Of Transplantation 2022, 22: 3150-3169. PMID: 35822346, DOI: 10.1111/ajt.17147.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsOrgan transplant recipientsTransplant recipientsConsensus conferenceSolid organ transplant recipientsInfectious diseasesSetting of transplantationInfectious disease diagnosticsTransplant infectious diseasesHigh-quality evidenceEvidence-based recommendationsMultiplex molecular assaysNext-generation sequencing assayDiagnostic stewardshipConsensus statementUnmet needMass spectrometry-based assayClinical useRecipientsClinical microbiologyMolecular assaysAmerican SocietyTransplantationFinancial barriersDiseaseSequencing assaysEvaluating clinical effectiveness of SARS‐CoV‐2 vaccine in solid organ transplant recipients: A propensity score matched analysis
Tucker M, Azar MM, Cohen E, Gan G, Deng Y, Palacios C, Malinis M. Evaluating clinical effectiveness of SARS‐CoV‐2 vaccine in solid organ transplant recipients: A propensity score matched analysis. Transplant Infectious Disease 2022, 24: e13876. PMID: 35684932, PMCID: PMC9348300, DOI: 10.1111/tid.13876.Peer-Reviewed Original ResearchConceptsSolid organ transplant recipientsSARS-CoV-2 infectionOrgan transplant recipientsCritical COVID-19Clinical effectivenessTransplant recipientsVaccine eraVaccinated solid organ transplant recipientsCOVID-19Propensity score-matched cohortSARS-CoV-2 vaccinationSevere coronavirus disease 2019Cause-specific Cox regression modelsCOVID-19-related mortalitySARS-CoV-2 vaccinesSARS-CoV-2 infection ratesCurrent vaccine recommendationsKey preventative strategiesPrimary vaccine seriesRetrospective cohort studyDoses of mRNACox regression modelCoronavirus disease 2019Poisson regression modelsVaccine seriesReal‐world experience with available, outpatient COVID‐19 therapies in solid organ transplant recipients during the omicron surge
Radcliffe C, Palacios CF, Azar MM, Cohen E, Malinis M. Real‐world experience with available, outpatient COVID‐19 therapies in solid organ transplant recipients during the omicron surge. American Journal Of Transplantation 2022, 22: 2458-2463. PMID: 35583664, PMCID: PMC9348251, DOI: 10.1111/ajt.17098.Peer-Reviewed Original ResearchConceptsSolid organ transplant recipientsOral antiviral agentsOrgan transplant recipientsOutpatient therapyTransplant recipientsAntiviral agentsCOVID-19-related morbidityMonoclonal antibodiesKidney transplant recipientsRate of hospitalizationCOVID-19 therapyReal-world effectivenessSARS-CoV-2 pandemicCOVID-19 diagnosisModerate diseaseRetrospective reviewMean ageOutpatient settingClinical trialsSubstantial burdenTherapyCoronavirus diseaseMean timeHealthcare systemReal-world experienceDematiaceous fungal infections in solid organ transplantation: Systematic review and Bayesian meta‐analysis
Radcliffe C, Radcliffe AJ, Azar MM, Grant M. Dematiaceous fungal infections in solid organ transplantation: Systematic review and Bayesian meta‐analysis. Transplant Infectious Disease 2022, 24: e13819. PMID: 35253959, DOI: 10.1111/tid.13819.Peer-Reviewed Original ResearchMeSH KeywordsAntifungal AgentsBayes TheoremChildHumansMaleMiddle AgedMycosesOrgan TransplantationTransplant RecipientsConceptsSolid organ transplant recipientsDematiaceous fungal infectionSoft tissue infectionsFungal infectionsInfectious syndromesSystematic reviewEarly post-transplant periodCentral nervous system infectionCommon infectious syndromesPost-transplant periodNervous system infectionOrgan transplant recipientsSolid organ transplantationEnglish-language reportsInfection typeKidney recipientsLiver recipientsPediatric reportsTransplant recipientsPulmonary infectionSystem infectionTissue infectionsWorse prognosisDisseminated infectionMean ageClinical effectiveness of additional primary SARS‐CoV‐2 vaccine doses for solid organ transplant recipients
Radcliffe C, Azar MM, Cohen E, Tucker M, Grubaugh ND, Malinis M. Clinical effectiveness of additional primary SARS‐CoV‐2 vaccine doses for solid organ transplant recipients. Clinical Transplantation 2022, 36: e14601. PMID: 35064939, DOI: 10.1111/ctr.14601.Commentaries, Editorials and Letters
