Fever in transplant recipients may be due to infection,episodes of graft rejection in solid organ transplant recipients, or graft-versus-host disease following haematopoietic stem cell transplantation (HSC). Infections in solid transplant recipients are grouped according to the time of onset. Those in the first month are related to the underlying condition or surgical complications. Those occurring 1–6 months after transplantation are characteristic of impaired T-cell function.
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Risk Factors for CMV infection have been identified and patients commonly receive either prophylaxis or intensive monitoring involving regular testing for CMV DNA by PCR and early initiation of anti-CMV therapy using intravenous ganciclovir or oralvalganciclovir if tests become positive. Following HSCT, infections in the first 4 weeks are more common in patients receiving a myeloablative conditioning regimen. Later infections are more common if an allogeneic procedure is performed.
Post-transplant lymphoproliferative disorder (PTLD) is an Epstein–Barr virus (EBV)-associated lymphoma that can complicate transplantation, particularly when primary EBV infection occurs after transplantation.
The medicines that can be thought of use are:-