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Updated: Feb 27, 2026
Normothermic Ex Vivo Pancreas Perfusion for the Preservation of Pancreas Allografts before Transplantation
Published on: July 27, 2022
Donor Derived Candida stellimalicola in a Clinical Specimen: Preservation Fluid Contamination During Pancreas
Damien Dupont1,2, Antoine Huguenin3, Elodie Tisserand4
1Institut des Agents Infectieux, Parasitologie Mycologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, 69004, France. damien.dupont@chu-lyon.fr.
Abstract:
We report here a case of possible donor-derived Candida stellimalicola infection after pancreas transplantation. Candida stellimalicola, an environmental non-filamentous yeast, was isolated from both the peritoneal fluid of the graft donor and the preservation fluid of the transplanted pancreas. Interestingly, this strain exhibited high minimum inhibitory concentrations to azoles. These results justified the use of echinocandins as therapy instead of fluconazole. This switch permitted a favorable outcome. To our knowledge, this is the first report of C. stellimalicola from clinical samples and therefore the first reported case of a possible human infection. This case report highlights the need for standardized microbiological procedures in solid organ transplant settings. Moreover, it underlines the importance of using molecular identification technique when routine techniques do not allow successful identification of the pathogen. It is of utmost importance to determine sensitivity profile, even in the absence of species-level identification, because resistance to fluconazole is not uncommon, especially in emergent species.
Insights
A rare yeast, Candida stellimalicola, caused infection after pancreas transplant. Echinocandins were effective when azoles failed, leading to a favorable outcome in this first reported human case.
Area of Science:
- Medical Mycology
- Transplant Infectious Diseases
Background:
- Solid organ transplantation, particularly pancreas transplantation, carries risks of opportunistic infections.
- Emerging fungal pathogens pose diagnostic and therapeutic challenges in immunocompromised patients.
Observation:
- Candida stellimalicola, an environmental yeast, was identified in the donor's peritoneal fluid and the transplanted pancreas preservation fluid.
- The isolated C. stellimalicola strain demonstrated high minimum inhibitory concentrations to azole antifungals.
Findings:
- Treatment was switched from fluconazole to echinocandins due to azole resistance, resulting in a successful clinical outcome.
- This represents the first reported case of Candida stellimalicola infection potentially originating from a donor organ.
Implications:
- Highlights the importance of molecular identification techniques for accurate fungal pathogen identification in transplant recipients.
- Emphasizes the need for antifungal susceptibility testing, especially for emerging yeast species, to guide effective therapy.
- Underscores the necessity of standardized microbiological surveillance in solid organ transplant settings to prevent donor-derived infections.
