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Outcomes of solid organ transplant recipients with invasive aspergillosis and other mold infections
Author(s) -
Farges Cédric,
Cointault Olivier,
Murris Marlène,
Lavayssiere Laurence,
LakhdarGhazal Shérazade,
Del Bello Arnaud,
Hebral AnneLaure,
Esposito Laure,
Nogier MarieBéatrice,
Sallusto Federico,
Iriart Xavier,
Charpentier Elena,
Guitard Joelle,
Muscari Fabrice,
Dambrin Camille,
Porte Lydie,
Kamar Nassim,
Cassaing Sophie,
Faguer Stanislas
Publication year - 2020
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 - 10.1111/tid.13200
Subject(s) - medicine , aspergillosis , incidence (geometry) , transplantation , vasoactive , mechanical ventilation , organ transplantation , kidney transplantation , renal replacement therapy , logistic regression , immunology , physics , optics
Objectives To characterize the clinical presentation and outcomes of invasive mold infections (IMI) in solid organ transplant (SOT) recipients. Methods Inclusion of all SOT recipients with IMI diagnosed between 2008 and 2016 at a referral center for SOT. Univariable analyses identified factors associated with death at one year, and logistic regression models retained independent predictors. Results 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.