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Updated: May 13, 2026
Murine Intrapulmonary Tracheal Transplantation: A Model for Investigating Obliterative Airway Disease After Lung Transplantation
Published on: November 10, 2023
Preemptive treatment with voriconazole in lung transplant recipients
Background:
Invasive fungal infection (IFI) is associated with high mortality in lung transplant (LTx) recipients. Data for voriconazole use in preemptive treatment remain scant.
Method:
A single-center, retrospective cohort study was conducted to investigate the efficacy and safety of voriconazole preemptive treatment for post-LTx colonization.
Results:
We reviewed 62 adult LTx patients, who received their first course of voriconazole prophylaxis (i.e., as preemptive treatment) between July 2003 and June 2010. Outcomes were determined at 6 and 12 months after commencing therapy. Aspergillus fumigatus (75.8%) was the most common colonizing isolate. Median duration of voriconazole prophylaxis was 85 days. At 6 months, 1 LTx patient (1.6%) had IFI, 47 (75.8%) cleared their colonizing isolate, 3 (4.8%) had persistent colonization, 7 (11.3%) had recurrent colonization, 1 (1.6%) had new colonization, 2 (3.2%) had aspergilloma, and 1 (1.6%) was clinically unstable with no culture results. Sixteen (25.8%) had died by 12 months. Ten (16.1%) had likely drug-related hepatotoxicity. LTx patients with diabetes mellitus within 30 days before commencing prophylaxis were at higher risk of recurrent Aspergillus colonization at 6 months (P = 0.030). Chronic rejection within 30 days before prophylaxis was associated with 12-month mortality (P = 0.007).
Conclusions:
Voriconazole preemptive treatment resulted in low incidence of IFI and IFI-related mortality.
Insights
Voriconazole preemptive treatment for lung transplant recipients showed a low incidence of invasive fungal infection (IFI) and IFI-related mortality. This study highlights voriconazole
Area of Science:
- Medical Science
- Pharmacology
- Transplant Surgery
Background:
- Invasive fungal infections (IFIs) pose a significant mortality risk for lung transplant (LTx) recipients.
- Limited data exist on the efficacy of voriconazole for preemptive treatment in this vulnerable patient population.
- Post-lung transplant colonization requires effective management strategies to prevent invasive disease.
Purpose of the Study:
- To evaluate the efficacy and safety of voriconazole as a preemptive treatment for fungal colonization after lung transplantation.
- To assess the incidence of invasive fungal infection (IFI) and mortality rates in lung transplant recipients receiving voriconazole prophylaxis.
Main Methods:
- Retrospective cohort study of 62 adult lung transplant recipients receiving voriconazole prophylaxis.
- Voriconazole was administered as preemptive treatment for post-transplant colonization.
- Outcomes including IFI, colonization clearance, and mortality were assessed at 6 and 12 months.
Main Results:
- A low incidence of IFI (1.6%) was observed at 6 months post-therapy.
- Aspergillus fumigatus was the most common colonizing pathogen (75.8%).
- Hepatotoxicity occurred in 16.1% of patients; diabetes and chronic rejection were associated with adverse outcomes.
Conclusions:
- Voriconazole preemptive treatment demonstrates a low incidence of invasive fungal infection and associated mortality in lung transplant recipients.
- The findings support the use of voriconazole for preemptive management of fungal colonization post-lung transplantation.
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