Invasive Pulmonary Aspergillosis After Solid Organ Transplantation: Diagnosis and Treatment Based on 28 Years of Transplantation Experience

M. K. Ju, D. J. Joo, S. J. Kim, H. K. Chang, M. S. Kim, S. I. Kim, Y. S. Kim

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Abstract

Invasive pulmonary aspergillosis (IPA) is a serious and lethal complication among organ transplant recipients. This report described the clinical manifestations and treatment of IPA over a 28-year period. From January 1979 to December 2007, 3215 organ transplant patients (2954 kidney and 261 liver recipients) were enrolled in the study. Nine patients developed IPA (7 kidney and 2 liver recipients), yielding an incidence of 0.003% (9/3215). Five IPA patients (55.6%) were diagnosed by transbronchial lung biopsy or autopsy, and 3 (33.3%) by sputum culture study. One patient was diagnosed through clinical manifestations and observations of IPA characteristics on chest X ray. We used amphotericin B (n = 4; 44.4%), voriconazole (n = 2; 22.2%), or fluconazole (n = 1; 11.1%) as the primary antifungal agents, but 2 patients could not receive antifungal agents due to rapid disease progression and sequential mortality. This study showed a high mortality rate among IPA patients (55.6%; 5/9). Only patients who received early antifungal agent thereby after a prompt diagnosis recovered from IPA. This survival advantage warrants careful monitoring for invasive fungal infections after organ transplantation with immediate administration of antifungal agents or surgical intervention.

Original languageEnglish
Pages (from-to)375-378
Number of pages4
JournalTransplantation Proceedings
Volume41
Issue number1
DOIs
Publication statusPublished - 2009 Jan 1

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All Science Journal Classification (ASJC) codes

  • Surgery
  • Transplantation

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