Risk Factors for Early Fungal Disease in Solid Organ Transplant Recipients: A Systematic Review and Meta-analysis.

Autor:	Pennington KM; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.; William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN., Martin MJ; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN., Murad MH; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN., Sanborn D; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN., Saddoughi SA; Division of Thoracic Surgery, Mayo Clinic, Rochester, MN., Gerberi D; Department of Library Services, Mayo Clinic, Rochester, MN., Peters SG; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.; William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN., Razonable RR; William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN.; Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN., Kennedy CC; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.; William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN.; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.
Jazyk:	angličtina
Zdroj:	Transplantation [Transplantation] 2024 Apr 01; Vol. 108 (4), pp. 970-984. Date of Electronic Publication: 2023 Nov 13.
DOI:	10.1097/TP.0000000000004871
Abstrakt:	Background: Invasive fungal infections are associated with high morbidity in solid organ transplant recipients. Risk factor modification may help with preventative efforts. The objective of this study was to identify risk factors for the development of fungal infections within the first year following solid organ transplant. Methods: We searched for eligible articles through February 3, 2023. Studies published after January 1, 2001, that pertained to risk factors for development of invasive fungal infections in solid organ transplant were reviewed for inclusion. Of 3087 articles screened, 58 were included. Meta-analysis was conducted using a random-effects model to evaluate individual risk factors for the primary outcome of any invasive fungal infections and invasive candidiasis or invasive aspergillosis (when possible) within 1 y posttransplant. Results: We found 3 variables with a high certainty of evidence and strong associations (relative effect estimate ≥ 2) to any early invasive fungal infections across all solid organ transplant groups: reoperation (odds ratio [OR], 2.92; confidence interval [CI], 1.79-4.75), posttransplant renal replacement therapy (OR, 2.91; CI, 1.87-4.51), and cytomegalovirus disease (OR, 2.97; CI, 1.78-4.94). Both posttransplant renal replacement therapy (OR, 3.36; CI, 1.78-6.34) and posttransplant cytomegalovirus disease (OR, 2.81; CI, 1.47-5.36) increased the odds of early posttransplant invasive aspergillosis. No individual variables could be pooled across groups for invasive candidiasis. Conclusions: Several common risk factors exist for the development of any invasive fungal infections in solid organ transplant recipients. Additional risk factors for invasive candidiasis and aspergillosis may be unique to the pathogen, transplanted organ, or both. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu