Arbovirus in Solid Organ Transplants: A Narrative Review of the Literature

The incidence of arbovirus infections has increased in recent decades. Other than dengue, chikungunya, and West Nile viruses, the data on arbovirus in solid organ transplant (SOT) are limited to case reports, and infections in renal transplant recipients account for most of the reported cases. Dengu...

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Main Authors: Kiran Gajurel, Reshika Dhakal, Stan Deresinski
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Viruses
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Online Access:https://www.mdpi.com/1999-4915/16/11/1778
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author Kiran Gajurel
Reshika Dhakal
Stan Deresinski
author_facet Kiran Gajurel
Reshika Dhakal
Stan Deresinski
author_sort Kiran Gajurel
collection DOAJ
description The incidence of arbovirus infections has increased in recent decades. Other than dengue, chikungunya, and West Nile viruses, the data on arbovirus in solid organ transplant (SOT) are limited to case reports, and infections in renal transplant recipients account for most of the reported cases. Dengue and West Nile infections seem to be more severe with higher mortality in SOT patients than in the general population. Acute kidney injury is more frequent in patients with dengue and chikungunya although persistent arthralgia with the latter is less frequent. There is no clear relationship between arboviral infection and acute cellular rejection. Pre-transplant screening of donors should be implemented during increased arboviral activity but, despite donor screening and negative donor nucleic acid amplification test (NAT), donor derived infection can occur. NAT may be transiently positive. IgM tests lack specificity, and neutralizing antibody assays are more specific but not readily available. Other tests, such as immunohistochemistry, antigen tests, PCR, metagenomic assays, and viral culture, can also be performed. There are a few vaccines available against some arboviruses, but live vaccines should be avoided. Treatment is largely supportive. More data on arboviral infection in SOT are needed to understand its epidemiology and clinical course.
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spelling doaj-art-92f3de02a38f41dcb0cfcd2d114644ad2024-11-26T18:25:38ZengMDPI AGViruses1999-49152024-11-011611177810.3390/v16111778Arbovirus in Solid Organ Transplants: A Narrative Review of the LiteratureKiran Gajurel0Reshika Dhakal1Stan Deresinski2Division of Infectious Diseases, Carolinas Medical Center, Atrium Health, Charlotte, NC 28204, USALabcorp, Indianapolis, IN 46214, USADivision of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA 94305, USAThe incidence of arbovirus infections has increased in recent decades. Other than dengue, chikungunya, and West Nile viruses, the data on arbovirus in solid organ transplant (SOT) are limited to case reports, and infections in renal transplant recipients account for most of the reported cases. Dengue and West Nile infections seem to be more severe with higher mortality in SOT patients than in the general population. Acute kidney injury is more frequent in patients with dengue and chikungunya although persistent arthralgia with the latter is less frequent. There is no clear relationship between arboviral infection and acute cellular rejection. Pre-transplant screening of donors should be implemented during increased arboviral activity but, despite donor screening and negative donor nucleic acid amplification test (NAT), donor derived infection can occur. NAT may be transiently positive. IgM tests lack specificity, and neutralizing antibody assays are more specific but not readily available. Other tests, such as immunohistochemistry, antigen tests, PCR, metagenomic assays, and viral culture, can also be performed. There are a few vaccines available against some arboviruses, but live vaccines should be avoided. Treatment is largely supportive. More data on arboviral infection in SOT are needed to understand its epidemiology and clinical course.https://www.mdpi.com/1999-4915/16/11/1778arboviruschikungungadenguedonor derivedJapanese encephalitisPowassan
spellingShingle Kiran Gajurel
Reshika Dhakal
Stan Deresinski
Arbovirus in Solid Organ Transplants: A Narrative Review of the Literature
Viruses
arbovirus
chikungunga
dengue
donor derived
Japanese encephalitis
Powassan
title Arbovirus in Solid Organ Transplants: A Narrative Review of the Literature
title_full Arbovirus in Solid Organ Transplants: A Narrative Review of the Literature
title_fullStr Arbovirus in Solid Organ Transplants: A Narrative Review of the Literature
title_full_unstemmed Arbovirus in Solid Organ Transplants: A Narrative Review of the Literature
title_short Arbovirus in Solid Organ Transplants: A Narrative Review of the Literature
title_sort arbovirus in solid organ transplants a narrative review of the literature
topic arbovirus
chikungunga
dengue
donor derived
Japanese encephalitis
Powassan
url https://www.mdpi.com/1999-4915/16/11/1778
work_keys_str_mv AT kirangajurel arbovirusinsolidorgantransplantsanarrativereviewoftheliterature
AT reshikadhakal arbovirusinsolidorgantransplantsanarrativereviewoftheliterature
AT standeresinski arbovirusinsolidorgantransplantsanarrativereviewoftheliterature