Spectrum of Aspergillus Infection in Lung Transplant Recipients

Fungal Infections in Transplant and Oncology Patients

“…Most Aspergillus infections historically occurred within the first year following SOT [20,73,74]. Tracheobronchial and/or anastomotic Aspergillus infections typically occurred within the first 90 days post transplant compared with invasive pulmonary aspergillosis which tended to occur later [73,74].…”

“…Further clouding the picture, the distinction between colonization and infection with Aspergillus can be difficult. For example, Aspergillus can be recovered from the lower respiratory tract of many patients post lung transplant, but based on a review of the literature, progression from colonization to infection in lung-transplant recipients is rare [20]. In contrast, recovery of Aspergillus from lower respiratory tract specimens in patients with hematologic malignancy or undergoing HSCT has a high positive predictive value for invasive disease [21].…”

“…Further, consistent with trends among transplant populations, the prevalence of IFI remained high and constant throughout the study period (1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003); although the rate of IC decreased, the prevalence of invasive mold infections increased [12]. Aspergillus can be recovered from the lower respiratory tract of many patients post lung transplant, but based on a review of the literature, progression from colonization to infection in lung-transplant recipients is rare [20]. In contrast, recovery of Aspergillus from lower respiratory tract specimens in patients with hematologic malignancy or undergoing HSCT has a high positive predictive value for invasive disease [21].…”

“…In addition, a recent Australian study of candidemia in SOT recipients found that 54% of infections developed greater than 6 months after transplant, the majority of these in renal transplant recipients. Notably, nearly all these patients were hospitalized at the time of diagnosis due to complications from various bacterial infections and had been receiving broadspectrum antibiotics [72].Most Aspergillus infections historically occurred within the first year following SOT [20,73,74]. Tracheobronchial and/or anastomotic Aspergillus infections typically occurred within the first 90 days post transplant compared with invasive pulmonary aspergillosis which tended to occur later [73,74].…”

Gene Expression Profiling of Bronchoalveolar Lavage Cells during Aspergillus Colonization of the Lung Allograft

“…[14][15][16] While invasive disease is more common after lung transplant than with other solid organ transplants, it still affects only a small percentage of lung recipients. 17,18 In contrast, asymptomatic Aspergillus infection or "colonization" occurs in approximately one-third of lung transplant recipients within one year. 18 Importantly, we have previously shown that Aspergillus colonization is associated with an increased risk of chronic lung allograft dysfunction (CLAD).…”