SAN FRANCISCO — Children who contract pulmonary lung infections in the year after receiving a lung transplant are 70% more likely to die than are those with no such infections, Dr. Lara A. Danziger-Isakov reported in a poster presentation at the American Transplant Congress.
This suggests that clinicians should consider prophylaxis in children judged to be at risk, concluded Dr. Danziger-Isakov, of the Cleveland Clinic, and her colleagues.
The multicenter, retrospective cohort analysis involved 555 patients at 12 centers, all of whom had data collected from the time of transplant until death, retransplantation, or 365 days after transplantation. During that time, 92 (17%) of those children contracted 99 pulmonary fungal infections, and 12 died.
The fungal infections occurred throughout the posttransplant year, with a mean of 78 days and a median of 26 days post transplant. Children with infections were significantly older than those without (15.2 years versus 12.6 years), and were significantly more likely to have pretransplant colonization. Candida and Aspergillus species were the most common organisms recovered from the infected children; 23% of the children with Aspergillus and the 7% of the children with Candida died, they said at the meeting cosponsored by the American Society of Transplant Surgeons and the American Society of Transplantation.