Coccidioidomycosis in healthy persons evaluated for liver or kidney donation.

TitleCoccidioidomycosis in healthy persons evaluated for liver or kidney donation.
Publication TypeJournal Article
Year of Publication2007
AuthorsBlair JE, Mulligan DC
JournalTransplant infectious disease : an official journal of the Transplantation Society//Transpl Infect Dis
Pagination78 - 82
Date Published2007
ISBN Number1398-22731398-2273
Other Numbersd1d, 100883688
Keywords*Coccidioides/im [Immunology], *Coccidioidomycosis/ep [Epidemiology], *Coccidioidomycosis/et [Etiology], *Kidney Transplantation/ae [Adverse Effects], *Liver Transplantation/ae [Adverse Effects], *Living Donors, Adult, Antibodies, Fungal/bl [Blood], Coccidioidomycosis/bl [Blood], Female, Humans, Longitudinal Studies, Male, Middle Aged, Organ Transplantation/ae [Adverse Effects], Seroepidemiologic Studies, United States/ep [Epidemiology]

Coccidioidomycosis is a fungal infection caused by Coccidioides species endemic to the southwestern United States, where it poses unique challenges for transplant recipients. Donor-derived coccidioidomycosis has been documented, but its risk of transmission is not known. We prospectively screened 568 healthy persons requesting evaluation for possible liver or kidney donation. Twelve (2.1%) of the 568 donor candidates were seropositive (11 initially and 1 with seroconversion and symptomatic illness within 1 week after negative screening). Three of these 12 patients proceeded to kidney donation, and a fourth patient proceeded to liver donation. None of the 4 transplant recipients received special coccidioidal prophylaxis, although all were administered fluconazole according to standard antifungal prophylaxis protocols. At follow-up (7-54 months), no coccidioidomycosis was identified in any recipient. The prevalence of coccidioidal antibodies was low among potential organ donor candidates, but the risk of donor-derived coccidioidomycosis remains unknown and further study is warranted.

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