20 Jun 2024Article
Invasive Pulmonary Aspergillosis in Lung Transplant Recipients: Retrospective Clinical Analysis from a Tertiary Transplant Center
Affiliations
Article Info
1 Infectious Diseases and Clinical Microbiology Department, Koşuyolu High Specialization Training and Research Hospital, 34865 Istanbul, Türkiye
2 Pediatric Health and Diseases Department, Koşuyolu High Specialization Training and Research Hospital, 34865 Istanbul, Türkiye
Published: 20 Jun 2024
Copyright © 2024 The Author(s).
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
AIM: Aspergillosis is the most common invasive fungal infection among lung transplant recipients (LTRs). Although its incidence is lower than that of bacterial or viral infections, it poses a similar or even higher mortality rate due to challenges in early diagnosis, limited treatment options, and various complications. Therefore, we aimed to evaluate the pulmonary aspergillosis cases in our tertiary lung transplant center. METHODS: A retrospective analysis of 146 LTRs was performed. The demographic data, microbiological and histopathological test results, and radiological findings used for Aspergillus identification were recorded. RESULTS: Aspergillus spp. was detected in 13 of 146 LTRs (9%), mean age 42.5 ± 14.06 years, an average of 18.9 months after lung transplantation. 3 cases (23%) had Aspergillus growth in tissue culture, and 2 (15.4%) showed fungal elements with septal hyaline fibrils in tissue pathology. Aspergillus spp Polymerase chain reaction (PCR) was positive in bronchoalveolar lavage of 8 (61.5%) cases. In addition, 4 (30.7%) cases had relevant tomography findings. The most common pathogens were A. Terreus (21%), A. Fumigatus (14%), and A. Flavus (14%). The mortality rate was 15%. CONCLUSIONS: LTRs are at high risk of Aspergillus spp infections. Early diagnosis with microbiological, histopathological, and radiological tests, in addition to well-established prevention strategies, prophylaxis, and treatment will provide a better survival rate for patients.
Keywords
- fungal infection
- lung transplant recipient
- invasive pulmonary aspergillosis