| Everyone | Vaccinate if seronegative or not vaccinated | With epidemiologic risk factors | |
| Pathogen | |||
| Cytomegalovirus | X | ||
| Epstein Barr Virus | X | ||
| Varicella | X | X | |
| HIV (HIV-1 and -2 immunoassay)* | X | ||
| Hepatitis B virus (HBsAg, HBsAb, HBcAb)*¶ | X | X | |
| Hepatitis C virus*¶ | X | ||
| Treponema pallidum (Venereal Disease Research Laboratory or rapid plasma reagin) | X | ||
| Tuberculosis (screening skin test or interferon-gamma release assay for tuberculosisΔ) | X | ||
| Mumps, measles, and rubella | X | X | |
| Toxoplasma gondii (heart transplant candidates) | X | ||
| Coccidioides antibody | X | ||
| Histoplasma antibody | X | ||
| Blastomyces antibody | X | ||
| Strongyloides stercoralis serology◊ | X | ||
| Trypanosoma cruzi (Chagas disease) | X | ||
| Leishmania spp (visceral disease only, may cross react with T. cruzi) | X | ||
| Schistosoma spp (cystoscopy may be useful in renal transplant candidates) | X | ||
| HTLV1 and 2 (suboptimal screening platforms in low-prevalence areas) | X | ||
| Hepatitis A serology | X | X | |
| SARS-CoV-2 (COVID-19) NAAT§ | X | ||
| Other tests | |||
| Chest radiograph, urinalysis | X | ||
| Stool exam for ova and parasites | X | ||
HBsAg: hepatitis B surface antigen; HBsAb: hepatitis B surface antibody; HBcAb: hepatitis B core antibody; HTLV: human T-lymphotropic virus; SARS-CoV-2: severe acute respiratory syndrome coronavirus 2; COVID-19: coronavirus disease 2019; NAAT: nucleic acid amplification testing.
* Repeat as close as possible to time of transplant (at least within one week of transplant) and repeat for recipients of organs from donors with increased risk for transmission of infection. Refer to the UpToDate topic on screening and diagnostic testing for HIV infection for the preferred approach.
¶ For individuals with known infection or at increased risk for infection (based on risk factors detected in the medical and/or social history), quantitative nucleic acid testing should also be performed.
Δ Refer to the UpToDate topic on tuberculosis in solid organ transplant candidates for the preferred approach.
◊ Strongyloides stercoralis: Empiric therapy (ivermectin × 2 doses) is often used in place of serologic testing for appropriate epidemiologic history.
§ All transplant candidates should be screened for SARS-CoV-2 (sensitive nucleic acid assay) during pandemic and deferred if positive and if feasible. Transplant candidates with ongoing respiratory illness or radiographic pulmonary infiltrates should generally be deferred. SARS-CoV-2 antibody screening assays are highly variable and probably not useful for routine screening; may be useful in demonstrating immune response to prior infection.