2021
Longitudinal Immune Profiling of a Severe Acute Respiratory Syndrome Coronavirus 2 Reinfection in a Solid Organ Transplant Recipient
Klein J, Brito AF, Trubin P, Lu P, Wong P, Alpert T, Peña-Hernández MA, Haynes W, Kamath K, Liu F, Vogels CBF, Fauver JR, Lucas C, Oh J, Mao T, Silva J, Wyllie AL, Muenker MC, Casanovas-Massana A, Moore AJ, Petrone ME, Kalinich CC, Dela Cruz C, Farhadian S, Ring A, Shon J, Ko AI, Grubaugh ND, Israelow B, Iwasaki A, Azar MM, Team F. Longitudinal Immune Profiling of a Severe Acute Respiratory Syndrome Coronavirus 2 Reinfection in a Solid Organ Transplant Recipient. The Journal Of Infectious Diseases 2021, 225: 374-384. PMID: 34718647, PMCID: PMC8807168, DOI: 10.1093/infdis/jiab553.Peer-Reviewed Original ResearchMeSH KeywordsAgedAntibodies, NeutralizingAntibodies, ViralCOVID-19HumansMaleOrgan TransplantationPhylogenyReinfectionSARS-CoV-2Transplant RecipientsConceptsSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfectionLongitudinal immune profilingTransplant recipientsImmune profilingPrimary SARS-CoV-2 infectionCD4 T cell poolMale renal transplant recipientSolid organ transplant recipientsSARS-CoV-2 reinfectionSARS-CoV-2 antibodiesSARS-CoV-2 infectionWhole viral genome sequencingRenal transplant recipientsImmune escape mutationsOrgan transplant recipientsT cell poolTime of reinfectionCoronavirus disease 2019Lower neutralization titersHumoral memory responsesViral genome sequencingInitial diagnosisImmunologic deficiencyHumoral responseImmunologic investigationsChanging trends in mortality among solid organ transplant recipients hospitalized for COVID‐19 during the course of the pandemic
Heldman MR, Kates OS, Safa K, Kotton CN, Georgia SJ, Steinbrink JM, Alexander BD, Hemmersbach‐Miller M, Blumberg EA, Multani A, Haydel B, La Hoz RM, Moni L, Condor Y, Flores S, Munoz CG, Guitierrez J, Diaz EI, Diaz D, Vianna R, Guerra G, Loebe M, Rakita RM, Malinis M, Azar MM, Hemmige V, McCort ME, Chaudhry ZS, Singh PP, Kramer K, Velioglu A, Yabu JM, Morillis JA, Mehta SA, Tanna SD, Ison MG, Derenge AC, van Duin D, Maximin A, Gilbert C, Goldman JD, Lease ED, Fisher CE, Limaye AP, Team T. Changing trends in mortality among solid organ transplant recipients hospitalized for COVID‐19 during the course of the pandemic. American Journal Of Transplantation 2021, 22: 279-288. PMID: 34514710, PMCID: PMC8653312, DOI: 10.1111/ajt.16840.Peer-Reviewed Original ResearchConceptsSolid organ transplant recipientsOrgan transplant recipientsTransplant recipientsCOVID-19IL-6/ILComorbidity-adjusted mortalityUse of corticosteroidsUse of hydroxychloroquineMultivariable logistic regressionBaseline comorbiditiesMulticenter registryImproved survivalReceptor inhibitorsGeneral populationMortality trendsMortalityLogistic regressionFurther studiesLater periodRecipientsCorticosteroidsComorbiditiesHydroxychloroquinePandemicPatientsResponse to “SARS‐CoV‐2 vaccine effectiveness trumps immunogenicity in solid organ transplant recipients”
Malinis M, Cohen E, Azar MM. Response to “SARS‐CoV‐2 vaccine effectiveness trumps immunogenicity in solid organ transplant recipients”. American Journal Of Transplantation 2021, 21: 4106-4107. PMID: 34328268, PMCID: PMC8441690, DOI: 10.1111/ajt.16770.Commentaries, Editorials and LettersCOVID‐19 in hospitalized lung and non‐lung solid organ transplant recipients: A comparative analysis from a multicenter study
Heldman MR, Kates OS, Safa K, Kotton CN, Georgia SJ, Steinbrink JM, Alexander BD, Hemmersbach‐Miller M, Blumberg EA, Crespo MM, Multani A, Lewis AV, Beaird O, Haydel B, La Hoz RM, Moni L, Condor Y, Flores S, Munoz CG, Guitierrez J, Diaz EI, Diaz D, Vianna R, Guerra G, Loebe M, Rakita RM, Malinis M, Azar MM, Hemmige V, McCort ME, Chaudhry ZS, Singh P, Hughes K, Velioglu A, Yabu JM, Morillis JA, Mehta SA, Tanna SD, Ison MG, Tomic R, Derenge A, van Duin D, Maximin A, Gilbert C, Goldman JD, Sehgal S, Weisshaar D, Girgis RE, Nelson J, Lease ED, Limaye AP, Fisher CE, Team T. COVID‐19 in hospitalized lung and non‐lung solid organ transplant recipients: A comparative analysis from a multicenter study. American Journal Of Transplantation 2021, 21: 2774-2784. PMID: 34008917, PMCID: PMC9215359, DOI: 10.1111/ajt.16692.