S2k guideline "Viral infections in organ and allogeneic stem cell transplant recipients: diagnosis, prevention and treatment"

Under the leadership of Society of Virology e.V. (GfV) and the German Association for the Control of Viral Diseases (DVV) and coordinated by Professor Barbara Schmidt, the S2k guideline "Viral infections in organ and allogeneic stem cell transplant recipients: diagnostics, prevention and therapy" (AWMF registry number 093-002) was successfully revised.

The final approved version (version 2.0, updated August 2024) is available on the AWMF website at the following link: https://register.awmf.org/de/leitlinien/detail/093-002

Summary

Patients after solid organ transplantation (SOT) and allogeneic stem cell transplantation (allo-SZT) are particularly at risk of viral infections due to the severe therapy-related immunosuppression. Screening before and risk-adapted monitoring after transplantation, combined with prophylaxis or pre-emptive therapy, can prevent or mitigate such diseases in many cases. This S2k guideline , updated in 2024, addresses various risk constellations in an evidence-based manner and establishes a consensus on the methodology, frequency and scope of virological examinations as well as the type and duration of prophylaxis and (pre-emptive) therapy. Adapted to the respective risk profile of the patient, a total of 15 specialist societies involved in SOT and allo-SZT have compiled practical information on virological diagnostics and drug or T-cell-based therapy in inpatient and outpatient settings. The virus-related individual chapters provide an overview of the current state of knowledge for the respective virus (herpes simplex virus 1 and 2, varicella zoster virus, cytomegalovirus, Epstein-Barr virus, human herpesvirus 6, adenoviruses, parvovirus B19, BK polyomavirus, respiratory viruses) in the context of SOT and allo-SZT. To this end, the interdisciplinary expert group has compiled tables in short form for all viruses. The recommendations are based on the evaluation of the available scientific evidence and were drawn up by consensus of the experts in accordance with the AWMF guidelines.

What is new? The updated version of the guideline addresses the fact that new antivirals have been approved or will soon be available, new prophylaxis options (e.g. RSV vaccines) have been developed and T-cell-based immunotherapy is now much more important than before.

Leading professional associations
Society of Virology (GfV e.V.)
German Association for the Control of Viral Diseases (DVV e.V.)

Participating professional associations
Working Group for Pediatric Immunology (API e.V.)
Federal Association of German Pathologists (BDP e.V.)
German Society for Nephrology (DGfN e.V.)
German Society for Internal Medicine (DGIM e.V.)
German Society for Hematology and Medical Oncology (DGHO e.V.)
German Society for Pathology (DGP e.V.)
German Society for Pediatric Infectiology (DGPI e.V.)
German Society for Transfusion Medicine and Immunohematology (DGTI e.V.)
German Leukemia & Lymphoma Aid (DLH e.V.)
German Transplantation Society (DTG e.V.)
Society for Pediatric Nephrology (GPN e.V.)
Society for Pediatric Oncology and Hematology (GPOH e.V.)
Paul Ehrlich Society for Infection Therapy (PEG e.V.)

Author
Annemarie Berger (GfV)
Veronica di Cristanziano (GfV)
Hermann Einsele (DGHO)
Britta Eiz-Vesper (DGTI)
Lutz Fischer (DTG)
Helmut Fickenscher (DVV)
Christa Flechtenmacher (DGP, BDP)
Barbara Gärtner (DVV)
Andreas Groll (PEG)
Joachim Hahn (DGHO)
Albert Heim (GfV)
Britta Höcker (GPN)
Ulrike Holtkamp (DLH)
Johannes Korth (DGIM)
Andi Krumbholz (GfV)
Marie von Lilienfeld-Toal (DGHO)
Britta Maecker-Kolhoff (GPOH)
Susanne Modrow (GfV)
Jürgen Rissland (GfV)
Andreas Rosenwald (DGP, BDP)
Andreas Sauerbrei (GfV)
Barbara Schmidt (GfV; Coordinator)
Corinna Schmitt (GfV)
Paul Schnitzler (GfV)
Ansgar Schulz (API)
Martina Sester (DVV)
Helmut Sitter (certified guideline consultant of the AWMF)
Christoph Steininger (external reviewer)
Maximilian Stich (GPN)
Julia Tabatabai (DGPI)
Jörg Timm (GfV)
Burkhard Tönshoff (DTG)
Jürgen Wenzel (GfV)
Oliver Witzke (DGfN)