The incidence of fungal infections in pancreas transplant recipients in the absence of systemic antifungal prophylaxis. Clin Transplant 2019 Oct;33(10):e13691
Date
08/11/2019Pubmed ID
31400149DOI
10.1111/ctr.13691Scopus ID
2-s2.0-85071480974 (requires institutional sign-in at Scopus site) 10 CitationsAbstract
BACKGROUND: There is a lack of high-level evidence identifying meaningful outcomes and the place in therapy for systemic perioperative antifungal prophylaxis (ppx) in pancreas transplant recipients. As our program does not routinely utilize systemic perioperative antifungal ppx in pancreas transplant recipients, we assessed the incidence of post-transplant infectious complications.
METHODS: This was a single-center, retrospective cohort study of consecutive adult pancreas transplant recipients between 01/2016 and 04/2018 to describe the incidence of fungal infections. Patients with a history of previous simultaneous pancreas-kidney (SPK) transplant, HIV, or unexplained use of antifungal ppx after transplantation were excluded. The primary outcome was the incidence of fungal infections within 3 months after transplantation.
RESULTS: After screening 60 patients, 56 met inclusion criteria. Within 3 months post-transplantation, two (3.6%) patients had a positive fungal culture requiring systemic antifungal treatment. The sources for infection in both cases were intra-abdominal fluid cultures, positive for Candida albicans. Both patients were treated with fluconazole. Allograft-related outcomes included a 6-month pancreas graft survival of 91.1% and pancreas transplant rejection incidence of 10.7%.
CONCLUSION: In this single-center experience, pancreas transplant recipients not receiving systemic antifungal ppx had similar infectious and graft-related outcomes to what is reported in literature.
Author List
Shaikh SA, Zimmerman A, Nolan A, Cooper M, Abrams PLAuthor
Matthew Cooper MD Chief, Director, Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultFemale
Follow-Up Studies
Fungi
Graft Rejection
Graft Survival
Humans
Incidence
Male
Mycoses
Pancreas Transplantation
Postoperative Complications
Prognosis
Retrospective Studies
Risk Factors
Transplant Recipients