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Prognosis of Invasive Aspergillosis in Kidney Transplant Recipients: A Case-Control Study
BACKGROUND: Invasive aspergillosis (IA) is a major cause of invasive fungal infection in kidney transplant recipients (KTR), and it has a high mortality rate. However, its impact on patients and graft survival has not been well defined in the current era of voriconazole first-line therapy. METHODS:...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5082998/ https://www.ncbi.nlm.nih.gov/pubmed/27819031 http://dx.doi.org/10.1097/TXD.0000000000000584 |
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author | Desbois, Anne-Claire Poiree, Sylvain Snanoudj, Renaud Bougnoux, Marie-Elisabeth Sberro-Soussan, Rebecca Lanternier, Fanny Legendre, Christophe Lortholary, Olivier Scemla, Anne |
author_facet | Desbois, Anne-Claire Poiree, Sylvain Snanoudj, Renaud Bougnoux, Marie-Elisabeth Sberro-Soussan, Rebecca Lanternier, Fanny Legendre, Christophe Lortholary, Olivier Scemla, Anne |
author_sort | Desbois, Anne-Claire |
collection | PubMed |
description | BACKGROUND: Invasive aspergillosis (IA) is a major cause of invasive fungal infection in kidney transplant recipients (KTR), and it has a high mortality rate. However, its impact on patients and graft survival has not been well defined in the current era of voriconazole first-line therapy. METHODS: We retrospectively collected all cases of KTR-associated IA occurring at Necker Enfants Malades Hospital, Paris, from 2003 to 2013. These cases were compared with a group of controls (1:3) who were matched by age, year of kidney transplantation, and sex. The characteristics of IA were also studied. RESULTS: Sixteen patients developed IA after KTR. Most IA cases were limited to the lungs (81.3%), with mild respiratory symptoms in only 53% of the patients. The patients were administered voriconazole (n = 15, 94%) and/or posaconazole (n = 2, 13%). The 12-week and 1-year postinfection survival rates were 94% and 81%, respectively. Compared with the controls (n = 46), patients and death-censored graft survivals rates were significantly lower after IA (P = 0.017 and 0.001, respectively). In the patients with IA, the occurrences of cardiovascular diseases before transplantation (P < 0.0001), delayed graft function (P < 0.0001), and infectious complications (0.0018) were significantly more frequent. CONCLUSIONS: Even with voriconazole therapy, the prognosis of patients with IA after kidney transplantation is still poor. When the patients survive to IA, they have a high risk of graft loss. |
format | Online Article Text |
id | pubmed-5082998 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-50829982017-03-27 Prognosis of Invasive Aspergillosis in Kidney Transplant Recipients: A Case-Control Study Desbois, Anne-Claire Poiree, Sylvain Snanoudj, Renaud Bougnoux, Marie-Elisabeth Sberro-Soussan, Rebecca Lanternier, Fanny Legendre, Christophe Lortholary, Olivier Scemla, Anne Transplant Direct Original Clinical Science BACKGROUND: Invasive aspergillosis (IA) is a major cause of invasive fungal infection in kidney transplant recipients (KTR), and it has a high mortality rate. However, its impact on patients and graft survival has not been well defined in the current era of voriconazole first-line therapy. METHODS: We retrospectively collected all cases of KTR-associated IA occurring at Necker Enfants Malades Hospital, Paris, from 2003 to 2013. These cases were compared with a group of controls (1:3) who were matched by age, year of kidney transplantation, and sex. The characteristics of IA were also studied. RESULTS: Sixteen patients developed IA after KTR. Most IA cases were limited to the lungs (81.3%), with mild respiratory symptoms in only 53% of the patients. The patients were administered voriconazole (n = 15, 94%) and/or posaconazole (n = 2, 13%). The 12-week and 1-year postinfection survival rates were 94% and 81%, respectively. Compared with the controls (n = 46), patients and death-censored graft survivals rates were significantly lower after IA (P = 0.017 and 0.001, respectively). In the patients with IA, the occurrences of cardiovascular diseases before transplantation (P < 0.0001), delayed graft function (P < 0.0001), and infectious complications (0.0018) were significantly more frequent. CONCLUSIONS: Even with voriconazole therapy, the prognosis of patients with IA after kidney transplantation is still poor. When the patients survive to IA, they have a high risk of graft loss. Lippincott Williams & Wilkins 2016-07-01 /pmc/articles/PMC5082998/ /pubmed/27819031 http://dx.doi.org/10.1097/TXD.0000000000000584 Text en Copyright © 2016 The Authors. Transplantation Direct. Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. |
spellingShingle | Original Clinical Science Desbois, Anne-Claire Poiree, Sylvain Snanoudj, Renaud Bougnoux, Marie-Elisabeth Sberro-Soussan, Rebecca Lanternier, Fanny Legendre, Christophe Lortholary, Olivier Scemla, Anne Prognosis of Invasive Aspergillosis in Kidney Transplant Recipients: A Case-Control Study |
title | Prognosis of Invasive Aspergillosis in Kidney Transplant Recipients: A Case-Control Study |
title_full | Prognosis of Invasive Aspergillosis in Kidney Transplant Recipients: A Case-Control Study |
title_fullStr | Prognosis of Invasive Aspergillosis in Kidney Transplant Recipients: A Case-Control Study |
title_full_unstemmed | Prognosis of Invasive Aspergillosis in Kidney Transplant Recipients: A Case-Control Study |
title_short | Prognosis of Invasive Aspergillosis in Kidney Transplant Recipients: A Case-Control Study |
title_sort | prognosis of invasive aspergillosis in kidney transplant recipients: a case-control study |
topic | Original Clinical Science |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5082998/ https://www.ncbi.nlm.nih.gov/pubmed/27819031 http://dx.doi.org/10.1097/TXD.0000000000000584 |
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