INFECTION IN THE ORGAN TRANSPLANT RECIPIENT - AN OVERVIEW

Considerable progress has been made in elucidating the factors involve d in the pathogenesis of infection in the organ transplant patient. On e of the general principles that has emerged is that the risk of clini cal infection, particularly opportunistic infection, is determined lar gely by the interaction between the patient's net state of immunosuppr ession and the epidemiologic exposures the patient encounters. The the rapeutic prescription for the transplant patient has two components-an immunosuppressive component to prevent and treat rejection and an ant imicrobial component, which is linked to the intensity of the immunosu ppressive therapy required, to make this safe. This reflects the recog nition that the two major barriers to successful transplantation, reje ction and infection, are closely tied together by the current requirem ent for lifelong immunosuppressive therapy. Progress in one area will have beneficial effects on the other.