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. 2020 Apr;22(2):e13250.
doi: 10.1111/tid.13250. Epub 2020 Feb 5.

Incidence and outcomes of invasive fungal infection among solid organ transplant recipients: A population-based cohort study

Seyed M Hosseini-Moghaddam  1   2   3   4 , Alexandra Ouédraogo  1 , Kyla L Naylor  1 , Sarah E Bota  1 , Shahid Husain  2 , Danielle M Nash  1   4 , J Michael Paterson  1   5   6
Affiliations

Incidence and outcomes of invasive fungal infection among solid organ transplant recipients: A population-based cohort study

Seyed M Hosseini-Moghaddam et al. Transpl Infect Dis. 2020 Apr.

Abstract

Background: Invasive fungal infection (IFI) in solid organ transplant (SOT) recipients is associated with significant morbidity and mortality. The long-term probability of post-transplant IFI is poorly understood.

Methods: We conducted a population-based cohort study using linked administrative healthcare databases from Ontario, Canada, to determine the incidence rate; 1-, 5-, and 10-year cumulative probabilities of IFI; and post-IFI all-cause mortality in SOT recipients from 2002 to 2016. We also determined post-IFI, death-censored renal allograft failure.

Results: We included 9326 SOT recipients (median follow-up: 5.35 years). Overall, the incidence of IFI was 8.3 per 1000 person-years. The 1-year cumulative probability of IFI was 7.4% for lung, 5.4% for heart, 1.8% for liver, 1.2% for kidney-pancreas, and 1.1% for kidney-only allograft recipients. Lung transplant recipients had the highest incidence rate and 10-year probability of IFI: 43.0 per 1000 person-years and 26.4%, respectively. The 1-year all-cause mortality rate after IFI was 34.3%. IFI significantly increased the risk of mortality in SOT recipients over the entire follow-up period (hazard ratio: 6.50, 95% CI: 5.69-7.42). The 1-year probability of death-censored renal allograft failure after IFI was 9.8%.

Conclusion: Long-term cumulative probability of IFI varies widely among SOT recipients. Lung transplantation was associated with the highest incidence of IFI with considerable 1-year all-cause mortality.

Keywords: Invasive fungal infection; mycoses; solid organ transplantation.

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References

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