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IInvasive fungal infections following renal transplantation: A review of 2410 recipients

Behzad Einollahi, Mahboob Lessan-Pezeshki, Vahid Pourfarziani, Eghlim Nemati, Mohsen Nafar, Fatemeh Pour-Reza-Gholi, Mohammad Hassan Ghadyani, Fariba Samadian, Pedram Ahmadpoor, Jafar Aslani

Ann Transplant 2008; 13(4): 55-58

ID: 880219

Published:


Background: Organ transplant recipients, on long-term graft preserving immunosuppressive therapy, are at increased risk for life threatening opportunistic fungal infections.
Material/Methods: In order to evaluate the incidence of invasive fungal infections (IFIs) and to identify the most common fungal pathogens, we conducted a retrospective study on 2410 ESRD cases undergone living kidney transplantation in three transplant centers between 1998 and 2008.
Results: IFIs developed in 21 recipients (0.87%), 17 male and 4 female. Their  immunosuppression was cyclosporine based. The mean age of patients was 48±10 (ranged from 32 to 67) years. Diagnosis was made by radiological findings, positive blood or bronchoalveolar lavage (BAL) cultures and tissue biopsies. Mucormycosis was the most common cause of IFIs in population studied (n=11), followed by disseminated candidiasis (n=4), aspergillosis (n=3), nocardiasis (n=2) and  histoplasmosis (n=1). Pulmonary involvement was dominant (47.6%). The treatment was successful in only 10 patients and the rest died.
Conclusions: In our large series of kidney transplant recipients, mucormycosis was found to be the most common cause of invasive fungal infection. Prompt diagnosis and treatment are necessary to avoid the life threatening complications and may greatly improve prognosis.

Keywords: fungal infections, renal transplantation, mucormycosis



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