M Wożniak, M Leśniewska, M Kotomska, A Nowak, A Ksit-Bąbel, E Nosarzewska, P Fiedor
Ann Transplant 2009; 14(1): 80-80
Immunodeficiency in patients awaiting transplantation begins already during an end-stage organ failure and continues post-transplant secondary to immunosuppressive medication as well as antibiotic and antifungal therapy Long-term immunosuppression in transplant recipients predisposes to active viral infections (CMV, HBV, HCV, HSV and HPV). Anti-viral prophylaxis plays a significant role in preventing or reducing replication of CMV and hepatitis B viruses. 15-20% of transplant recipients develop clinical signs of Human Papilloma Virus infection at 2-5 years post transplant. Surgery of the anogenital region for condylomata acuminata presents a risk of exposure to medical staff and/or the possibility of viral DNA incorporation/transmission in cases where electrocoagulation or laser therapy is used. The operating room should be equipped with a system of HEPA/laminar filters, while staff should wear single-use gowns and draping. Repeated disinfection and scrubbing prevents contamination of disrupted skin or mucosal membranes with infective material.
Conclusions: 1. Appropriate training of surgical staff should be instituted and guidelines followed in regard to this population of patients. 2. Aseptic and antiseptic procedures are foremost in preventing infection transmission. 3. Primary HBV and HPV prophylaxis (vaccinations) should be considered for surgical theatre staff.