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VAD infection during bridge-to-transplant, unique aspects of treatment and prevention

Koval, Christinea,b

Current Opinion in Organ Transplantation: August 2018 - Volume 23 - Issue 4 - p 400–406
doi: 10.1097/MOT.0000000000000548
INFECTIOUS COMPLICATIONS IN TRANSPLANTATION: Edited by Shimon Kusne
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Purpose of review VAD infections remain a frequent complication of VAD care and can markedly affect patient management before and after transplantation. This review highlights the standard-of-care approaches offered by recent guidelines as well as published data that may improve the care for patients with these challenging and often persistent infections.

Recent findings Prevention and management of VAD infections has become more standardized with updated consensus guidelines published in 2017. Unfortunately, advanced devices have not markedly affected the incidence of VAD infection. Efforts to improve, yet streamline, the prevention of VAD-specific infections are ongoing. However, the data provided in the best of recent publications are rarely effectively comparative. Granular data on management strategies are limited to a few studies. Nevertheless, several publications provide more detailed posttransplant outcomes for patients with pretransplant VAD infections and demonstrate overall excellent posttransplant survival.

Summary Prevention and management of VAD-specific and VAD-related infections are the ongoing work of all VAD programs. Consensus guidelines are a marker of progress for this field. Despite very good posttransplant outcomes for these patients, more granular data are required to understand how such patients arrive successfully to transplantation and how their posttransplant course is affected.

aTransplant Infectious Disease, Department of Infectious Disease, Transplant Center

bCleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, Ohio, USA

Correspondence to Christine Koval, MD, Section Head, Transplant Infectious Disease, Department of Infectious Disease, Transplant Center, Cleveland, Ohio, USA; Assistant Professor of Medicine, Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, 9500 Euclid Avenue, G021, Cleveland, OH 44195, USA. Tel: +1 216 444 8831; fax: +1 216 445 9446; e-mail: kovalc@ccf.org

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