Mt. Larocco et Sj. Burgert, INFECTION IN THE BONE-MARROW TRANSPLANT RECIPIENT AND ROLE OF THE MICROBIOLOGY LABORATORY IN CLINICAL TRANSPLANTATION, Clinical microbiology reviews, 10(2), 1997, pp. 277
Over the past quarter century tremendous technological advances have b
een made in bone marrow and solid organ transplantation Despite these
advances, an enduring problem for the transplant recipient is infectio
n. As immunosuppressive regimens have become more systematic, it is ap
parent that different pathogens affect the transplant recipient at dif
ferent time points in the posttransplantation course, since the), are
influenced by multiple intrinsic and extrinsic factors. An understandi
ng of this evolving risk for infection is essential to the management
of the patient following transplantation and is a key to the early dia
gnosis and treatment of infection. Likewise, diagnosis of infection is
dependent upon the quality of laboratory support, and services provid
ed by the clinical microbiology laboratory play an important role in a
ll phases of clinical transplantation. These include the prescreening
of donors and recipients for evidence of active or latent infection, t
he timely and accurate microbiologic evaluation of the transplant pati
ent with suspected infection, and the surveillance of asymptomatic all
ograft recipients for infecton. Expert services in bacteriology, mycol
ogy, parasitology, virology, and serology are needed and communication
between the laboratory and the transplantation team is paramount for
providing clinically relevant cost-effective diagnostic testing.