Evidence That Graft‐Site Candidiasis after Kidney Transplantation Is Acquired during Organ Recovery: A Multicenter Study in France

Abstract

Graft-transmitted candidiasis that ends most often in fungal arteritis is associated with high morbidity and mortality after kidney transplantation and is related to organ contamination during recovery in the donor.

Candida Species Contamination of Preservation Fluid—Outcome of Renal Transplantation in 6 Patients

“…Albano et al reported positive cultures in 8 of 11 arterial specimens, but in only 2 of 11 recipients the blood cultures were positive. 9 Renal arteritis cannot be ruled out in the absence of candidemia or candiduria.…”

“…5,8,12,13 Appropriate antifungal prophylactic therapy has not been determined yet, and centers are applying different approaches, ranging from no therapy to therapy with 2 drugs for at least 3 months. 9,13 When a renal artery aneurysm is detected, the end result is almost invariably allograft removal. 6e9,20 In Conclusion, perfusion fluid contamination in our sample occurred in 6 of 70 samples (incidence of 8.6%).…”

“…9 The prevalence of yeast contamination of kidney preservation fluid is variable. Botterel et al have recently published a study with a prevalence of 3.1%, using plating media specific for yeasts.…”

Donor-Derived Fungal Infections in Organ Transplant Recipients: Guidelines of the American Society of Transplantation, Infectious Diseases Community of Practice

“…Donor-derived fungal infections are a rare but significant complication in transplant recipients (1)(2)(3). The existence of a transmissible infection in the donor and the risk posed by such transmissions often remains unrecognized at the time of recovery of organs.…”

Mucormycosis of the Transplanted Kidney With Renal Papillary Necrosis

“…Clinical presentation of these patients includes pain and tenderness over the graft site, fever, a progressive decline in renal function, leukocytosis, hematuria, enlarged kidney on ultrasonography with typical radiologic features on contrast-enhanced computerized tomography. 16 Renal papillary involvement may sometimes be seen in transplant patients owing to acute rejection, 6 with fungal infections of the renal allograft including renal candidiasis, 8,17 aspergillosis, 9 cryptococcosis, 18 or histoplasmosis. 19 The association of renal papillary necrosis with renal allograft mucormycosis as seen in our patient is unusual.…”