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Infection prevention is critical for transplant patients
Each year, ~150,000 transplants are performed worldwide, requiring immunosuppressive therapies to prevent acute rejection.
Unfortunately, immunocompromised transplant patients are highly susceptible to post-operative infections.
These conventional and opportunistic infections are an important cause of morbidity and mortality in transplant recipients.
Are you managing infection risk?
Protect your patients with QuantiFERON immune monitoring
Find freedom from CMV-related events
Cytomegalovirus (CMV) is the most common and problematic viral infection in solid organ transplant recipients.
What can you do when CMV viral load assays and CMV IgG antibody testing aren’t providing a complete picture of your patient’s immune status?
Recent international transplant guidelines state that the assessment of CMV cell-mediated immunity (CMI) can be used to inform the risk of CMV infection (1). In addition, recent interventional studies have demonstrated the potential clinical utility of using a CMV T cell immunity test in clinical practice to guide antiviral prophylaxis (2, 3).
Maintain the optimal therapeutic window for your patients
An estimated 40–70% of posttransplant mortality is attributable to the immunosuppression of the transplant recipient (6). An over-immunosuppressed patient is susceptible to opportunistic infections and drug toxicity. But an under-immunosuppressed patient can experience allograft rejection (7, 8).
Are crude markers like therapeutic drug monitoring and clinical events enough to predict your patients’ outcomes? To move towards individualized patient management, you need to complement existing methods with novel and objective markers of immune function that can aid in maintaining the optimal therapeutic window for your patients (6, 9).
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References
(1) Kotton, C.N. et al. (2018) The third international consensus guidelines on the management of Cytomegalovirus in solid-organ transplantation. Transplantation 102, 900-931.
(2) Kumar, D. et al. (2017) An interventional study using cell-mediated immunity to personalize therapy for Cytomegalovirus infection after transplantation. Am. J. Transplant. 17, 2468-2473.
(3) Westall, G.P. et al. (2019) A randomized study of Quantiferon CMV-directed versus fixed-duration valganciclovir prophylaxis to reduce late CMV after lung transplantation. Transplantation. 103, 1005-1013.
(4) Manuel, O. et al. (2013) Assessment of cytomegalovirus-specific cell-mediated immunity for the prediction of cytomegalovirus disease in high-risk solid-organ transplant recipients: a multicenter cohort study. Clin. Infect. Dis. 56, 817–824.
(5) Lisboa, L.F. et al. (2012) Clinical utility of cytomegalovirus cell-mediated immunity in transplant recipients with cytomegalovirus viremia. Transplantation 93, 195-200.
(6) Sood, S. et al. (2014) A novel biomarker of immune function and initial experience in a transplant population. Transpl. J. 97, e50–e51.
(7) Fernández-Ruiz, M., Kumar, D., and Humar, A. (2014) Clinical immune-monitoring strategies for predicting infection risk in solid organ transplantation.Clin. Transl. Immunol. 3, e12.
(8) Sood, S. and Testro, A.G. (2014) Immune monitoring post liver transplant. World J. Transplant. 4, 30.
(9) Mian, M. et al. (2018) Evaluation of a novel global immunity assay to predict infection in organ transplant recipients. Clin. Infect. Dis. 66, 1392-1397.