Details

Autor(en) / Beteiligte

• Song, Alice T. W.
• Clemente, Wanessa Trindade

Titel

Yellow Fever in Transplantation

Ist Teil von

• Current infectious disease reports, 2021-11, Vol.23 (11), Article 18

Ort / Verlag

New York: Springer US

Erscheinungsjahr

2021

Quelle

SpringerLink

Beschreibungen/Notizen

• Purpose of Review Yellow fever is an emerging infectious disease, with epidemics occurring in Africa and South America, and poses great concern due to high lethality rates of up to 60% in severe cases, despite the availability of an efficacious vaccine. In this paper, we sought to review the epidemiology, clinical manifestations, diagnosis, prevention strategies, and treatment in overall and in the transplant population. Recent Findings Yellow fever control relies mainly on adequate vaccine coverage, and as the yellow fever vaccine is composed of live, attenuated virus, it is contraindicated in the immunosuppressed individuals, including solid organ transplant and hematopoietic stem cell transplant recipients. Therefore, these patients should be preferably vaccinated in the pre-transplant period. There are few case series where vaccine is given to immunocompromised patients that showed a low incidence of adverse effects, although the number of patients in these reports is small. Donors who live in or with recent travel to yellow fever endemic or epidemic areas should be evaluated as to their suitability for donation. There is no specific therapy for infection and supportive treatment in intensive care units is required in severe cases. Recently, liver transplantation has been performed in several severe yellow fever cases, and although it was lifesaving in some, overall, there were high post-transplant mortality rates. Summary Yellow fever is still responsible for devastating epidemics, and some particularities pertaining to the transplant population are discussed. Prevention strategies including vaccination in the pre-transplant period and recommendations for donors living or with recent travel to yellow fever high-risk areas are discussed, as well as recent attempts of treatment with liver transplantation in severe cases.