Clinical Presentation and Determinants of Mortality of Invasive Pulmonary Aspergillosis in Kidney Transplant Recipients: A Multinational Cohort Study

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dc.citation.issue11
dc.citation.volume16
dc.contributor.authorLopez-Medrano, F.
dc.contributor.authorFernandez-Ruiz, M.
dc.contributor.authorSilva, J. T.
dc.contributor.authorCarver, P. L.
dc.contributor.authorvan Delden, C.
dc.contributor.authorMerino, E.
dc.contributor.authorPerez-Saez, M. J.
dc.contributor.authorMontero, M.
dc.contributor.authorCoussement, J.
dc.contributor.authorMazzolin, Milene de Abreu [UNIFESP]
dc.contributor.authorCervera, C.
dc.contributor.authorSantos, L.
dc.contributor.authorSabe, N.
dc.contributor.authorScemla, A.
dc.contributor.authorCordero, E.
dc.contributor.authorCruzado-Vega, L.
dc.contributor.authorMartin-Moreno, P. L.
dc.contributor.authorLen, O.
dc.contributor.authorRudas, E.
dc.contributor.authorde Leon, A. P.
dc.contributor.authorArriola, M.
dc.contributor.authorLauzurica, R.
dc.contributor.authorDavid, M.
dc.contributor.authorGonzalez-Rico, C.
dc.contributor.authorHenriquez-Palop, F.
dc.contributor.authorFortun, J.
dc.contributor.authorNucci, M.
dc.contributor.authorManuel, O.
dc.contributor.authorPano-Pardo, J. R.
dc.contributor.authorMontejo, M.
dc.contributor.authorMunoz, P.
dc.contributor.authorSanchez-Sobrino, B.
dc.contributor.authorMazuecos, A.
dc.contributor.authorPascual, J.
dc.contributor.authorHorcajada, J. P.
dc.contributor.authorLecompte, T.
dc.contributor.authorMoreno, A.
dc.contributor.authorCarratala, J.
dc.contributor.authorBlanes, M.
dc.contributor.authorHernandez, D.
dc.contributor.authorFarinas, M. C.
dc.contributor.authorAndres, A.
dc.contributor.authorAguado, J. M.
dc.coverageHoboken
dc.date.accessioned2020-07-31T12:47:26Z
dc.date.available2020-07-31T12:47:26Z
dc.date.issued2016
dc.description.abstractThe prognostic factors and optimal therapy for invasive pulmonary aspergillosis (IPA) after kidney transplantation (KT) remain poorly studied. We included in this multinational retrospective study 112 recipients diagnosed with probable (75.0% of cases) or proven (25.0%) IPA between 2000 and 2013. The median interval from transplantation to diagnosis was 230 days. Cough, fever, and expectoration were the most common symptoms at presentation. Bilateral pulmonary involvement was observed in 63.6% of cases. Positivity rates for the galactomannan assay in serum and bronchoalveolar lavage samples were 61.3% and 57.1%, respectively. Aspergillus fumigatus was the most commonly identified species. Six- and 12-week survival rates were 68.8% and 60.7%, respectively, and 22.1% of survivors experienced graft loss. Occurrence of IPA within the first 6 months (hazard ratio [HR]: 2.29en
dc.description.abstractp-value = 0.027) and bilateral involvement at diagnosis (HR: 3.00en
dc.description.abstractpvalue = 0.017) were independent predictors for 6-week all-cause mortality, whereas the initial use of a voriconazole-based regimen showed a protective effect (HR: 0.34en
dc.description.abstractp-value = 0.007). The administration of antifungal combination therapy had no apparent impact on outcome. In conclusion, IPA entails a dismal prognosis among KT recipients. Maintaining a low clinical suspicion threshold is key to achieve a prompt diagnosis and to initiate voriconazole therapy.en
dc.description.affiliationUniv Complutense, Sch Med, Dept Med,Hosp Octubre I 12 12, Unit Infect Dis,Hosp Univ Octubre 12,Inst Invest, Madrid, Spain
dc.description.affiliationUniv Michigan Hlth Syst, Ann Arbor, MI USA
dc.description.affiliationUniv Hosp Geneva, Dept Med Special, Infect Dis Serv, Geneva, Switzerland
dc.description.affiliationHosp Univ Gen, Infect Dis Unit, Alicante, Spain
dc.description.affiliationHosp del Mar, Med Res Inst, IMIM, Dept Nephrol, Barcelona, Spain
dc.description.affiliationHosp del Mar, Med Res Inst, IMIM, Dept Infect Dis, Barcelona, Spain
dc.description.affiliationUniv Libre Bruxelles, Hop Erasme, Dept Nephrol Dialysis & Kidney Transplantat, Brussels, Belgium
dc.description.affiliationUniv Fed Sao Paulo UNIFESP, Div Nephol, Dept Med, Sao Paulo, Brazil
dc.description.affiliationFundacao Oswaldo Ramos, Hosp Rim Hipertensao, Sao Paulo, Brazil
