NURAN SARİ, BASAK BACİ, MEHMET SAİD CANLİ, OGUZ ÇİNAR, SARP UTKU DURGUT, ZÜMRA OLCAR, ÇAGLAR SEL, ERDEM YİLDİRİM, EMRE KARAKAYA, ÖZLEM KURT AZAP, ATİLLA SEZGİN, MEHMET HABERAL
Experimental and Clinical Transplantation - 2025;23(1):60-66
Objectives: Solid-organ transplant recipients are prone to infections due to intensive immunosuppression treatments after transplant. Incidence of viral infections is gradually increasing. During the COVID-19 pandemic, transplant patients were shown to be at increased risk of infections. We investigated viral infections in transplant patients before and during the pandemic to guide patient follow-up. Materials and Methods: We collected data of solid-organ transplant recipients ≧18 years old who experienced viral infections during 2019-2023. We analyzed demographic data, transplant types, and clinical outcomes with SPSS software (version 25.0); P < .05 was statistically significant. Results: We analyzed 238 patients (mean age 43.9 ± 14.9 years; 69.7% male) diagnosed with viral infections: 79.8% received kidney transplants, 16.4% liver, and 3.8% heart. The most prevalent virus was SARS-CoV-2 (64.7%), followed by influenza (18.1%) and cytomegalovirus (7.6%). Mean age for heart transplant was lower than among other transplant types (P = .015). Fever, cough, and sputum production were common in influenza infections (P = .012, P = .041, and P = .009, respectively); myalgia and dyspnea were common with SARS-CoV-2 (P = .029 and P = .013, respectively). Rates of bacteremia and intensive care unit admission were high for cytomegalovirus infections (P = .002, P = .031). Thrombocytopenia and bacteremia were detected more frequently for liver transplants (P = .004 and P = .013, respectively). Empirical antibiotic treatment was started in 17.2% of patients. Twenty-nine patients were monitored in the intensive care unit, and 12.1% died. Mortality was significantly higher in patients >65 years old and in the presence of bacteremia (P = .001). Conclusions: Vaccination, early detection, and pre-ventive strategies play pivotal roles to manage viral infections in solid-organ transplant recipients. Future research should focus on optimized prophylaxis and individualized care plans.
