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8.8 Prevention
In addition to the medications for prophylaxis against viruses and Pneumocystis
jirovecii, SOT recipients are educated to take other measures to prevent infection,
including hand hygiene, masking, and avoiding sick contacts, foods that have higher
risk of bacterial contamination, and travel to locations with endemic infectious dis-
eases. The primary care provider can assist by keeping vaccinations up to date (see
Chap. 14). SOT recipients should be reminded not to accept live vaccines. Vaccine
guidelines change regularly—it is important to regularly check updated recommen-
dations, and if in doubt, discuss with the transplant team.
8.9 Conclusion
Infection remains a signicant risk in SOT recipients. A knowledge of the time
course of immunosuppression and potential pathogens will assist in the evaluation
and management of the SOT recipient who presents to the primary care setting with
potentially infectious symptoms. Signs and symptoms of infection may present sub-
tly in SOT recipients due to immunosuppression; thus, primary care providers must
maintain a high index of suspicion when evaluating these patients in clinic. A higher
level of care is often required for more severe infections because of the increased
risk for complications and monitoring required due to immunosuppression, and
consultation with the transplant team and an infectious disease specialist is often
indicated. With timely and appropriate care, infections may be treated successfully
in the SOT recipient.
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