Aspergillus spp. renal arteritis after kidney transplantation: A reappraisal

Transpl Infect Dis. 2023 Oct;25(5):e14108. doi: 10.1111/tid.14108. Epub 2023 Jul 28.

Abstract

Background: Aspergillus spp. is an uncommon and life-threatening cause of transplantrenal artery pseudoaneurysm after kidney transplantation.

Case: We report the case of a 62-year-old woman who underwent kidney transplantation 10 months before and presented a 7-cm asymptomatic transplant renal artery pseudoaneurysm. Transplanted kidney and pseudoaneurysm were surgically removed in emergency. Renal graft, urine, and pseudoaneurysm cultures grew Aspergillus flavus. She recovered after 12 months of antifungal therapy.

Literature review: To date 14 cases of Aspergillus spp. renal arteritis after kidney transplantation have been published, including 50% Aspergillus flavus arteritis. Vast majority were diagnosed within 90 days after transplantation (73%). Despite allograft nephrectomy and antifungal therapy, mortality rate was high (33%).

Keywords: Aspergillus flavus; kidney transplant recipient; kidney transplantation; pseudoaneurysm; renal arteritis; transplant renal artery.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aneurysm, False* / etiology
  • Aneurysm, False* / microbiology
  • Antifungal Agents / therapeutic use
  • Arteritis* / drug therapy
  • Arteritis* / microbiology
  • Aspergillus
  • Aspergillus flavus
  • Female
  • Humans
  • Kidney
  • Kidney Transplantation* / adverse effects
  • Middle Aged

Substances

  • Antifungal Agents