Outcomes of solid organ transplant recipients with invasive aspergillosis and other mold infections

Transpl Infect Dis. 2020 Feb;22(1):e13200. doi: 10.1111/tid.13200. Epub 2019 Nov 6.


Objectives: To characterize the clinical presentation and outcomes of invasive mold infections (IMI) in solid organ transplant (SOT) recipients.

Methods: Inclusion of all SOT recipients with IMI diagnosed between 2008 and 2016 at a referral center for SOT. Univariable analyses identified factors associated with death at one year, and logistic regression models retained independent predictors.

Results: Of the 1739 patients that received a SOT during this period, 68 developed IMI (invasive aspergillosis [IA] in 58). Cumulative incidence of IMI at 1 year ranged from 1.2% to 18.8% (kidney and heart transplantation, respectively). At baseline, compared with other IMI, the need for vasoactive drugs was more frequent in patients with IA. During follow-up, 35 patients (51%) were admitted to the ICU and required mechanical ventilation (n = 27), vasoactive drugs (n = 31), or renal replacement therapy (n = 31). The need for vasoactive drugs (OR 7.34; P = .003) and a positive direct examination (OR 10.1; P = .004) were independently associated with the risk of death at 1 year in patients with IA (n = 33; 57%) CONCLUSIONS: Characteristics of IMI at presentation varied according to the underlying transplanted organ and the mold species. Following IA, one-year mortality may be predicted by the need for hemodynamic support and initial fungal load.

Keywords: Aspergillus; invasive aspergillosis; non-Aspergillus molds; outcomes; solid organ transplantation.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aspergillosis / epidemiology*
  • Female
  • Humans
  • Incidence
  • Invasive Fungal Infections / epidemiology*
  • Invasive Fungal Infections / mortality
  • Male
  • Middle Aged
  • Organ Transplantation*
  • Retrospective Studies
  • Transplant Recipients*
  • Treatment Outcome