Devastating Invasive Aspergillus Infection Following Commercial Kidney Transplantation: Case Report, Review of Literature, and Ethical Issues

Abstract

We described an extraordinary case of invasive aspergillosis (IA) after commercial kidney transplantation. Massive infestation by angiotrophic fungi with morphological features of Aspergillus caused fungal arteritis of renal blood vessels with detachment of the kidney graft from the iliac artery with ipsilateral leg ischemia, necessitating graft removal and recurrent vascular surgery to restore the blood supply to the leg. A literature review comprising various features of invasive aspergillosis and ethical aspects of commercial kidney transplantations is elucidated in this paper.

Keywords:

• invasive aspergillosis
• IA
• transplant tourism
• TT
• galactomannan

Ethics and Consent Statements

1. The patient has signed an informed consent including the consent to publish images (including CT scan and pathology).

2. The policy of our institution does not require permission for publication of a case report.

3. Organ source: Our article is dedicated to the theme of “organ trade” and “transplant tourism (TT)”. Our patient traveled abroad for commercial living unrelated to donor kidney transplantation. The source of donated organ is by organ trade and not in accordance with the declaration of Istanbul as discussed in our article with serious complication of Aspergillus arteritis caused by infected kidney graft.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

Professor Yosef Shmuel Haviv reports personal fees from Nephrocare Israel, outside the submitted work. The authors declare no other conflicts of interest in this work.

Additional information

Funding

The authors declare no funding was received for this work.