Pulmonary fungal infections in kidney transplant recipients: an 8-year study

Abstract

Invasive fungal infections are among the most important causes of mortality among transplant patients. One of the most common manifestations of these infections is pulmonary fungal infection (PFI). The present study sought to evaluate the rate of PFI in kidney transplant patients.

Materials and methods: We retrospectively analyzed the data of 595 patients who underwent kidney transplantation from February 1999 to February 2007. Bronchoalveolar lavage (BAL) culture and tissue biopsy were used to confirm PFI.

Results: Thirteen of 595 patients (2.2%) experienced PFI. The most common pathogen (8/13, 41.5%) was Aspergillus, with 5 (38.5%) infected with Aspergillus only, 2 (15.4%) with both Aspergillus and Candida, and 1 (7.7%) with Aspergillus and mucormycosis. Seven of 13 (53.8%) died and 4 (30.7%) lost the transplanted kidney. Immunosuppressive therapy following rejection and prescription of broad spectrum antibiotics were the most important risk factors for fungal infections in these patients.

Conclusions: Fungal infections are among the most important causes of mortality among transplant patients, of which the most common manifestation is pulmonary. Immunosuppressive therapy and broad spectrum antibiotics are important risk factors, and Aspergillus is the most common pathogen responsible for fungal infections.