Impact of mold infections in explanted lungs on outcomes of lung transplantation.

Transplantation
Aniket VadnerkarM Hong Nguyen

Abstract

Little is known about the incidence or significance of mold infections in the explanted lungs of lung transplant recipients. We reviewed the histopathology of the explanted lungs from 304 patients who underwent lung transplantation at our institution from 2005 to 2007 and received alemtuzumab induction therapy and posttransplant voriconazole prophylaxis. Invasive mold infections were present in the explanted lungs of 5% (14 of 304) of patients, including chronic necrotizing pneumonias (n=7), mycetomas (n=4), and invasive fungal pneumonias (n=3). Only 21% (3 of 14) received immunosuppressive therapy within 1 year before lung transplantation, suggesting that lung damage itself predisposed patients to mold infections. The risk of mold infection was higher in patients with cystic fibrosis (11%, 4 of 35) than other underlying lung diseases (4%, 10 of 269). Pulmonary mold infections were not diagnosed or suspected in 57% (8 of 14) of patients. Despite secondary voriconazole prophylaxis, fungal infections developed in 43% (6 of 14) of patients with mold infections of the explanted lungs compared with 14% (42 of 290) of patients without mold infections (P=0.01). Three patients developed invasive fungal infections while on voriconazole ...Continue Reading

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Citations

Dec 24, 2011·TheScientificWorldJournal·Rafal Krenke, Elzbieta M Grabczak
Aug 11, 2010·Expert Review of Anti-infective Therapy·Frank-Michael C Müller, Marc Seidler
Mar 13, 2016·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Shahid HusainOrla Morrissey
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