Invasive pulmonary aspergillosis in heart transplant recipients.

Abstract

OBJECTIVES:

Invasive pulmonary aspergillosis is the most common invasive mycosis in heart transplant recipients. Early clinical recognition of this complication is difficult and laboratory data is not specific. Our aim was to study the characteristics of invasive pulmonary aspergillosis infections in heart transplant recipients.

MATERIALS AND METHODS:

Between 2007 and 2013, there were 82 patients who underwent heart transplant at our institution, including 6 patients who were diagnosed with invasive pulmonary aspergillosis. Medical records of these patients were reviewed for demographic, clinical, and radiographic features, microbiology data, serum galactomannan levels, antifungal treatment, and overall outcomes.

RESULTS:

The most common species causing the infection was Aspergillus fumigatus. The infection was encountered irrespective of the duration since the transplant. Bronchoalveolar lavage with positive culture for Aspergillus species and/or abnormal serum galactomannan level was suggestive of invasive pulmonary aspergillosis.

CONCLUSIONS:

In our opinion, empiric antifungal therapy should be commenced as soon as invasive pulmonary aspergillosis is suspected in heart transplant recipients to reduce mortality. Although the duration of antifungal therapy for invasive pulmonary aspergillosis is debatable, heart transplant recipients may require long-term therapy to avoid recurrence.

• Authors: Elif Küpeli, Gaye Ulubay, Sevil Bayram Akkurt, Füsun Öner Eyüboğlu, Atilla Sezgin
• Journal: Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation (Exp Clin Transplant) Vol. 13 Suppl 1 Pg. 352-5 (Apr 2015) ISSN: 2146-8427 [Electronic] Turkey
• PMID: 25894189 (Publication Type: Journal Article)

Chemical References

• Antifungal Agents
• Biomarkers
• Immunosuppressive Agents
• Mannans
• galactomannan
• Galactose

Topics

• Adult
• Antifungal Agents (therapeutic use)
• Aspergillus (classification, isolation & purification)
• Biomarkers (blood)
• Bronchoalveolar Lavage Fluid (microbiology)
• Female
• Galactose (analogs & derivatives)
• Heart Transplantation (adverse effects, mortality)
• Humans
• Immunosuppressive Agents (adverse effects)
• Invasive Pulmonary Aspergillosis (diagnosis, drug therapy, etiology, microbiology, mortality)
• Lung (microbiology)
• Male
• Mannans (blood)
• Medical Records
• Middle Aged
• Retrospective Studies
• Risk Factors
• Time Factors
• Treatment Outcome
• Turkey