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Fungal infections in pediatric lung transplant recipients: colonization and invasive disease

Michael Liu1, Sarah Worley, George B Mallory

  • 1Department of Pediatrics, Children's Hospital, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|September 29, 2009
PubMed
Abstract

Insights

Post-transplant fungal colonization in pediatric lung recipients is linked to older age, cytomegalovirus prophylaxis, and prior respiratory viral infections. However, neither colonization nor pulmonary fungal infections impacted long-term outcomes like rejection or death.

Area of Science:

  • Pediatric critical care medicine
  • Transplant immunology
  • Infectious diseases

Background:

  • Pulmonary fungal infections (PFIs) and colonization are potential complications following pediatric lung transplantation.
  • Understanding the epidemiology and risk factors for PFIs is crucial for improving patient outcomes.

Purpose of the Study:

  • To evaluate the epidemiology of fungal colonization and PFIs in pediatric lung transplant recipients.
  • To investigate the impact of these fungal issues on post-transplant outcomes.

Main Methods:

  • Retrospective analysis of 55 pediatric lung transplant recipients (2002-2007).
  • Utilized Cox proportional hazard models to assess risk factors for colonization, PFI, and other outcomes.
  • Examined associations between pre- and post-transplant colonization and clinical outcomes.

Main Results:

  • 60% of patients experienced post-transplant fungal colonization; 20% developed proven or probable PFI.
  • Post-transplant fungal colonization was associated with older recipient age, cytomegalovirus (CMV) prophylaxis, and prior respiratory viral infections.
  • No association was found between fungal colonization/PFI and chronic allograft rejection or mortality.

Conclusions:

  • Fungal colonization and PFIs did not significantly increase the risk of chronic rejection or death in this cohort.
  • Risk factors for post-transplant fungal colonization include older age, CMV prophylaxis, and preceding viral respiratory infections.

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