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Published on: March 9, 2018
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Invasive aspergillosis after kidney transplant: case-control study
Line Heylen1, Johan Maertens2, Maarten Naesens1
1Department of Nephrology Department of Immunology and Microbiology, K.U. Leuven, Belgium.
Summary
Kidney transplant recipients with prolonged renal replacement therapy before transplant face higher early invasive aspergillosis (IA) risk. The serum galactomannan index predicts mortality in these patients.
Area of Science:
- Nephrology
- Infectious Diseases
- Transplantation Immunology
Background:
- Invasive aspergillosis (IA) poses a significant mortality risk for transplant recipients.
- Specific risk factors for IA in kidney transplant (KTx) patients remain underexplored.
Purpose of the Study:
- To identify renal transplant-specific risk factors for invasive aspergillosis (IA).
- To determine factors associated with mortality in KTx patients with IA.
Main Methods:
- A case-control study involving 41 adult KTx recipients with IA (1995-2013).
- A control group of 82 KTx recipients without IA, matched 1:2.
- Analysis of pre- and post-transplant clinical data.
Main Results:
- Leukopenia post-transplant was a risk factor for IA (OR, 2.345).
- Early IA (≤3 months) linked to prolonged pre-transplant renal replacement therapy and leukopenia.
- Late IA (>3 months) associated with donor cytomegalovirus seropositivity.
- Mortality rate at 12 weeks was 39%, predicted by disseminated infection, leukopenia, and high serum galactomannan index.
Conclusions:
- Prolonged pre-transplant renal replacement therapy increases early IA risk in kidney transplant recipients.
- The serum galactomannan index is a predictor of mortality in KTx patients with IA.
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