Epidemiology, risk factors, and association of antifungal prophylaxis on early invasive fungal infection in heart transplant recipients

Yetmar, Zachary A.; Lahr, Brian D.; Brumble, Lisa; Banacloche, Juan Gea; Steidley, D. Eric; Kushwaha, Sudhir S.; Beam, Elena

doi:10.1111/tid.13714

Cited by 8 publications

(14 citation statements)

References 27 publications

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“…Fortunately, regarding viral infections, a large contemporary cohort study on heart transplant recipients demonstrated that cytomegalovirus infection was not associated with cardiac allograft rejection [68]. However, a retrospective cohort study from 2000 to 2009 on 966 patients who underwent heart transplantation depicted that renal replacement therapy and allograft rejection were related to invasive fungal and mold infections [69].…”

Section: Deep Sternal Wound Infection and Other Infectionsmentioning

confidence: 99%

“…Previous studies have suggested hemodynamically irrelevant pericardial effusion, which could be observed during common echocardiography, is associated with increased mortality in patients as a valuable predictor of adverse outcomes in patients with heart failure [91]. Interestingly, by assessment of 152 patients who underwent heart transplantation from 1989 to 2012, Stämpfli et al revealed that pericardial effusion irrelevant to surgery in heart transplantation recipients could predict adverse outcomes as this early complication able reduction in bacterial, viral, fungal, and Nocardia post-transplantation infectious episodes [62,69,71]. In spite of these effective treatment methods regarding multidrug-resistant and extensively drug-resistant bacterial infections that pivotally threaten one-year survival, the crucial need for further studies appeared to be extremely necessary [63].…”

Section: Pericardial Effusion and Constrictiv Pericarditismentioning

confidence: 99%

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Early Postoperative Cardiac Complications Following Heart Transplantation

Negargar

Sadeghi

2023

GMJ

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Cardiovascular disorders remain the leading cause of death around the world. Heart transplantation is considered the only therapeutic choice defined as the gold standard strategy to manage end-stage heart failure. Nevertheless, the remaining postoperative complications compromise both the survival rate and quality of life in heart transplantation recipients. The present study aimed to review the current findings concerning the main early complications after heart transplantation, reliable predictors, diagnostic approaches, novel surgical techniques, and management strategies. The results demonstrated that significant advances in immunosuppressive pharmaceuticals, determining appropriate policies for donor acceptance, pre and post-operative treatment/care, selection of the most compatible donor with the recipient, and the suggestion of novel diagnostic and surgical techniques over the past decade had dropped the mortality and morbidity rates early after transplantation. However,marrhythmia, atrial flutter, atrial fibrillation, deep sternal wound infection along with other sites infections, low cardiac output syndrome, acute graft dysfunction, pericardial effusion, constrictive pericarditis, and acute cellular rejection could be considered as the major early complications following heart transplantations that pivotally require further investigations.

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Section: Deep Sternal Wound Infection and Other Infectionsmentioning

confidence: 99%

Section: Pericardial Effusion and Constrictiv Pericarditismentioning

confidence: 99%

Early Postoperative Cardiac Complications Following Heart Transplantation

Negargar

Sadeghi

2023

GMJ

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“…Table 1 summarizes key study characteristics. Topically, 20 studies pertained to liver transplant, [27][28][29][30][31][32][33][34][35][36][52][53][54][55][56][57][58][59]77,78 15 to lung transplant, 5, [38][39][40][41][64][65][66][67]69,71,72,[74][75][76] 9 to kidney transplant, 25,26,[46][47][48][49][50][51]73 6 to heart transplant, [22][23][24][43][44][45] 1 to small bowel transplant, 68 2 to pancreas-kidney tr...…”

Section: Study Characteristicsmentioning

confidence: 99%

“…In heart transplant, 2 studies evaluated risk factors specific to IA. 22,24 Renal replacement therapy (OR, 3.44; CI, 1.68-7.04) 22,24 increased the risk of early post-heart transplant IA with moderate certainty of evidence.…”

Section: Heart Transplantmentioning

confidence: 99%

“…Induction immune suppression, particularly with T-cell-depleting agents, and acute rejection are commonly discussed as risk factors for IFI. Acute rejection 24 and induction immune suppression 45 were found to be significant risk factors in the early posttransplant period in 2 studies. Unfortunately, the remaining studies that evaluated these risk factors did not limit the outcome to the early posttransplant period preventing pooling.…”

Section: Any Invasive Fungal Infectionmentioning

confidence: 99%

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Risk Factors for Early Fungal Disease in Solid Organ Transplant Recipients: A Systematic Review and Meta-analysis

Pennington,

Martin,

Murad

et al. 2023

Transplantation

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Background. Invasive fungal infections are associated with high morbidity in solid organ transplant recipients. Risk factor modification may help with preventative efforts. The objective of this study was to identify risk factors for the development of fungal infections within the first year following solid organ transplant. Methods. We searched for eligible articles through February 3, 2023. Studies published after January 1, 2001, that pertained to risk factors for development of invasive fungal infections in solid organ transplant were reviewed for inclusion. Of 3087 articles screened, 58 were included. Meta-analysis was conducted using a random-effects model to evaluate individual risk factors for the primary outcome of any invasive fungal infections and invasive candidiasis or invasive aspergillosis (when possible) within 1 y posttransplant. Results. We found 3 variables with a high certainty of evidence and strong associations (relative effect estimate ≥ 2) to any early invasive fungal infections across all solid organ transplant groups: reoperation (odds ratio [OR], 2.92; confidence interval [CI], 1.79-4.75), posttransplant renal replacement therapy (OR, 2.91; CI, 1.87-4.51), and cytomegalovirus disease (OR, 2.97; CI, 1.78-4.94). Both posttransplant renal replacement therapy (OR, 3.36; CI, 1.78-6.34) and posttransplant cytomegalovirus disease (OR, 2.81; CI, 1.47-5.36) increased the odds of early posttransplant invasive aspergillosis. No individual variables could be pooled across groups for invasive candidiasis. Conclusions. Several common risk factors exist for the development of any invasive fungal infections in solid organ transplant recipients. Additional risk factors for invasive candidiasis and aspergillosis may be unique to the pathogen, transplanted organ, or both.

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Epidemiology of Invasive Fungal Infections in Solid Organ Transplant Recipients: a North American Perspective

Runyo

Rotstein²

2022

Curr Fungal Infect Rep

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Epidemiology, risk factors, and association of antifungal prophylaxis on early invasive fungal infection in heart transplant recipients

Abstract: Invasive fungal infection following heart transplantation is associated with acute rejection and renal replacement therapy. Antifungal prophylaxis appears to be protective (HR 0.32, 95% CI 0.11-0.96).

Cited by 8 publications

References 27 publications

Early Postoperative Cardiac Complications Following Heart Transplantation

Early Postoperative Cardiac Complications Following Heart Transplantation

Risk Factors for Early Fungal Disease in Solid Organ Transplant Recipients: A Systematic Review and Meta-analysis

Epidemiology of Invasive Fungal Infections in Solid Organ Transplant Recipients: a North American Perspective

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