Candida species contamination of preservation fluid-outcome of renal transplantation in 6 patients.

TitleCandida species contamination of preservation fluid-outcome of renal transplantation in 6 patients.
Publication TypeJournal Article
Year of Publication2013
AuthorsRodrigues BF, Natario AS, Vizinho RS, Jorge CM, Weigert AL, Martinho A, Toscano C, Marques TT, Machado DS
JournalTransplantation proceedings// Transplant Proc
Volume45
Issue6
Pagination2215 - 9
Date Published2013//
ISBN Number1873-2623
Other Numberswe9, 0243532
Keywords*Candida albicans/ip [Isolation & Purification], *Candida glabrata/ip [Isolation & Purification], *Candidiasis/mi [Microbiology], *Drug Contamination, *Kidney Transplantation/ae [Adverse Effects], *Organ Preservation Solutions/ae [Adverse Effects], *Organ Preservation/ae [Adverse Effects], Aged, Antifungal Agents/tu [Therapeutic Use], Candidiasis/di [Diagnosis], Candidiasis/th [Therapy], Child, Preschool, Female, Graft Survival, Humans, Male, Middle Aged, Prospective Studies, Reoperation, Time Factors, Treatment Outcome
Abstract

BACKGROUND: Fungal infections are a rare but important cause of morbidity and mortality in kidney transplantation. Fungal contamination of the kidney preservation fluid may, sometimes, be the cause of these infections. However, the clinical consequences of fungal contamination of this fluid are not completely understood and literature on this topic is controversial. The purpose of this study was to determine the incidence of preservation fluid contamination by fungi and its clinical consequences., METHODS: From June 2010 to September 2011, a prospective cohort analysis was conducted at our center, enrolling all patients who received a renal allograft and whose perfusion fluid was analyzed for microbiology sterility. Patients with perfusion fluids positive for fungi were further studied: the patients' status was assessed during regular visits and data were recorded, including clinical characteristics, infections, graft function, immunosuppressive regimen and outcomes., RESULTS: Microbiologic, cultures of 70 kidney perfusion fluids using specific mycologic media, obtained from 74 cadaveric renal transplants (4 fluids were unsuitable for analysis), were evaluated. Six samples were positive for yeasts (8.6%), with 4 isolates of Candida albicans and 2 isolates of Candida glabrata. Four patients had no evidence of fungal infection during the follow-up period (median 321 days); conversely, 2 patients developed severe mycotic vascular complications leading to transplantectomy., CONCLUSIONS: Perfusion fluid contamination by fungi is an elusive situation that can lead either to an unremarkable clinical course or to graft loss life-threatening situations. Routine culture of kidney perfusion fluid is critical for prompt diagnosis and early implementation of appropriate treatment.Copyright © 2013 Elsevier Inc. All rights reserved.

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