{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T07:22:48Z","timestamp":1792135368484,"version":"4.4.0"},"reference-count":73,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n            <jats:title>Background.<\/jats:title>\n            <jats:p>There is no consensus guidance on when to reinitiate <jats:italic toggle=\"yes\">Pneumocystis jirovecii<\/jats:italic> pneumonia (PJP) prophylaxis in solid organ transplant (SOT) recipients at increased risk. The 2019 American Society of Transplantation Infectious Diseases Community of Practice (AST IDCOP) guidelines suggested to continue or reinstitute PJP prophylaxis in those receiving intensified immunosuppression for graft rejection, cytomegalovirus (CMV) infection, higher dose of corticosteroids, or prolonged neutropenia.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods.<\/jats:title>\n            <jats:p>A literature search was conducted evaluating all literature from existence through April 22, 2020, using MEDLINE and EMBASE. (The International Prospective Register of Systematic Reviews registration number: CRD42019134204).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results.<\/jats:title>\n            <jats:p>A total of 30 studies with 413\u2009276 SOT recipients were included. The following factors were associated with PJP development: acute rejection (pooled odds ratio [pOR],\u20092.35; 95% confidence interval [CI], 1.69-3.26); study heterogeneity index [I<jats:sup>2<\/jats:sup>]\u2009=\u200923.4%), CMV-related illnesses (pOR,\u20093.14; 95% CI, 2.30-4.29; I<jats:sup>2<\/jats:sup>\u2009=\u200948%), absolute lymphocyte count &lt;500 cells\/mm<jats:sup>3<\/jats:sup> (pOR,\u20096.29; 95% CI, 3.56-11.13; I<jats:sup>2<\/jats:sup>\u2009=\u20090%), BK polyomavirus-related diseases (pOR,\u20092.59; 95% CI, 1.22-5.49; I<jats:sup>2<\/jats:sup>\u2009=\u20090%), HLA mismatch \u22653 (pOR,\u20091.83; 95% CI, 1.06-3.17; I<jats:sup>2<\/jats:sup>\u2009=\u20090%), rituximab use (pOR,\u20093.03; 95% CI, 1.82-5.04; I<jats:sup>2<\/jats:sup>\u2009=\u20090%), and polyclonal antibodies use for rejection (pOR,\u20093.92; 95% CI, 1.87-8.19; I<jats:sup>2<\/jats:sup>\u2009=\u20090%). On the other hand, sex, CMV mismatch, interleukin-2 inhibitors, corticosteroids for rejection, and plasmapheresis were not associated with developing PJP.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions.<\/jats:title>\n            <jats:p>PJP prophylaxis should be considered in SOT recipients with lymphopenia, BK polyomavirus-related infections, and rituximab exposure in addition to the previously mentioned risk factors in the American Society of Transplantation Infectious Diseases Community of Practice guidelines.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/tp.0000000000003576","type":"journal-article","created":{"date-parts":[[2020,12,15]],"date-time":"2020-12-15T18:17:43Z","timestamp":1608056263000},"page":"2291-2306","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":35,"title":["A Comprehensive Evaluation of Risk Factors for Pneumocystis jirovecii Pneumonia in Adult Solid Organ Transplant Recipients: A Systematic Review and Meta-analysis"],"prefix":"10.1097","volume":"105","author":[{"given":"Nitipong","family":"Permpalung","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD."},{"name":"Division of Mycology, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veraprapas","family":"Kittipibul","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Miami\/Jackson Memorial Hospital, Miami, FL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poemlarp","family":"Mekraksakit","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pattara","family":"Rattanawong","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saman","family":"Nematollahi","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean X.","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology, Department of Pathology, Johns Hopkins University, School of Medicine, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seema Mehta","family":"Steinke","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,10,1]]},"reference":[{"key":"R1-20250607","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1007\/s10096-002-0758-5","article-title":"Analysis of underlying diseases and prognosis factors associated with Pneumocystis carinii pneumonia in immunocompromised HIV-negative patients.","volume":"21","author":"Roblot","year":"2002","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"R2-20250607","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1086\/339548","article-title":"Opportunistic infections in patients with and patients without acquired immunodeficiency syndrome.","volume":"34","author":"Sepkowitz","year":"2002","journal-title":"Clin Infect Dis"},{"key":"R3-20250607","doi-asserted-by":"crossref","first-page":"2450","DOI":"10.1001\/jama.286.19.2450","article-title":"New insights into transmission, diagnosis, and drug treatment of Pneumocystis 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