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Fungal infection in heart-lung transplant recipients receiving single-agent prophylaxis with itraconazole

Don Hayes1, Amanda M Ball, Heidi M Mansour

  • 1University of Kentucky, Lexington, KY, USA. don.hayes@uky.edu

Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation
|December 7, 2011
PubMed
Abstract

Insights

Single-agent antifungal prophylaxis with itraconazole did not alter fungal infection rates in heart and lung transplant patients. Infections increased with immunosuppression escalation for acute rejection.

Area of Science:

  • Transplant medicine
  • Infectious diseases
  • Pharmacology

Background:

  • Heart and lung transplant recipients face a high risk of invasive fungal infections.
  • Antifungal prophylaxis is crucial in managing post-transplant complications.

Purpose of the Study:

  • To evaluate the impact of single-agent itraconazole prophylaxis on fungal infection rates in heart and lung transplant recipients.
  • To assess the efficacy of itraconazole in preventing invasive fungal infections post-transplant.

Main Methods:

  • Observational, retrospective study design.
  • Evaluation of 4.5 years of data from heart and lung transplant recipients at the University of Kentucky Medical Center.
  • Analysis of fungal infection incidence in patients receiving itraconazole prophylaxis.

Main Results:

  • Overall fungal infection incidence was 16.9% (14/83) across both groups.
  • Heart transplant recipients had an 11.9% incidence (5/42), while lung recipients had a 22.0% incidence (9/41).
  • No significant change in fungal infection rates was observed compared to historical data.

Conclusions:

  • Single-agent itraconazole prophylaxis did not significantly affect fungal infection rates in heart or lung transplant recipients.
  • A notable increase in fungal infections occurred within 3 months of escalating immunosuppression for acute rejection.
  • Further strategies may be needed to manage fungal infections in this vulnerable population.

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