dc.description.affiliationUniv Barcelona, Sch Med, Inst Invest Biomed August Pi & Sunyer IDIBAPS, Dept Infect Dis,Hosp Clin, Barcelona, Spain
dc.description.affiliationCoimbra Hosp & Univ Ctr, Dept Urol & Kidney Transplantat, Renal Transplantat Unit, Coimbra, Portugal
dc.description.affiliationHosp Univ Bellvitge, Dept Infect Dis, Inst Invest Biomed Bellvitge IDIBELL, Barcelona, Spain
dc.description.affiliationUniv Paris 05, Hop Necker Enfants Malades, AP HP,RTRS Centaure, Serv Nephrol & Transplantat Adulte,Sorbonne Paris, Paris, France
dc.description.affiliationHosp Univ Vigen del Rocio, Infect Dis Unit, Inst Biomed Sevilla IBIS, Seville, Spain
dc.description.affiliationHosp Univ La Fe, Dept Nephrol, Valencia, Spain
dc.description.affiliationUniv Navarra Clin, Dept Nephrol, Pamplona, Spain
dc.description.affiliationHosp Univ Vall dHebron, Vall dHebron Res Inst, Dept Infect Dis, Barcelona, Spain
dc.description.affiliationHosp Univ Carlos Haya, Dept Nephrol, Malaga, Spain
dc.description.affiliationInst Nacl Ciencias Med & Nutr Salvador Zubiran, Dept Transplantat, Mexico City, DF, Mexico
dc.description.affiliationClin Nefrol Urol & Enfermedades Cardiovasc, Santa Fe, Argentina
dc.description.affiliationUniv Hosp Germans Trias & Pujol, Dept Nephrol, Barcelona, Spain
dc.description.affiliationUniv Hosp Birmingham NHS Fdn Trust, Dept Microbiol, Birmingham, W Midlands, England
dc.description.affiliationUniv Hosp Marques de Valdecilla, Dept Infect Dis, Santander, Spain
dc.description.affiliationUniv Hosp Doctor Negrin, Dept Nephrol, Las Palmas Gran Canaria, Spain
dc.description.affiliationUniv Hosp Ramon & Cajal, Dept Infect Dis, Madrid, Spain
dc.description.affiliationUniv Fed Rio de Janeiro, Hosp Univ Clementino Fraga Filho, Hematol Serv & Mycol Lab, Dept Internal Med, Rio De Janeiro, Brazil
dc.description.affiliationUniv Hosp CHUV, Dept Infect Dis, Lausanne, Switzerland
dc.description.affiliationUniv Hosp CHUV, Transplantat Ctr, Lausanne, Switzerland
dc.description.affiliationUniv Lausanne, Lausanne, Switzerland
dc.description.affiliationUniv Autonoma Madrid, Sch Med, Hosp Univ La Paz, Dept Internal Med, Madrid, Spain
dc.description.affiliationHosp Univ Cruces, Dept Infect Dis, Bilbao, Spain
dc.description.affiliationHosp Gen Univ Gregorio Maranon, Dept Microbiol & Infect Dis, Madrid, Spain
dc.description.affiliationUniv Autonoma Madrid, Sch Med, Hosp Univ Puerta Hierro Majadahonda, Dept Nephrol, Madrid, Spain
dc.description.affiliationHosp Univ Puerta del Mar, Dept Nephrol, Cadiz, Spain
dc.description.affiliationHosp Univ La Fe, Infect Dis Unit, Valencia, Spain
dc.description.affiliationUniv Complutense, Hosp Univ Octubre 12, Dept Nephrol, Inst Invest,Hosp Octubre I 12 12,Dept Med,Sch Med, Madrid, Spain
dc.description.affiliationUnifespDivision of Nephrology, Department of Medicine, Universidade Federal de São Paulo‐UNIFESP, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipPlan Nacional de I+D+i and Instituto de Salud Carlos III (Proyecto Integrado de Excelencia [PIE])
dc.description.sponsorshipSubdireccion General de Redes y Centros de Investigacion Cooperativa, Spanish Ministry of Economy and Competitiveness, Spanish Network for Research in Infectious Diseases - European Development Regional Fund (EDRF)
dc.description.sponsorshipPfizer Pharmaceutical
dc.description.sponsorshipInstituto de Salud Carlos III, Spanish Ministry of Economy and Competitiveness
dc.description.sponsorshipIDPIE: 13/00045
dc.description.sponsorshipIDEDRF: REIPI RD12/0015
dc.description.sponsorshipIDPfizer Pharmaceutical: REI-ANT-2013-01
dc.description.sponsorshipIDInstituto de Salud Carlos III: JR14/00036
dc.format.extent3220-3234
dc.identifierhttp://dx.doi.org/10.1111/ajt.13837
dc.identifier.citationAmerican Journal Of Transplantation. Hoboken, v. 16, n. 11, p. 3220-3234, 2016.
dc.identifier.doi10.1111/ajt.13837
dc.identifier.issn1600-6135
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/56827
dc.identifier.wosWOS:000388204600021
dc.language.isoeng
dc.publisherWiley-Blackwell
dc.relation.ispartofAmerican Journal Of Transplantation
dc.rightsinfo:eu-repo/semantics/openAccess
dc.titleClinical Presentation and Determinants of Mortality of Invasive Pulmonary Aspergillosis in Kidney Transplant Recipients: A Multinational Cohort Studyen
dc.typeinfo:eu-repo/semantics/article
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