Open AccessInvasive fungal infections in kidney and liver transplant recipients in a center in northeast Brazil
Author(s) -
Pablo Eliack Linhares de Holanda,
Cláudia Maria Costa de Oliveira,
Teresinha do Menino Jesus Silva Leitão,
José Huygens Parente Garcia,
Maria Danielly de Almeida Sousa,
Renata Antunes Bruno da Silva,
Sônia Leite da Silva,
Evelyne Santana Girão
Publication year - 2021
Publication title -
research, society and development
Language(s) - English
Resource type - Journals
ISSN - 2525-3409
DOI - 10.33448/rsd-v10i10.18699
Subject(s) - medicine , aspergillosis , tacrolimus , cryptococcosis , liver transplantation , surgery , transplantation , gastroenterology , immunology
Objective: Describe the main invasive fungal infections (IFIs) after kidney and liver transplantation at a referral center, as well as their evolution, treatment, and clinical features. Material and Methods: This was a retrospective, observational, descriptive, case series study involving IFIs diagnosed between January 2012 and December 2019 in kidney and liver transplant recipients. Results: Among 769 kidney transplants, only 1 patient received the organ from a living donor and the other transplants were from deceased donors. 15 IFIs were diagnosed (7 histoplasmoses, 4 cryptococcoses, 3 candidemias, and 1 aspergillosis), while in 673 liver transplants, 8 IFIs were diagnosed (6 candidemias, 1 murcomycosis, and 1 cryptococcosis). Of the total 23 patients, 6 (26%) had infection diagnosed within 6 months after transplantation. The primary immunosuppressive regimen used was tacrolimus (82.6%), prednisone (82.6%), and mycophenolate (56.5%). Amphotericin B deoxycholate was the leading antifungal agent used for treatment, with nephrotoxicity in 80% of the cases. In the clinical follow-up, 14 patients progressed to cure (60.9%) and 9 to death (39.1%). A worsening of renal function was observed in most patients in the present study. Conclusion: Candidemia, histoplasmosis, and cryptococcosis were the most frequent IFIs, with the majority occurring later, 6 months after transplantation, and associated with high mortality.