Fungal infections in transplantation patients

Abstract

Invasive fungal infections have became one of the principal obstacles to successful solid organ and bone marrow transplantation. The natural history and incidence of systemic fungal infection varies with the type of organ transplanted and the immunosuppressive therapy administered; the majority of infections occur within the first two months after transplantation. The most common fungi that cause disease in transplant recipients are Candida spp. and Aspergillus spp. The clinical presentations of fungal infections in solid-organ transplant recipients are non specific and often overlap with other infectious and non infectious processes; for this reason it's important maintain a high index of suspicion for this type of infection so to start an aggressive diagnostic and therapeutic approach. Difficulty in establishing an etiological diagnosis, lack of effective therapy in certain situations, difficult management of certain antifungal drugs due to toxicity and/or interaction with immunosuppressive drugs, and limited data on effective antifungal prophylactic regimens in solid-organ transplantation represent major problems in the treatment of fungal infection in this population