Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: Invasive Fungal infections in lung transplant recipients(LTR) were common and harmful, remaining a major cause of morbidity and mortality after lung transplantation. The incidence, clinical features, and prophylactic strategies of invasive fungal infections at our lung transplant center in China is unknown.
*Methods: This was a single-center, retrospective cohort study. We reviewed the medical records of all 157 adult LTR from March 2017 to December 2018, involving 136 males(86.6%) and 21 females(13.4%) aged 21~78 years with a median age of 62.0 years. 102 single lung(65%) and 55 double lung(35%) transplant recipients were followed up at postoperative 1,3,6,9,12,18,24 months.
*Results: 52 of the 157 LTR(33.1%) developed invasive fungal infections with a total of 70 cases. 41.4% (29/70 cases) of the infections occurred within one month of the surgery. The most common pathogens that cause invasive fungal infections after lung transplantation are Aspergillus spp (97.1%, 68/70 cases), most commonly Aspergillus flavus(27.1%,19/70 cases ) followed by Aspergillus fumigatus(17.1%,12/70 cases) and Aspergillus niger(10%,7/70 cases). Pulmonary fungal infections were mainly tracheobronchial aspergillosis (82.9%, 58/70 cases), followed by invasive pulmonary aspergillosis (14.3%, 10/70 cases). In 49 (94.2%) patients, nebulized amphotericin B(nAB) and intravenous carpofen were indicated as prophylaxis,except for voriconazole used in 3 patients with definite preoperative aspergillus infection. 90.4% (47/52 cases) were treated with voriconazole monotherapy and 9.6%(5/52 cases) with combination therapy. Anastomotic fistula occurred in 10 (19.2%) and anastomotic stenosis occurred in 8 (15.4%) of the 52 recipients. Septic shock due to fungal or associated bacterial infection resulted in 17 deaths, a high mortality rate of 32.7%.
*Conclusions: The incidence of invasive fungal infection after lung transplantation is high, especially tracheobronchial aspergillosis with Aspergillus flavus as the main pathogenic fungus. It is important to select appropriate fungal control programs to improve the prognosis of lung transplant recipients.
To cite this abstract in AMA style:Zhao L, Chen W, Guo L, Jing L, Liang C, Chen J, Wang C. The Incidence, Clinical Characteristics and Prophylactic Strategy of Invasive Fungal Infections in Lung Transplantation [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/the-incidence-clinical-characteristics-and-prophylactic-strategy-of-invasive-fungal-infections-in-lung-transplantation/. Accessed September 25, 2020.
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