Review Article

Invasive Mold Infections in Solid Organ Transplant Recipients

Table 2

Characteristics of IMIs by type of SOT.

LiverLung Kidney Heart

Species distribution
(% among IFIs) [3]
Candidiasis 78.7%
Aspergillus sp. 7.9%
Crypto sp. 7.1%
Zygomycetes 3.1%
Other molds 0%
Candidiasis 23.9%
Aspergillus sp. 63%
Crypto sp. 2.2%
Zygomycetes 2.2%
Other molds 9.7%
Candidiasis 60.6%
Aspergillus sp. 11.9%
Crypto sp. 19.3%
Zygomycetes 0.9%
Other molds 2.7%
Candidiasis 65%
Aspergillus sp. 25%
Crypto sp. 2.5%
Zygomycetes 2.5%
Other molds 2.5%

Median time to IA, days [3]99.5 504382

Risk factors for IA [50] Re-transplantation
Renal failure, particularly hemodialysis transplantation for fulminant hepatic failure
Reoperation
Single lung transplant
Early airway ischemia
CMV infection
Rejection and augmented immunosuppression Pretransplant Aspergillus colonization
Posttransplant Aspergillus colonization within a year of transplant
Acquired hypogammaglobulinemia
Graft failure requiring hemodialysis
High and prolonged duration of corticosteroids
Isolation of Aspergillus species in respiratory tract cultures Reoperation
CMV disease
Posttransplant hemodialysis
Existence of an episode of invasive aspergillosis in the
program 2 months before or after heart transplant

Site of IMIs Lung 70.6%
Sinus 17.6%
Skin and soft tissue 35.3%
Lung 100%
Sinus 9.5%
Skin and soft tissue 0%
Lung 85.3%
Sinus 5.6%
Skin and soft tissue 11.1%
Lung 66.7%
Sinus 16.7%
Skin and soft tissue 33.3%

Chest CT findings for patients with IANodular lesions 0%
Infiltrates/consolidations 73%
Nodular lesions 20%
Infiltrates/consolidations 80%
Nodular lesions 50%
Infiltrates/consolidations 50%
Nodular lesions 67%
Infiltrates/consolidations 33%

IA: invasive aspergillosis, CMV:Cytomegalovirus, IFIs: invasive fungal infections, and IMIs: invasive molds infections.