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Epidemiology, risk factors and outcomes of invasive aspergillosis in solid organ transplant recipients in the Swiss Transplant Cohort Study.

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Neofytos, Dionysios Chatzis, Olga [UCL] Nasioudis, Dimitrios Boely Janke, Elsa Doco Lecompte, Thanh Swiss Transplant Cohort Study

(eng) BACKGROUND: There is lack of recent multicenter epidemiological data on invasive aspergillosis (IA) among solid organ transplant recipient (SOTr) in the mold-acting antifungal era. We describe the epidemiology and outcomes of IA in a contemporary cohort of SOTr using the Swiss Transplant Cohort Study. METHODS: All consecutive SOTr with proven or probable IA between 01.05.2008 and 31.12.2014 were included. A case-control study to identify IA predictors was performed: 1-case was matched with 3-controls based on SOT type, transplant center, and time post-SOT. RESULTS: Among 2868 SOTr, 70 (2.4%) patients were diagnosed with proven (N: 30/70, 42.9%) or probable (N: 40/70, 57.1%) IA. The incidence of IA was 8.3%, 7.1%, 2.6%, 1.3%, and 1.2% in lung, heart, combined, kidney, and liver transplant recipients, respectively, Galactomannan immunoassay was positive in 1/3 of patients tested. Only 33/63 (52.4%) of patients presented with typical pulmonary radiographic findings. Predictors of IA included: renal insufficiency, re-operation, and bacterial and viral infections. 12-week mortality was higher in liver (85.7%, 6/7) compared to other (15.9%, 10/63; P < .001) SOTr. CONCLUSIONS: Invasive aspergillosis remains a rare complication post-SOT, with atypical radiographic presentations and low positivity rates of biomarkers posing significant diagnostic challenges. Although overall mortality has decreased in SOTr, it remains high in liver SOTr.

Document type Article de périodique (Journal article) – Article de recherche
Publication date 2018
Language Anglais
Journal information "Transplant infectious disease" - Vol. 20, no. 4, p. e12898 [1-11] (2018)
Peer reviewed yes
Publisher Munksgaard ((Denmark) Copenhagen)
issn 1398-2273
e-issn 1399-3062
Publication status Publié
Affiliations UCL - (SLuc) Service de pédiatrie spécialisée
UCL - SSS/IREC/SLUC - Pôle St.-Luc
Keywords epidemiology ; invasive aspergillosis ; solid organ transplant recipients
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Bibliographic reference Neofytos, Dionysios ; Chatzis, Olga ; Nasioudis, Dimitrios ; Boely Janke, Elsa ; Doco Lecompte, Thanh ; et. al. Epidemiology, risk factors and outcomes of invasive aspergillosis in solid organ transplant recipients in the Swiss Transplant Cohort Study.. In: Transplant infectious disease, Vol. 20, no. 4, p. e12898 [1-11] (2018)
Permanent URL http://hdl.handle.net/2078.1/204316