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Murine Intrapulmonary Tracheal Transplantation: A Model for Investigating Obliterative Airway Disease After Lung Transplantation
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Fungal infections in lung transplantation. Incidence, risk factors and prognostic significance

E Ruffini1, S Baldi, M Rapellino

  • 1Department of Thoracic Surgery, University of Torino, 3, Via Genova, 10126 Torino, Italy. enrico.ruffini@unito.it

Sarcoidosis, Vasculitis, and Diffuse Lung Diseases : Official Journal of WASOG
|July 5, 2001
PubMed
Abstract

Insights

Fungal infections are common after lung transplants, often linked to bacterial infections, cytomegalovirus disease, and steroid use. However, these infections do not impact long-term survival rates in transplant recipients.

Area of Science:

  • Infectious Diseases
  • Transplantation Medicine
  • Pulmonology

Background:

  • Fungal infections pose a significant threat to lung transplant recipients, contributing to high mortality and morbidity.
  • Understanding the risk factors and outcomes of these infections is crucial for improving patient care.

Purpose of the Study:

  • To report institutional experience with fungal infections post-lung transplantation.
  • To identify correlations between fungal infections and bacterial infections, cytomegalovirus (CMV) disease, rejection, and steroid therapy.
  • To assess the impact of fungal infections on long-term survival after lung transplantation.

Main Methods:

  • A retrospective study of 60 lung transplant recipients.
  • Analysis of incidence, presentation patterns, and time to fungal infection.
  • Correlation analysis in 30 patients with at least 1-year follow-up.

Main Results:

  • Fungal infections occurred in 44% of patients, with severe infections in 11%.
  • Significant correlations were found between fungal infections and respiratory bacterial infections (p=0.0003), CMV disease (p=0.00001), and steroid therapy (p=0.04).
  • No statistically significant impact of fungal infection on long-term survival was observed (p=0.08).

Conclusions:

  • Fungal infections are frequent and can be severe in lung transplant recipients.
  • Preoperative fungal presence does not contraindicate transplantation; postoperative antifungal prophylaxis, such as aerosolized liposomal Amphotericin B, is recommended.
  • Fungal infections are associated with steroid therapy and CMV disease, suggesting prophylaxis in these scenarios. Fungal infection is not an independent predictor of long-term survival.

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