Ventricular assist device-related infections and solid organ transplantation-Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice

Clin Transplant. 2019 Sep;33(9):e13552. doi: 10.1111/ctr.13552. Epub 2019 Apr 29.

Abstract

The Infectious Diseases Community of Practice of the American Society of Transplantation has published evidenced-based guidelines on the prevention and management of infectious complications in SOT recipients since 2004. This updated guideline reviews the epidemiology of ventricular assist device (VAD) infections and provides recommendations for the management and prevention of these infections. Almost one half of those awaiting heart transplantation are supported with VADs. Despite advances in device technologies, VAD infections commonly complicate mechanical circulatory support and remain typified by common components and anatomic locations. These infections have important implications for transplant candidates, most notably increased wait-list mortality. Strategic management of these infections is crucial for successful transplantation. Coincidentally, explantation of all VAD components at the time of transplantation is often the definitive cure for the device-associated infection. Highlighted in this updated guideline is the reported success of transplantation in patients with a variety of pre-existing VAD infections and guidance on post-transplant management strategies.

Keywords: bacteremia; device infection; driveline infection; ventricular assist device.

MeSH terms

  • Anti-Infective Agents / therapeutic use*
  • Heart-Assist Devices / adverse effects*
  • Humans
  • Organ Transplantation / adverse effects*
  • Practice Guidelines as Topic / standards*
  • Prosthesis-Related Infections / diagnosis*
  • Prosthesis-Related Infections / drug therapy*
  • Prosthesis-Related Infections / etiology
  • Societies, Medical
  • Transplant Recipients

Substances

  • Anti-Infective Agents