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Published on: March 22, 2012
Invasive Pulmonary Aspergillosis in Lung Transplant Recipients: Retrospective Clinical Analysis from a Tertiary
Sibel Doğan Kaya1, Yeşim Uygun Kızmaz1, Aysu Türkmen Karaağaç2
1Infectious Diseases and Clinical Microbiology Department, Koşuyolu High Specialization Training and Research Hospital, 34865 Istanbul, Türkiye.
Aim:
Aspergillosis is the most common invasive fungal infection among lung transplant recipients (LTRs). Although its incidence is lower than that of bacterial or viral infections, it poses a similar or even higher mortality rate due to challenges in early diagnosis, limited treatment options, and various complications. Therefore, we aimed to evaluate the pulmonary aspergillosis cases in our tertiary lung transplant center.
Methods:
A retrospective analysis of 146 LTRs was performed. The demographic data, microbiological and histopathological test results, and radiological findings used for Aspergillus identification were recorded.
Results:
Aspergillus spp. was detected in 13 of 146 LTRs (9%), mean age 42.5 ± 14.06 years, an average of 18.9 months after lung transplantation. 3 cases (23%) had Aspergillus growth in tissue culture, and 2 (15.4%) showed fungal elements with septal hyaline fibrils in tissue pathology. Aspergillus spp Polymerase chain reaction (PCR) was positive in bronchoalveolar lavage of 8 (61.5%) cases. In addition, 4 (30.7%) cases had relevant tomography findings. The most common pathogens were A. Terreus (21%), A. Fumigatus (14%), and A. Flavus (14%). The mortality rate was 15%.
Conclusions:
LTRs are at high risk of Aspergillus spp infections. Early diagnosis with microbiological, histopathological, and radiological tests, in addition to well-established prevention strategies, prophylaxis, and treatment will provide a better survival rate for patients.
Insights
Pulmonary aspergillosis affects 9% of lung transplant recipients (LTRs), leading to a 15% mortality rate. Early diagnosis and intervention are crucial for improving survival in these high-risk patients.
Area of Science:
- Medical Mycology
- Transplant Infectious Diseases
- Pulmonology
Background:
- Aspergillosis is a significant invasive fungal infection in lung transplant recipients (LTRs).
- It presents diagnostic challenges and high mortality rates, comparable to bacterial or viral infections.
- Tertiary care centers focus on evaluating pulmonary aspergillosis in LTRs.
Purpose of the Study:
- To evaluate pulmonary aspergillosis cases in a tertiary lung transplant center.
- To identify the incidence and characteristics of Aspergillus infections in LTRs.
- To assess diagnostic methods and outcomes for aspergillosis in this population.
Main Methods:
- Retrospective analysis of 146 LTRs.
- Recorded demographic data, microbiological, histopathological, and radiological findings.
- Focused on Aspergillus identification methods.
Main Results:
- Aspergillus spp. detected in 9% (13/146) of LTRs.
- Common pathogens included Aspergillus Terreus (21%), A. Fumigatus (14%), and A. Flavus (14%).
- Mortality rate was 15%; PCR in bronchoalveolar lavage was positive in 61.5% of cases.
Conclusions:
- Lung transplant recipients face a high risk of Aspergillus infections.
- Early diagnosis through combined microbiological, histopathological, and radiological methods is vital.
- Integrated prevention, prophylaxis, and treatment strategies enhance patient survival.
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