Fungal Infections and Colonization after Bilateral Lung Transplant: A Six-Year Single-Center Experience

Area of Science:

• Pulmonology
• Infectious Diseases
• Transplant Surgery

Background:

• Fungal infections (FIs) are a significant cause of morbidity and mortality in lung transplant recipients (LTRs) within the first year post-transplant.
• Early detection and treatment of FIs are critical for improving LTR outcomes.
• Aspergillus species are a common cause of fungal colonization in this patient population.

Purpose of the Study:

• To assess the incidence of FIs and fungal colonization in the first year after bilateral lung transplantation.
• To identify risk factors associated with FIs and colonization.
• To compare fungal incidence across different prophylactic antifungal strategies.

Main Methods:

• Retrospective screening of bilateral LTRs at Padua University Hospital.
• Exclusion criteria included age <18, re-transplantation, and pre-LT mechanical support.
• Analysis of 157 LTRs to determine FI and colonization rates and associated factors.

Main Results:

• Overall incidence of FIs was 8% (13 patients) and fungal colonization was 23% (36 patients).
• Aspergillus spp. was the predominant organism identified in colonization cases.
• No independent risk factors for FIs were identified, and no significant differences in FI or colonization rates were observed between groups receiving different prophylactic strategies.

Conclusions:

• The study found an 8% incidence of FIs and 23% incidence of fungal colonization in the first year post-bilateral lung transplant.
• No significant predisposing factors or differences in outcomes related to antifungal prophylaxis strategies were identified.
• Larger studies are warranted to validate these findings and further investigate risk factors and optimal prophylactic measures.