Clinical risk factors for invasive aspergillosis in lung transplant recipients: Results of an international cohort study

Aguilar, Claire; Hamandi, Bassem; Fegbeutel, Christine; Silveira, F.; Verschuuren, Erik; Ussetti, P.; Chin‐Hong, Peter; Solé, Amparó; Holmes‐Liew, Chien‐Li; Billaud, Éliane; Grossi, Paolo; Manuel, Oriol; Levine, Deborah J.; Barbers, Richard G.; Hadjiliadis, Denis; Singer, Lianne G.; Husain, Shahid

doi:10.1016/j.healun.2018.06.008

Cited by 63 publications

(66 citation statements)

References 31 publications

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“…We were unable to do a more robust clinical risk factors multivariate analysis or ROC curves owing to the lower number of patients with IPA, however, our primary objective was to assess the cytokines role in Aspergillus colonization and other studies have evaluated the clinical risk factors of IPA in LTRs. 11,33 Pro-inflammatory cytokines are not specific to IPA and have also been associated with bacterial infections 34 and rejection 35 in some studies. However, only five patients had positive bacterial cultures in BAL other than commensal flora and none in the Suspected IPA group.…”

Section: Discussionmentioning

confidence: 99%

Cytokine profile in lung transplant recipients with Aspergillus spp colonization

Herrera

Gohir

Foroutan

et al. 2019

Transplant Infectious Dis

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We studied cytokine profiles in BAL of LTRs with Aspergillus spp colonization who did not progress to IPA in the absence of antifungal prophylaxis. This was a retrospective, single center case‐control study. BAL samples were analyzed for cytokines. Patients with Aspergillus spp in BAL who did not receive prophylaxis and did not develop IPA were compared to LTRs with Aspergillus spp that received prophylaxis, LTRs with IPA and controls. Twenty‐one patients with Aspergillus colonization who did not develop IPA, seven patients with suspected IPA who received prophylaxis, 4 IPA and 19 controls were included. IPA group had significantly higher levels (median [IQR]) of MIP‐1 beta compared to the Suspected IPA group (5 vs 5 P: 0.03). The Suspected IPA group had significantly higher levels of IL‐12 (11.38 vs 1 P: 0.0001), IL‐1 RA (86.11 vs 23.98 P: 0.0118), IP‐10 (22.47 vs 0.86 P: 0.0151), HGF (40.92 vs 16.82 P: 0.0055), and MIG (169.62 vs 5 P: 0.0005) than Colonization group. We have identified a unique cytokine signature in patients with Aspergillus colonization that do not develop IPA. Our study forms basis for a larger study to use these cytokines profile to identify patients at a lower risk of developing IPA.

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Section: Discussionmentioning

confidence: 99%

Cytokine profile in lung transplant recipients with Aspergillus spp colonization

Herrera

Gohir

Foroutan

et al. 2019

Transplant Infectious Dis

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“…In lung transplant recipients, invasive aspergillosis is the predominant fungal infection [44,71,75]. In the past, the incidence of IA in this group of patients was reported in the range of 4.0-23.3%, however, newer studies point to a lower frequency of this disease [44].…”

Section: Lung and Heart-lung Transplant Recipientsmentioning

confidence: 99%

“…The most common species linked to the etiology of IA in lung transplant recipients is Aspergillus fumigatus. In an international, multicenter, retrospective cohort study of 900 consecutive adult lung transplant recipients with 4 years of follow-up, 79 patients developed 115 episodes of IA [75]. Aspergillus fumigatus was isolated in 72 of 115 (63%) episodes [75].…”

Section: Lung and Heart-lung Transplant Recipientsmentioning

confidence: 99%

“…In an international, multicenter, retrospective cohort study of 900 consecutive adult lung transplant recipients with 4 years of follow-up, 79 patients developed 115 episodes of IA [75]. Aspergillus fumigatus was isolated in 72 of 115 (63%) episodes [75]. In a retrospective study of 251 lung transplant recipients, Aspergillus was isolated from 86 (33%) cases including 50 patients colonized with Aspergillus spp., 17 recipients with tracheobronchitis, and 19 cases of IA [76].…”

Section: Lung and Heart-lung Transplant Recipientsmentioning

confidence: 99%

“…before lung transplantation remains controversial. Some authors indicate its importance within the first year after lung transplantation, if the recipient was colonized in the period of 6 months before lung transplantation, while others did not find any significant link between Aspergillus pre-transplant colonization and occurrence of IA in the post-transplant period [44,[75][76][77]. Other risk factors for IA, which are unique to lung transplant recipients, comprise bronchial anastomotic leaks and other complications within the surgical site, airway narrowing, allograft dysfunction and/or graft ischaemia, reperfusion injury, CMV infection, bronchiolitis, and requirement for more intensive immunosuppressive therapy to prevent graft rejection [44,76].…”

Section: Lung and Heart-lung Transplant Recipientsmentioning

confidence: 99%

See 2 more Smart Citations

Invasive Aspergillosis in Transplant Recipients

Wróblewska¹,

Sulik-Tyszka²,

Figiel³

et al. 2020

Surgical Recovery

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Patients with hematological malignancies and recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT) as well as solid organ transplant recipients are the groups of patients with the highest risk of invasive fungal infections (IFI). Neutropenia, lymphopenia, chemotherapy of malignancies, radiation therapy, immunosuppressive therapy, administration of glucocorticosteroids, use of central venous catheters, dialysis therapy, liver and kidney failure, and diabetes are diseases and medical conditions which foster invasive fungal infections. In recent years, it has been observed that the most common etiological agents of these infections are yeastlike fungi of the genus Candida, and the second most common is moulds Aspergillus spp. Antifungal agent recommended for therapy of IFI caused by Aspergillus is voriconazole, according to the present guidelines. A combined therapy using voriconazole and caspofungin may not be effective. According to numerous publications, in case of infections caused by strains resistant to voriconazole, a therapeutic success is possible after a switch to the liposomal form of amphotericin B. Due to nonspecific clinical symptoms of IFI caused by Aspergillus spp., histopathological as well as mycological and serological tests, echocardiographic examination, magnetic resonance imaging (MRI) and computer tomography (CT) may contribute to an early and reliable diagnosis of invasive aspergillosis.

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Aspergillus in Solid Organ and Stem Cell Transplant Patients: Emerging Options for Diagnosis and Management

Villalobos¹,

Husain²

2020

Emerging Transplant Infections

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Invasive aspergillosis is a major cause of morbidity and mortality in hematopoietic stem cell transplant and solid organ transplant recipients. The introduction of new noninvasive tests, combined with more effective and better-tolerated antifungal agents, has decreased the mortality rates associated with invasive aspergillosis. This review provides an update on the epidemiology of this disease in transplant patients, the associated risk factors that have been identified in each transplant population, and the current approaches for diagnosis, management, and prevention of invasive aspergillosis.

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Clinical risk factors for invasive aspergillosis in lung transplant recipients: Results of an international cohort study

Cited by 63 publications

References 31 publications

Cytokine profile in lung transplant recipients with Aspergillus spp colonization

Cytokine profile in lung transplant recipients with Aspergillus spp colonization

Invasive Aspergillosis in Transplant Recipients

Aspergillus in Solid Organ and Stem Cell Transplant Patients: Emerging Options for Diagnosis and Management

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