Travel Medicine, Transplant Tourism, And The Solid Organ Transplant Recipient
Summary of recommendations
- The topic of travel after transplant should be raised during the pre‐transplant evaluation.
- Solid organ transplant recipients should be seen by a travel med‐ icine specialist with expertise in management of immunocom‐ promised hosts (or who can discuss with the primary transplant clinician, as needed) prior to travel to regions with higher rates of infection.
- Patients should be advised not to travel to areas with higher infection risk during the first year after transplant and/or during times of increased immunosuppression (ie, treatment of rejection). Graft function should be stable.
- Travel recommendations, immunizations, and prophylaxis will depend on location of travel and the destination's risk of infection and country‐specific recommendations.
- Vaccine‐preventable illnesses
- Patients should be up to date with routine immunizations including vaccines to protect against influenza, streptococcus, measles, varicella, hepatitis B, tetanus, diphtheria, and pertussis.
- Travel‐related immunizations will depend on travel destination and may include vaccines to protect against hepatitis A, typhoid, polio, meningococcus, rabies, and Japanese encephalitis.
- Live vaccines are contraindicated in SOT recipients, and SOT travelers should not receive the yellow fever vaccine, measles vaccine, BCG vaccine, or live oral vaccines including oral polio and oral typhoid.
- Patients traveling to countries with Yellow Fever Immunization requirements should travel with an official waiver or documentation of prior vaccination
- Malaria
- Malaria prophylaxis should be based on country‐specific guidelines.
- Caution in choosing prophylaxis should be taken given possibility of drug interactions with immunosuppressant agents.
- Travelers’ diarrhea
- Patients should be vigilant about food and water precautions, and travel with antibiotics for self‐treatment of travelers’ diarrhea.
- Counseling
- Topics including prevention of food‐ and water‐borne illness, respiratory infections, insect‐borne illnesses, and blood‐borne and sexually transmitted infections should be covered during the pre‐travel visit, as should important non‐infectious topics such as sun exposure prevention and risk of altitude sickness.
- Patients should travel with adequate supply of medications (especially immunosuppressants) and copies of prescriptions. They should be aware of transplant centers at which they could seek medical attention if they become ill while away. They should have travel medical insurance.
- Patients should be aware to seek medical attention if they develop signs and symptoms of infection upon return home after travel.
Recommendation Grading
Overview
Title
Travel Medicine, Transplant Tourism, And The Solid Organ Transplant Recipient
Authoring Organization
American Society of Transplantation
Publication Month/Year
April 1, 2019
Last Updated Month/Year
July 7, 2022
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Document Objectives
These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review recommendations for prevention and management of travel‐related infection in solid organ transplant (SOT) recipients as well as risks associated with transplant tourism.
Target Patient Population
Solid organ transplant recipients
Inclusion Criteria
Female, Male, Adolescent, Adult, Older adult
Health Care Settings
Ambulatory, Hospital, Outpatient
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Prevention, Management
Diseases/Conditions (MeSH)
D014180 - Transplantation, D019737 - Transplants, D016377 - Organ Transplantation, D057236 - Travel Medicine, D014611 - Vaccination, D000076082 - Travel-Related Illness
Keywords
vaccination, solid organ transplant, travel medicine
Source Citation
Buchan, CA, Kotton, CN. Travel medicine, transplant tourism, and the solid organ transplant recipient—Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019; 33:e13529.