Complications of invasive mycoses in organ transplant recipients

ABSTRACT

Introduction: Opportunistic mycoses remain a significant complication in organ recipients.

Areas covered: This review is an evidence-based presentation of current state-of-knowledge and our perspective on recent developments in the field

Expert commentary: Invasive fungal infections are associated with reduced allograft and patient survival, increase in healthcare resource utilization, and newly appreciated but largely unrecognized immunologic sequelae, such as immune reconstitution syndrome. Given adverse outcomes associated with established infections, prophylaxis is a widely used strategy for the prevention of these infections. Currently available biomarkers that detect circulating fungal cell wall constituents i.e., galactomannan and 1, 3-β-D-glucan have not proven to be beneficial as screening tools for employing targeted prophylaxis or as diagnostic assays in this patient population. However, subsets of patients at risk for opportunistic fungal infections can be identified based on clinically identifiable characteristics or events. Preventive strategies targeted towards these patients are a rational approach for optimizing outcomes.

KEYWORDS:

• Fungal infections
• Candida
• Aspergillus
• Cryptococcus
• transplant
• solid organ transplant
• liver transplant
• lung transplant
• immune reconstitution syndrome
• antifungal prophylaxis

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This paper was not funded.