Candida Species Contamination of Preservation Fluid—Outcome of Renal Transplantation in 6 Patients

Rodrigues, B.F.; Natário, Ana; Vizinho, Ricardo; Jorge, Cristina; Weigert, André; Martinho, António; Toscano, Cristina; Marques, Teresa; Machado, Domingos

doi:10.1016/j.transproceed.2013.03.024

Cited by 21 publications

(35 citation statements)

References 24 publications

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“…In Matignon et al, eight cases with fungal contamination were confirmed through preservation fluid culture, and antifungal therapy was initiated; excitingly, five patients did not develop serious vascular complications. A similar phenomenon was reported in Rodrigues et al . These cases indicate that serious vascular complications might be delayed or avoided with timely antifungal therapy.…”

Section: Discussionsupporting

confidence: 84%

“…Table lists the characteristics of 51 kidney transplant cases who had fungal arteritis: Case 1, Case 2, Case 3, Cases 4‐5, Cases 6‐7, Cases 8‐11, Case 12, Cases 13‐16, Cases 17‐20, Case 21, Cases 22‐34, Case 35, Case 36, Case 37, Case 38‐39, Case 40, Case 41, Cases 42‐43, Cases 44‐45, Cases 46‐47, Cases 48‐49, Case 50, and Case 51 (our present case). The median age of 38 reported cases was 40.0 years (range 15‐66 years).…”

Section: Report Of 51 Cases Of Fungal Arteritismentioning

confidence: 99%

“…Candida and Aspergillus species are the most common causes of invasive infections. Fungal infections can be caused by contamination of the organ during harvest, preservation, and handling, or at transplantation . These infections generally occur in the first months after KT and are mainly noted by doctors because of elevated serum creatinine, decreased urine output, sudden abdominal pain, and hemorrhagic shock.…”

Section: Introductionmentioning

confidence: 99%

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Fifty‐one cases of fungal arteritis after kidney transplantation: A case report and review of the literature

Tang

Shen

et al. 2017

Transplant Infectious Dis

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Fungal arteritis affecting graft arteries is a rare but life-threatening complication in kidney transplantation (KT). Here, we report the case of a patient with Aspergillus arteritis who experienced renal artery rupture 8 days after KT. We also reviewed 50 other reported cases of fungal arteritis after KT. We found that fungal contamination can occur during kidney graft harvest, preservation, and/or transplantation. Typically, early diagnosis, timely antifungal treatment, and emergency surgery seem crucial for avoiding life-threatening vascular complications.

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Section: Discussionsupporting

confidence: 84%

Section: Report Of 51 Cases Of Fungal Arteritismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Fifty‐one cases of fungal arteritis after kidney transplantation: A case report and review of the literature

Tang

Shen

et al. 2017

Transplant Infectious Dis

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“…We did not detect any PF-related mortality. This conflicting result may be explained, at least in part, by the fact that we did not detect any PF-related infection by Candida spp., whose mortality rate (and the rate of graft loss described in case series and cohort studies) is between 50% and 100% of cases [7, 26–28]. The prospective nature of the study may have contributed to the greater diagnostic sensitivity and to the earlier initiation of treatment.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Culturing the Organ Preservation Fluid on Solid Organ Transplantation: A Prospective Multicenter Cohort Study

Oriol

Sabé

Càmara

et al. 2019

Open Forum Infectious Diseases

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Background We analyzed the prevalence, etiology, and risk factors of culture-positive preservation fluid and their impact on the management of solid organ transplant recipients. Methods From July 2015 to March 2017, 622 episodes of adult solid organ transplants at 7 university hospitals in Spain were prospectively included in the study. Results The prevalence of culture-positive preservation fluid was 62.5% (389/622). Nevertheless, in only 25.2% (98/389) of the cases were the isolates considered “high risk” for pathogenicity. After applying a multivariate regression analysis, advanced donor age was the main associated factor for having culture-positive preservation fluid for high-risk microorganisms. Preemptive antibiotic therapy was given to 19.8% (77/389) of the cases. The incidence rate of preservation fluid–related infection was 1.3% (5 recipients); none of these patients had received preemptive therapy. Solid organ transplant (SOT) recipients with high-risk culture-positive preservation fluid receiving preemptive antibiotic therapy presented both a lower cumulative incidence of infection and a lower rate of acute rejection and graft loss compared with those who did not have high-risk culture-positive preservation fluid. After adjusting for age, sex, type of transplant, and prior graft rejection, preemptive antibiotic therapy remained a significant protective factor for 90-day infection. Conclusions The routine culture of preservation fluid may be considered a tool that provides information about the contamination of the transplanted organ. Preemptive therapy for SOT recipients with high-risk culture-positive preservation fluid may be useful to avoid preservation fluid–related infections and improve the outcomes of infection, graft loss, and graft rejection in transplant patients.

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“…Unlike donor or procurement risk factors, positivity is a clear indication for antifungal therapy. The frequency of PF contamination by Candida vary between institutions and ranges from 3%-9% in kidney transplantation [16][17][18], and 0.4-4.1% in liver transplantation [8,9,18]. When compared within the same institution using a standardized microbiological protocol, PF contamination in liver transplantation (4.1%) seemed to be slightly higher than that in kidney transplantation (3.1%) [18].…”

Section: Preservation Fluid Culturementioning

confidence: 96%

A Silent and Very Early Post-Liver Transplant Death by Candida Arteritis

Ko¹,

Guerra²,

Garvin³

2019

obm transplant

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Background: Graft site candidiasis is a serious complication after solid organ transplantation, often presenting as invasive arteritis leading to graft loss or even death. Case Report: We report a case of anastomotic site candidiasis leading to arterial rupture and death at postoperative day 10 with no clinical warning signs. Preservation fluid cultures were negative and postoperative Doppler ultrasonography did not show vascular compromise. Postmortem examination revealed microscopic arterial wall abscesses harbouring hyphae and yeast consistent with Candida species. Conclusions: Our case demonstrates a particularly early and silent death post-liver transplant due to Candida arteritis and highlights the limitations of current preventive and screening measures. We discuss potential routes of contamination and control measures.

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Candida Species Contamination of Preservation Fluid—Outcome of Renal Transplantation in 6 Patients

Cited by 21 publications

References 24 publications

Fifty‐one cases of fungal arteritis after kidney transplantation: A case report and review of the literature

Fifty‐one cases of fungal arteritis after kidney transplantation: A case report and review of the literature

The Impact of Culturing the Organ Preservation Fluid on Solid Organ Transplantation: A Prospective Multicenter Cohort Study

A Silent and Very Early Post-Liver Transplant Death by Candida Arteritis

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