Fungal infection in lung transplant recipients in perioperative period from one lung transplant center

Weizhen Qiao, Jian Zou, Fengfeng Ping, Zhenge Han, Lingling Li, Xiuzhi Wang


Background: This study aimed to analyze the distribution and prophylaxis strategy of pathogens causing fungal infection in lung transplant recipients from cardiac-brain dead donors in the perioperative period to provide evidence for antifungal prophylaxis and treatment in lung transplant recipients.
Methods: This retrospective study evaluated 194 lung transplant recipients from January 2015 to December 2016. Fungal pathogens were isolated and identified from respiratory tract cultures before and after transplantation in the perioperative period. The galactomannan (GM) testing of bronchoalveolar lavage fluid (BALF) might facilitate the diagnosis of Aspergillus infection. Data were statistically analyzed using SPSS 19.0.
Results: A total of 31 cases of fungal strains isolated from the 194 recipients were identified prior to lung transplantation, and the positive rate was 16.0% (31/194). A total of 27 cases of isolated fungal strains in the 194 recipients were identified, and the positive rate after lung transplantation was 13.9% (27/194) in the perioperative period. A total of 54 cases with positive fungal infection (27.8%) were detected before and after lung transplantation. Overall, 10.3% (20/194) of the lung transplant recipients developed fungal infection in the observation period. The most common fungal pathogens were filamentous fungi and Candida albicans.
Conclusions: Our data suggested that fungi were frequently isolated before and after transplantation from respiratory samples. However, the incidence of invasive fungal infection in lung transplant recipients in the perioperative period was relatively low. Targeted antifungal prophylaxis and treatment should be applied on the basis of the fungal distribution status of different individuals.