Premium
Cryptococcal meningitis: an analysis among 5521 consecutive organ transplant recipients
Author(s) -
Wu G.,
Vilchez R.A.,
Eidelman B.,
Fung J.,
Kormos R.,
Kusne S.
Publication year - 2002
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1034/j.1399-3062.2002.t01-1-02005.x
Subject(s) - medicine , meningitis , incidence (geometry) , cryptococcal meningitis , gastroenterology , population , liver transplantation , risk factor , transplantation , surgery , immunology , human immunodeficiency virus (hiv) , viral disease , physics , environmental health , optics
Cryptococcal meningitis has been reported to be an important cause of morbidity and mortality in renal transplant recipients. However, additional studies of recipients of other organ transplants suggested that these patients might be at low risk for cryptococcal meningitis. We examined the incidence and clinical features of cryptococcal meningitis among different groups of organ transplant patients at the University of Pittsburgh Medical Center. From January 1989 through July 1999, 28 patients were diagnosed with cryptococcal meningitis among 5521 transplant recipients. These included liver (11/2539), heart (8/372), kidney (7/2122), lung (1/432), and small bowel (1/56) recipients. The incidence of cryptococcal meningitis was higher in heart and small bowel recipients compared to other transplant populations ( P = 0.005). The cryptococcal meningitis‐related mortality in transplant recipients was 50% and was associated with altered mental status ( P = 0.001), absence of headache ( P = 0.02), and liver failure ( P = 0.002). Multivariable analysis indicated that liver failure was the only independent risk factor for poor prognosis ( P = 0.043). All cases of liver failure occurred among liver transplant recipients. Cryptococcal meningitis is associated with significant mortality among organ transplant recipients. The presence of allograft failure in liver transplant recipients with cryptococcal meningitis may be an indicator of poor prognosis in this patient population.