Matignon M, Botterel F, Audard V, Dunogue B, Dahan K, Lang P, Bretagne S, Grimbert P
Nephrology Unit, Henri Mondor Hospital, AP-HP, Institut Francilien de Techerche en Néphrologie et Transplantation (IFRNT) and Paris XII University, Créteil, France.
Am J Transplant. 2008 Mar;8(3):697-700. doi: 10.1111/j.1600-6143.2007.02112.x.
The complications of kidney graft preservation fluid infected by Candida sp. may range in severity from trivial infections to life-threatening complications, including graft arteritis and anastomotic rupture. Mandatory nephrectomy has recently been proposed as a means of preventing arterial wall rupture in such cases. We describe the clinical features and outcome of renal transplantation from a cadaveric donor in eight recipients with preservation fluid testing positive for Candida sp. Six patients were treated with antifungal drugs. After 1-2 years of follow-up, including regular imaging, none of the patients had developed arterial aneurysm, and all had a functional allograft and were alive. The contamination of renal graft preservation fluid with Candida sp. may be uneventful and should not systematically lead to removal of the graft. Until other risk factors for vascular complications have been determined, early antifungal treatment and repeated radiological monitoring are advisable for the prevention and/or early detection of such complications.
由念珠菌属感染的肾移植保存液的并发症严重程度不一，从轻微感染到危及生命的并发症都有，包括移植肾动脉炎和吻合口破裂。最近有人提出，在这种情况下，强制性肾切除术是预防动脉壁破裂的一种方法。我们描述了8例尸体供肾肾移植受者的临床特征和结局，这些受者的保存液念珠菌属检测呈阳性。6例患者接受了抗真菌药物治疗。经过1至2年的随访，包括定期影像学检查，所有患者均未发生动脉瘤，所有移植肾均功能良好，患者均存活。肾移植保存液被念珠菌属污染可能并无大碍，不应一概而论地导致移植肾被切除。在确定其他血管并发症的危险因素之前，建议早期进行抗真菌治疗并反复进行影像学监测，以预防和/或早期发现此类并发症。
