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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
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Updated: Aug 9, 2025

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Invasive Aspergillosis after Renal Transplantation.

Liyanage Shamithra Madhumali Sigera1, David W Denning1

  • 1Division of Evolution, Genomics and Infection, School of Biological Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Manchester M13 9PL, UK.

Journal of Fungi (Basel, Switzerland)
|February 25, 2023
PubMed
Summary
This summary is machine-generated.

Invasive aspergillosis (IA) is a serious risk for renal transplant recipients, with risk factors including age, diabetes, and immunosuppression. Early diagnosis and tailored treatment are crucial for survival.

Keywords:
antifungalsimmunosuppressioninvasive aspergillosisrenal transplantation

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Area of Science:

  • Nephrology
  • Infectious Diseases
  • Mycology

Background:

  • Renal transplantation is a common procedure, with over 95,000 performed in 2021.
  • Invasive aspergillosis (IA) affects 1 in 250 to 1 in 43 renal transplant recipients.
  • IA can occur years after transplantation, with a median onset time of nearly 3 years.

Purpose of the Study:

  • To review the epidemiology, risk factors, clinical presentation, diagnosis, and management of invasive aspergillosis in renal transplant recipients.
  • To highlight the importance of early diagnosis and appropriate treatment strategies.

Main Methods:

  • Literature review of invasive aspergillosis in renal transplant recipients.
  • Analysis of risk factors, clinical manifestations, diagnostic modalities, and therapeutic options.
  • Emphasis on diagnostic speed and treatment efficacy.

Main Results:

  • Key risk factors include old age, diabetes mellitus, delayed graft function, acute rejection, COPD, CMV disease, and neutropenia.
  • Pulmonary IA is most common (~75%), presenting with fever, dyspnea, cough, and hemoptysis, though non-specific symptoms occur in 20%.
  • Radiological findings include non-specific infiltrates and nodules; bilateral disease indicates a worse prognosis. Positive serum Aspergillus antigen predicts a poorer outcome.

Conclusions:

  • Prompt diagnosis via bronchoscopy, microscopy, culture, and antigen testing is vital.
  • Standard therapies include azoles (voriconazole, isavuconazole, posaconazole), with careful drug-drug interaction assessment.
  • Reducing immunosuppression, especially corticosteroids, and considering surgery or interferon-gamma are critical for improving survival in this high-mortality condition.