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCohort StudiesCOVID-19HumansLungOrgan TransplantationSARS-CoV-2Transplant RecipientsConceptsSolid organ transplant recipientsLung transplant recipientsOrgan transplant recipientsTransplant recipientsRisk factorsAllograft dysfunctionAdult solid organ transplant recipientsCOVID-19High mortalityChronic lung allograft dysfunctionOnly independent risk factorMultivariable logistic regression modelChronic allograft dysfunctionComorbidity-adjusted mortalityLung allograft dysfunctionMulticenter cohort studyIndependent risk factorCoronavirus disease 2019Logistic regression modelsLung transplantCohort studyHeart failureMulticenter studyDisease 2019MortalityEffectiveness of SARS‐CoV‐2 vaccination in fully vaccinated solid organ transplant recipients
Malinis M, Cohen E, Azar MM. Effectiveness of SARS‐CoV‐2 vaccination in fully vaccinated solid organ transplant recipients. American Journal Of Transplantation 2021, 21: 2916-2918. PMID: 34101990, PMCID: PMC8222879, DOI: 10.1111/ajt.16713.Peer-Reviewed Original Research
2020
Healthcare resource use among solid organ transplant recipients hospitalized with COVID‐19
Heldman MR, Kates OS, Haydel BM, Florman SS, Rana MM, Chaudhry ZS, Ramesh MS, Safa K, Kotton CN, Blumberg EA, Besharatian BD, Tanna SD, Ison MG, Malinis M, Azar MM, Rakita RM, Morillas JA, Majeed A, Sait AS, Spaggiari M, Hemmige V, Mehta SA, Neumann H, Badami A, Jeng A, Goldman JD, Lala A, Hemmersbach‐Miller M, McCort ME, Bajrovic V, Ortiz‐Bautista C, Friedman‐Moraco R, Sehgal S, Lease ED, Limaye AP, Fisher CE. Healthcare resource use among solid organ transplant recipients hospitalized with COVID‐19. Clinical Transplantation 2020, 35: e14174. PMID: 33349940, PMCID: PMC7883125, DOI: 10.1111/ctr.14174.Peer-Reviewed Original ResearchCOVID-19Health ResourcesHumansInpatientsOrgan TransplantationPandemicsTransplant RecipientsUnited StatesClinicopathologic Features of Tissue Granulomas in Transplant Recipients: A Single Center Study in a Nontuberculosis Endemic Region.
Nussbaum EZ, Patel KK, Assi R, Raad RA, Malinis M, Azar MM. Clinicopathologic Features of Tissue Granulomas in Transplant Recipients: A Single Center Study in a Nontuberculosis Endemic Region. Archives Of Pathology & Laboratory Medicine 2020, 145: 988-999. PMID: 33290524, DOI: 10.5858/arpa.2020-0271-oa.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedBartonellaBiopsyCommunicable DiseasesConnecticutCytomegalovirusFemaleGranulomaHematopoietic Stem Cell TransplantationHumansMaleMiddle AgedOrgan TransplantationPrevalenceRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsTransplantation, HomologousTreatment OutcomeYoung AdultConceptsEpidemiologic risk factorsPresence of symptomsInfectious etiologyAsymptomatic patientsTransplant recipientsTissue granulomasClinicopathologic featuresRisk factorsAllogeneic hematopoietic stem cell transplant recipientsHematopoietic stem cell transplant recipientsStem cell transplant recipientsYale-New Haven HospitalCommon infectious etiologiesLarge transplant populationCell transplant recipientsSingle-center studyCryptogenic organizing pneumoniaNew Haven HospitalRoutine disease surveillancePaucity of literatureCytomegalovirus hepatitisPosttransplant specimensBiopsy indicationOrganizing pneumoniaTransplant patientsClinical implications of SARS-CoV-2 cycle threshold values in solid organ transplant recipients
Gaston DC, Malinis M, Osborn R, Peaper DR, Landry M, Juthani-Mehta M, Azar MM. Clinical implications of SARS-CoV-2 cycle threshold values in solid organ transplant recipients. American Journal Of Transplantation 2020, 21: 1304-1311. PMID: 33043603, PMCID: PMC7675520, DOI: 10.1111/ajt.16357.Peer-Reviewed Original ResearchConceptsSolid organ transplant recipientsOrgan transplant recipientsClinical implicationsCycle threshold valuesSOT patientsTransplant recipientsSymptom onsetYale New Haven Health SystemUpper respiratory tract samplesSARS-CoV-2 viral RNASARS-CoV-2 viral dynamicsAdult SOT recipientsRetrospective chart reviewRespiratory tract samplesSARS-CoV-2 cycle threshold valuesInfection prevention measuresCOVID-19 severityViral RNAHigher clinical acuityPrimary diagnostic testRT-PCR assaysSOT recipientsChart reviewViral loadAdmission severityCoronavirus Disease 2019 in Solid Organ Transplant: A Multicenter Cohort Study
