Risk factors and outcomes in lung transplant recipients with nodular invasive pulmonary aspergillosis.

Abstract

BACKGROUND:

Whether nodular lesions have specific risk-factors or influence outcomes in lung transplant recipients with invasive aspergillosis, is not fully known.

METHODS:

The study population consisted of 64 consecutive lung transplant recipients with proven or probable invasive aspergillosis. Nodules, with or without halo/air crescent-sign were considered nodular presentations. Outcomes assessed were response rate (successful versus unsuccessful outcome) and all-cause mortality at 12 weeks.

RESULTS:

Overall, 34 patients had nodular and 30 had non-nodular lesions. Presence of nodular lesions was less likely to be associated with renal failure at baseline (adjusted OR 0.21, 95% CI, 0.04-0.97, p = 0.047), CMV infection (adjusted OR 0.18, 95% CI 0.04-0.75, p = 0.019) and receipt of antifungal prophylaxis (adjusted OR 0.22, 95% CI, 0.06-0.88, p = 0.032). Successful outcome and mortality rates in the study patients were 64.0% (41/64) and 25.0% (16/64), respectively. Nodular aspergillosis was associated with significantly higher successful outcome (adjusted OR 3.35, 95% CI, 1.06-10.54, p = 0.039) and lower mortality at 12 weeks (adjusted OR 0.20, 0.05-0.78, p = 0.021).

CONCLUSIONS:

Lung transplant recipients with nodular lesions due to invasive aspergillosis had better outcomes than those without such lesions.

• Authors: Nina Singh, Jose F Suarez, Robin Avery, Cornelia Lass-Flörl, Christian Geltner, Alessandro C Pasqualotto, G Marshall Lyon, Michelle Barron, Shahid Husain, Marilyn M Wagener, Jose G Montoya
• Journal: The Journal of infection (J Infect) Vol. 67 Issue 1 Pg. 72-8 (Jul 2013) ISSN: 1532-2742 [Electronic] England
• PMID: 23567625 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2013 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Antifungal Agents

Topics

• Antifungal Agents (therapeutic use)
• Female
• Humans
• Invasive Pulmonary Aspergillosis (drug therapy, mortality, pathology)
• Lung (pathology)
• Lung Transplantation
• Male
• Middle Aged
• Risk Factors
• Survival Analysis
• Transplantation
• Treatment Outcome