Invasive Aspergillosis in Kidney and Liver Transplant Recipients From a Pediatric Donor

Invasive aspergillosis is a rare but serious complication that can occur in solid-organ transplant recipients. This condition arises from an infection caused by Aspergillus, a widespread mold typically transmitted through the inhalation of its spores (conidia). This report presents 3 unique cases of invasive aspergillosis in patients who received either kidney or liver transplants from a 17-year-old deceased pediatric donor. The first case was a 27-yearold male kidney transplant recipient who developed symptoms at posttransplant day 65, leading to graft nephrectomy despite antifungal therapy. The second case, a 17-year-old male kidney transplant recipient with a posttransplant course similar to the first case, also required nephrectomy due to worsening invasive aspergillosis. The third case involved a 28-year-old female liver transplant recipient who presented with symptoms at posttransplant day 45 but recovered without the need for graft explant. The occurrence of Aspergillus in graft organs is generally rare and is often associated with systemic hematogenous dissemination before transplant. Clinicians should maintain a high index of suspicion for invasive mycotic infections in solid-organ transplant recipients, especially for patients who present with clump-like lesions on diagnostic imaging. Such awareness is crucial for timely diagnosis and management and may thereby potentially improve patient outcomes in this vulnerable population.