Chest
Clinical Investigations: Lung TransplantationAspergillus Airway Colonization and Invasive Disease After Lung Transplantation
Section snippets
MATERIALS AND METHODS
Between May 1986 and October 1994, we evaluated a consecutive series of 147 patients undergoing lung or heart-lung transplantation at the University of Minnesota. A transplantation case was defined as a new transplant or a retransplant that was performed at least 6 months after the original surgery when immunosuppression had been tapered to its lowest level.
After transplantation, all patients were maintained on a regimen of immunosuppression with cyclosporine, azathioprine, and prednisone (0.5
RESULTS
Between May 1986 and October 1994, 147 patients (62 men and 85 women) with advanced pulmonary or pulmonary vascular disease underwent 153 lung or heart-lung transplantation procedures at the University of Minnesota. The median patient age at the time of transplantation was 44 years (range, 3 to 64 years). Six of the 153 transplants were retransplant surgeries for acute or chronic graft failure. Four of the retransplants were performed more than 6 months after the original surgery and were thus
DISCUSSION
Invasive fungal infection caused by Aspergillus is an often fatal complication of lung transplantation.2,3,6,13 The lung is the presumed portal of entry for fungal spores, and direct invasion of the lung or airway is present in the vast majority of transplant recipients dying with invasive Aspergillosis.9,14, 15, 16 This was confirmed in our study where invasive disease had a 100%; mortality rate and four of the five patients with invasive disease had fungal invasion of the transplanted lung.
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