Scientific article
Open access

Invasive aspergillosis in solid organ transplant patients: diagnosis, prophylaxis, treatment, and assessment of response

Published inBMC infectious diseases, vol. 21, no. 1, 296
Publication date2021-03-24
First online date2021-03-24

Background: Invasive aspergillosis (IA) is a rare complication in solid organ transplant (SOT) recipients. Although IA has significant implications on graft and patient survival, data on diagnosis and management of this infection in SOT recipients are still limited.

Methods: Discussion of current practices and limitations in the diagnosis, prophylaxis, and treatment of IA and proposal of means of assessing treatment response in SOT recipients.

Results: Liver, lung, heart or kidney transplant recipients have common as well as different risk factors to the development of IA, thus each category needs a separate evaluation. Diagnosis of IA in SOT recipients requires a high degree of awareness, because established diagnostic tools may not provide the same sensitivity and specificity observed in the neutropenic population. IA treatment relies primarily on mold-active triazoles, but potential interactions with immunosuppressants and other concomitant therapies need special attention.

Conclusions: Criteria to assess response have not been sufficiently evaluated in the SOT population and CT lesion dynamics, and serologic markers may be influenced by the underlying disease and type and severity of immunosuppression. There is a need for well-orchestrated efforts to study IA diagnosis and management in SOT recipients and to develop comprehensive guidelines for this population.

  • Aspergillus
  • Invasive pulmonary aspergillosis
  • Microbiome
  • Mucorales
  • Mucormycosis
  • Solid organ transplantation
  • Aspergillosis / diagnosis
  • Aspergillosis / drug therapy
  • Aspergillosis / etiology
  • Aspergillosis / prevention & control
  • Humans
  • Immunosuppression Therapy / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Invasive Fungal Infections / diagnosis
  • Invasive Fungal Infections / drug therapy
  • Invasive Fungal Infections / etiology
  • Invasive Fungal Infections / prevention & control
  • Organ Transplantation / adverse effects
  • Patient Outcome Assessment
  • Practice Guidelines as Topic
  • Transplant Recipients
  • Triazoles / therapeutic use
Citation (ISO format)
NEOFYTOS, Dionysios et al. Invasive aspergillosis in solid organ transplant patients: diagnosis, prophylaxis, treatment, and assessment of response. In: BMC infectious diseases, 2021, vol. 21, n° 1, p. 296. doi: 10.1186/s12879-021-05958-3
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Article (Published version)
ISSN of the journal1471-2334

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