Fungal Infections in Lung Transplantation

Author:

Ramirez-Sanchez Claudia,Nguyen Vi N.,Law NancyORCID

Abstract

Abstract Purpose of Review We aim to understand the most common fungal infections associated with the post-lung transplant period, how to diagnose, treat, and prevent them based on the current guidelines published and our center’s experience. Recent Findings Different fungi inhabit specific locations. Diagnosis of invasive fungal infections (IFIs) depends on symptoms, radiologic changes, and a positive microbiological or pathology data. There are several molecular tests that have been used for diagnosis. Exposure to fungal prophylaxis can predispose lung transplant recipients to these emerging molds. Understanding and managing medication interactions and drug monitoring are essential in successfully treating IFIs. Summary With the increasing rate of lung transplantations being performed, and the challenges posed by the immunosuppressive regimen, understanding the risk and managing the treatment of fungal infections are imperative to the success of a lung transplant recipient. There are many ongoing clinical trials being conducted in hopes of developing novel antifungals.

Publisher

Springer Science and Business Media LLC

Subject

Transplantation,Nephrology,Hepatology,Immunology,Surgery

Reference125 articles.

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5. Baker AW, Maziarz EK, Arnold CJ, Johnson MD, Workman AD, Reynolds JM, Perfect JR, Alexander BD. Invasive fungal infection after lung transplantation: epidemiology in the setting of antifungal prophylaxis. Clin Infect Dis. 2020;70(1):30–9. Baker et al. prospectively collected data on prevalence rates and timing of invasive fungal infections (IFIs), risk factors for IFIs, and data from IFIs that broke through standard antifungal prophylaxis (aerosolized amphotericin B lipid comple) during the lung transplant hospitalization at a tertiary care academic hospital. Their results showed that lung transplant recipients had high rates of IFIs, despite receiving prophylaxis. Their data suggest benefit in providing systemic antifungal prophylaxis targeting Candida for up to 90 days after transplant and extending mold-active prophylaxis for up to 180 days after surgery.

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