Related Experiment Video
Updated: May 26, 2026
Murine Intrapulmonary Tracheal Transplantation: A Model for Investigating Obliterative Airway Disease After Lung Transplantation
Published on: November 10, 2023
Antifungal prophylaxis in lung transplantation
1Department of Infectious Disease, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio 44195, USA. averyr@ccf.org
Abstract:
Fungal infections are among the most serious complications of lung transplantation. The 1-year cumulative incidence of invasive fungal infections in lung transplant recipients is 6 to 10%, which is higher than most other solid organ transplant recipients. Aspergillus spp. are the most common etiologic agents, but Candida spp., non-Aspergillus mycelial fungi, Cryptococcus, Pneumocystis, and endemic mycoses can cause active infections in this population. Clinical manifestations of fungal infection in lung transplant recipients are protean, and include invasive pulmonary disease, airway and anastomotic infections, posttransplant empyemas, and disseminated infections. Most centers employ either universal or targeted antifungal prophylaxis in some form, but the agents, doses, durations, and monitoring strategies vary widely from one center to another. This review discusses the salient fungal organisms responsible for infection in lung transplant recipients and management strategies for prevention.
Insights
Lung transplant recipients face a high risk of fungal infections, with Aspergillus spp. being common. This review covers key fungi and prevention strategies for these serious complications.
Area of Science:
- Medicine
- Infectious Diseases
- Transplantation
Background:
- Fungal infections are a significant complication following lung transplantation, occurring in 6-10% of recipients within the first year.
- These infections are more prevalent in lung transplant recipients compared to other solid organ transplant recipients.
- A variety of fungi, including Aspergillus spp., Candida spp., Cryptococcus, Pneumocystis, and endemic mycoses, can cause active infections.
Purpose of the Study:
- To review the primary fungal organisms implicated in lung transplant recipients.
- To discuss the diverse clinical presentations of fungal infections in this population.
- To explore current and varied strategies for antifungal prophylaxis and prevention.
Main Methods:
- This is a review article, synthesizing existing literature on fungal infections in lung transplantation.
- It analyzes the epidemiology, clinical manifestations, and management of fungal infections.
- Focuses on prevention strategies, including antifungal prophylaxis.
Main Results:
- Aspergillus species are the most frequent cause of invasive fungal infections post-lung transplant.
- Clinical presentations are varied, encompassing pulmonary disease, airway infections, empyemas, and disseminated disease.
- Antifungal prophylaxis protocols differ significantly across transplant centers regarding agents, dosages, duration, and monitoring.
Conclusions:
- Fungal infections pose a serious threat to lung transplant recipients, necessitating careful monitoring and management.
- Standardization of antifungal prophylaxis strategies is needed due to current center-specific variations.
- Effective prevention and early recognition are crucial for improving outcomes in lung transplant recipients.
Related Concept Videos
01:15Antifungal Agents
01:16Kidney Transplant III: Nursing Management
01:25Transmission-based Precautions II: Airborne and Protective Environment
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...