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Candida Contamination in Kidney and Liver Organ Preservation Solution: Does It Matter?
Sabrina Stern1, Dmitri Bezinover2, Peter-M Rath3
1Department of General, Visceral and Transplant Surgery, University Duisburg-Essen, 45147 Essen, Germany.
Introduction:
Fungal infections remain a major challenge affecting outcomes after kidney (KT) and liver transplantation (LT).
Methods:
In this retrospective single center study, the incidence of Candida contamination in renal and hepatic graft preservation solution (PS) was evaluated. In addition, Candida associated infections in recipients and related complications were analyzed.
Results:
Overall, the PS of 1248 hepatic and 1273 renal grafts were evaluated. The incidence of fungal contamination in the PS of hepatic and renal grafts was 1.2% and 0.86%, respectively. Additionally, the hepatic PS of one patient who underwent a combined liver-kidney transplant had Candida contamination. Candida albicans was the most common organism (70.4%) and 65.4% of the patients received antifungal treatment. Candida-associated complications in the recipients was 19%. Complications in LT patients included Candida peritonitis and Candida sepsis. Two KT recipients with contaminated PS developed a mycotic aneurysm at the anastomotic site resulting in severe bleeding. The 1-year mortality in patients with PS contamination for LT and KT recipients was 33% and 18%, respectively. Although the incidence of fungal contamination of PS was low, contaminated PS was associated with a high mortality.
Conclusion:
The results of the study suggest that PS should be evaluated for fungal growth.
Insights
Fungal contamination in organ transplant preservation solution (PS) is rare but linked to severe complications and high mortality in kidney (KT) and liver transplant (LT) recipients. Early detection of Candida in PS is crucial for better patient outcomes.
Area of Science:
- Transplantation medicine
- Mycology
- Infectious diseases
Background:
- Fungal infections pose significant risks to kidney (KT) and liver transplant (LT) recipients.
- Candida contamination in graft preservation solutions (PS) is a potential source of post-transplant infections.
Purpose of the Study:
- To evaluate the incidence of Candida contamination in renal and hepatic graft preservation solutions (PS).
- To analyze Candida-associated infections, complications, and mortality in transplant recipients.
Main Methods:
- Retrospective analysis of 1248 hepatic and 1273 renal grafts.
- Evaluation of Candida contamination in preservation solutions (PS).
- Analysis of patient outcomes, including infections, complications, and mortality.
Main Results:
- The incidence of fungal contamination in PS was 1.2% for hepatic and 0.86% for renal grafts.
- Candida-associated complications occurred in 19% of recipients, including peritonitis, sepsis, and mycotic aneurysms.
- One-year mortality rates were 33% for LT and 18% for KT recipients with contaminated PS, indicating a high mortality risk.
Conclusions:
- Despite a low incidence, Candida contamination in PS is associated with severe complications and increased mortality.
- Routine evaluation of PS for fungal growth is recommended to improve patient outcomes in transplantation.
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