2013 - ISBTS 2013 Symposium
This page contains exclusive content for the member of the following sections: TTS, IXA, ITA. Log in to view.
Mini-Oral Communications 1
12.248 - Aspergillus infection in small bowel transplant recipients
Presenter: REEM, ALMAGHRABI, , United States
Authors: REEM ALMAGHRABI1, Mohamed Yassin1, Guilherme Costa1, Kareem Abu-Elmagd 1
Aspergillus infection in small bowel transplant recipients
REEM ALMAGHRABI1, Mohamed Yassin1, Guilherme Costa1, Kareem Abu-Elmagd 1
1MEDICINE, UPMC, PITTSBURGH, PA, United States
Background
Small bowel transplantation (SBT) either isolated or as a part of Multi-visceral is proven to be beneficial for patients with intestinal failure. Infectious complications especially fungal infections represent a major cause of morbidity and mortality in solid organ transplant (SOT) recipients. There are very limited data on invasive aspergillosis (IA) in SBT recipients.
Methods
A retrospective, descriptive study of the IA cases in SBT recipients at the UPMC. All SBT recipients 1996-2009 with positive culture for aspergillus species and computed tomography suspicious of aspergillus were included. Patients’ demographics, time and type of graft, immunosuppressive medications, acute rejections episodes, antirejection medications and cause of graft failure were collected.
Results
During the study period 1996-2009 there were 282 SBT cases performed. Aspergillus species were isolated in 27 cases (9.5%). Twenty cases had multi-visceral transplant while 7 cases had isolated SBT. Aspergillus was isolated from the respiratory tract in 16/27 cases, sinus in 1 case, bone biopsy in 1 case, inguinal wound in 1 case, deep wound in 1 case, abdominal wound in 2 cases, skin biopsy in 1 case and unspecified sites in 4 cases. A. Fumagitus was the predominant species, isolated in 14 cases followed by A.niger, A.flavus and A. terreus with 3 cases each. A.versicolor in 2, A.glaucus and A. terazonus with 1 case each.
Twenty patients had at least 1 episode of acute rejection. Murmonab-CD3 (OKT3), steroids and alemtuzumab were used to treat rejection episodes. Aspergillosis was the documented to be the cause of death in 8/27(30%).
Conclusion
IA represents a major burden in SBT. Sinupulmonary aspergillosis is the commonest site of infection. Acute rejections and use of anti-rejection medication increase the risk of acquiring IA. IA carries very high mortality rate in SBT recipients.
Important Disclaimer
By viewing the material on this site you understand and accept that:
- The opinions and statements expressed on this site reflect the views of the author or authors and do not necessarily reflect those of The Transplantation Society and/or its Sections.
- The hosting of material on The Transplantation Society site does not signify endorsement of this material by The Transplantation Society and/or its Sections.
- The material is solely for educational purposes for qualified health care professionals.
- The Transplantation Society and/or its Sections are not liable for any decision made or action taken based on the information contained in the material on this site.
- The information cannot be used as a substitute for professional care.
- The information does not represent a standard of care.
- No physician-patient relationship is being established.
Contact
Address
The Transplantation Society
International Headquarters
740 Notre-Dame Ouest
Suite 1245
Montréal, QC, H3C 3X6
Canada