Outcomes of solid organ transplant recipients with invasive aspergillosis and other mold infections.
Cédric FargesOlivier CointaultMarlène MurrisLaurence LavayssiereShérazade Lakhdar-GhazalArnaud Del BelloAnne-Laure HebralLaure EspositoMarie-Béatrice NogierFederico SallustoXavier IriartElena CharpentierJoelle GuitardFabrice MuscariCamille DambrinLydie PorteNassim KamarSophie CassaingStanislas FaguerPublished in: Transplant infectious disease : an official journal of the Transplantation Society (2019)
Of the 1739 patients that received a SOT during this period, 68 developed IMI (invasive aspergillosis [IA] in 58). Cumulative incidence of IMI at 1 year ranged from 1.2% to 18.8% (kidney and heart transplantation, respectively). At baseline, compared with other IMI, the need for vasoactive drugs was more frequent in patients with IA. During follow-up, 35 patients (51%) were admitted to the ICU and required mechanical ventilation (n = 27), vasoactive drugs (n = 31), or renal replacement therapy (n = 31). The need for vasoactive drugs (OR 7.34; P = .003) and a positive direct examination (OR 10.1; P = .004) were independently associated with the risk of death at 1 year in patients with IA (n = 33; 57%) CONCLUSIONS: Characteristics of IMI at presentation varied according to the underlying transplanted organ and the mold species. Following IA, one-year mortality may be predicted by the need for hemodynamic support and initial fungal load.
Keyphrases
- mechanical ventilation
- end stage renal disease
- ejection fraction
- chronic kidney disease
- newly diagnosed
- intensive care unit
- prognostic factors
- acute kidney injury
- acute respiratory distress syndrome
- risk factors
- coronary artery disease
- patient reported outcomes
- cardiovascular events
- adipose tissue
- type diabetes
- skeletal muscle
- drug induced
- extracorporeal membrane oxygenation