Invasive Fungal Infections after Renal Transplantation

S Ezzatzadegan, S Chen, JR Chapman


Background: Invasive fungal infection (IFI) is a leading cause of infection-related mortality among kidney allograft recipients.

Objective: To estimate the incidence and etiology of systemic fungal infection in renal allograft recipients in Sydney transplant facility.

Methods: 471 kidney recipients, transplanted between 2000 and 2010 at the Westmead Hospital renal transplantation center, Sydney, Australia, were retrospectively surveyed.

Results: IFI developed in 10 (2.1%) of 471 patients. With a mean±SD new kidney transplants per year of 42.9±13, the mean±SD incidence of IFI was 0.9±0.6 for each year of transplantation. 4 patients had received kidneys from living donors and 7 from cadavers with a mean±SD age of 50.5±14 years. The mean time to IFI was 33 months after transplantation with majority within the first 2 years. Cryptococcus neoformans was responsible for 50% of episodes (n=5) followed by Aspergillus fumigatus (n=3), and Pseudallescheria boydii (n=3); there was a single case of mucurmycosis. Lungs (n=5) followed by meninges (n=4) and skin (n=3) were the most commonly involved sites.

Conclusion: IFI remains a major concern in renal transplantation. A high index of suspicion is required for early diagnosis and treatment to reduce the mortality. In this regard, appropriate diagnostic tests are necessary, particularly for C. neoformans.


Fungal infections; Renal transplantation; Cryptococcosis

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 pISSN: 2008-6482
 eISSN: 2008-6490


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