Kates OS, Haydel BM, Florman SS, Rana MM, Chaudhry ZS, Ramesh MS, Safa K, Kotton CN, Blumberg EA, Besharatian BD, Tanna SD, Ison MG, Malinis M, Azar MM, Rakita RM, Morilla JA, Majeed A, Sait AS, Spaggiari M, Hemmige V, Mehta SA, Neumann H, Badami A, Goldman JD, Lala A, Hemmersbach-Miller M, McCort ME, Bajrovic V, Ortiz-Bautista C, Friedman-Moraco R, Sehgal S, Lease ED, Fisher CE, Limaye AP, Arya A, Jeng A, Kuo A, Luk A, Puing A, Rossi A, Brueckner A, Multani A, Keller B, Derringer D, Florescu D, Dominguez E, Sandoval E, Bilgili E, Hashim F, Silveira F, Haidar G, Joharji H, Murad H, Gani I, el-amm J, Kahwaji J, Popoola J, Yabu J, Hughes K, Saharia K, Gajurel K, Bowman L, Veroux M, Morales M, Fung M, Theodoropoulos N, de la Cruz O, Kapoor R, La Hoz R, Allam S, Vora S, McCarty T, Anderson-Haag T, Malhotra U, Kelly U, Bhandaram V, Bennett W, Lominadze Z. Coronavirus Disease 2019 in Solid Organ Transplant: A Multicenter Cohort Study. Clinical Infectious Diseases 2020, 73: e4090-e4099. PMID: 32766815, PMCID: PMC7454362, DOI: 10.1093/cid/ciaa1097.Peer-Reviewed Original ResearchMeSH KeywordsCohort StudiesCOVID-19HumansMaleMiddle AgedOrgan TransplantationSARS-CoV-2Transplant RecipientsConceptsSOT recipientsUnderlying comorbiditiesCohort studyLaboratory-confirmed COVID-19Solid organ transplant recipientsMulti-center cohort studyCOVID-19Multicenter cohort studyOrgan transplant recipientsPredictors of mortalitySolid organ transplantsMultivariable logistic regressionKidney/pancreasCoronavirus disease 2019 (COVID-19) pandemicElectronic case report formCase report formsDisease 2019 pandemicImmunosuppression intensityStandardized intakePrimary endpointTransplant recipientsHospitalized patientsMedian ageTransplant centersClinical featuresOrally Administered Human Immunoglobulin Therapy for Norovirus Enteritis in Solid Organ Transplant Recipients: A Case Series at a Single Academic Transplant Center
Nussbaum EZ, Azar M, Cohen E, McManus D, Topal J, Malinis M. Orally Administered Human Immunoglobulin Therapy for Norovirus Enteritis in Solid Organ Transplant Recipients: A Case Series at a Single Academic Transplant Center. Clinical Infectious Diseases 2020, 71: e206-e209. PMID: 31999825, DOI: 10.1093/cid/ciaa093.Peer-Reviewed Original ResearchMeSH KeywordsEnteritisHumansImmunization, PassiveImmunoglobulinsNorovirusOrgan TransplantationRetrospective StudiesTransplant RecipientsConceptsSolid organ transplant recipientsOrgan transplant recipientsNorovirus enteritisTransplant recipientsAcademic transplant centersHuman immunoglobulin therapyEffective treatment modalityImmunoglobulin therapySOT recipientsCase seriesTransplant centersIntractable diarrheaTreatment modalitiesMedical recordsHuman immunoglobulinEnteritisRecipientsDiarrheaTherapyImmunoglobulinEmerging Microbiology Diagnostics for Transplant Infections: On the Cusp of a Paradigm Shift.
Azar MM, Gaston DC, Kotton CN, Malinis MF. Emerging Microbiology Diagnostics for Transplant Infections: On the Cusp of a Paradigm Shift. Transplantation 2020, 104: 1358-1384. PMID: 31972701, DOI: 10.1097/tp.0000000000003123.BooksConceptsHematopoietic stem cell transplantationInfected transplant recipientsInfectious disease specialistsStem cell transplantationBlood culture specimensArray of pathogensTransplant recipientsTransplant cliniciansClinical outcomesDisease specialistsCell transplantationTransplant infectionsMagnetic resonance-based methodsMicrobiology diagnosticsSolid organsCulture specimensMolecular testingMolecular panelResistance determinantsInfectionOutcomesDiagnostic microbiologyResonance-based methodsPatientsTransplantation