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Epidemiology of Invasive Fungal Disease in Pediatric Heart Transplant Recipients

Matthew Liversedge1,2, Jeffrey Wang3, Mickael Boustany4

  • 1University of Cincinnati College of Medicine, Cincinnati, OH, United States.

Journal of the Pediatric Infectious Diseases Society
|November 8, 2025
PubMed

Insights

Invasive fungal disease (IFD) affects 4% of pediatric heart transplant patients. Risk factors include prolonged central access, delayed chest closure, and ECMO, necessitating antifungal treatments.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Transplantation Immunology

Background:

  • Invasive fungal disease (IFD) poses a significant risk in immunocompromised patients.
  • Pediatric heart transplant recipients are particularly vulnerable due to complex medical interventions.

Purpose of the Study:

  • To investigate the epidemiology of IFD in pediatric heart transplant recipients.
  • To identify risk factors associated with early-onset IFD and the need for antifungal therapy.

Main Methods:

  • Retrospective analysis of pediatric heart transplant recipients.
  • Identification of IFD cases and associated clinical factors.
  • Statistical analysis to determine risk factors.

Main Results:

  • Eight patients (4%) developed IFD post-transplant.
  • Early IFD was linked to prolonged central access, delayed chest closure, broad-spectrum antibiotics, and ECMO.
  • Delayed chest closure and ECMO correlated with systemic antifungal administration.

Conclusions:

  • IFD is a notable complication in pediatric heart transplant recipients.
  • Specific perioperative factors increase the risk of IFD.
  • Prompt recognition and management of IFD are crucial in this population.
Keywords:
antifungal prophylaxischildrenheart transplantationinvasive fungal disease

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