Early postoperative therapy after heart transplantation: Prophylaxis, diagnosis and antibiotic, antimycotic and antiviral therapy of infections

Aside from early graft failure, infections are the second leading cause of death after heart transplantation (HTx). Therefore, prophylaxis, diagnosis and adequate therapy of infections are fundamental for the short and long-term success of heart transplantation. Because immunosuppressive drug therapy is a prerequisite for transplantation, the range of infection is much larger than after other kinds of major thoracic operation. For prophylaxis, diagnosis and therapy, bacterial, viral, fungal and protozoal infections have to be taken into account, also as part of opportunistic infection. So far evidence-based recommendations for the prophylaxis and therapy of infections after HTx are rare. Therefore, it is necessary to use clinically proven strategies to prevent and treat infections.