Evaluation of infections in transplant recipients must involve consideration of infectious agents harbored by the donor organ and the recipient's immunosuppressive drug regimen, which increases susceptibility to latent infections (among other infections).

• Pretransplantation evaluation of the donor should include a thorough serologic evaluation for viral pathogens (e.g., HSV-1, HSV-2, VZV, CMV, EBV, HIV, and hepatitis A, B, and C viruses) and mycobacterial disease; other evaluations should be directed by the donor's history, including diet, exposures, and travel.
• Pretransplantation evaluation of the recipient is generally more comprehensive than that of the donor and should include assessment for respiratory viruses and GI pathogens. Given the effects of underlying chronic disease and chemotherapy, serologic testing of the recipient may not be reliable.