University of Pittsburgh, PA, USA.
Am J Transplant. 2012 Sep;12(9):2414-28. doi: 10.1111/j.1600-6143.2012.04100.x. Epub 2012 Jun 13.
Donor-derived fungal infections can be associated with serious complications in transplant recipients. Most cases of donor-derived candidiasis have occurred in kidney transplant recipients in whom contaminated preservation fluid is a commonly proposed source. Donors with cryptococcal disease, including those with unrecognized cryptococcal meningoencephalitis may transmit the infection with the allograft. Active histoplasmosis or undiagnosed and presumably asymptomatic infection in the donor that had not resolved by the time of death can result in donor-derived histoplasmosis in the recipient. Potential donors from an endemic area with either active or occult infection can also transmit coccidioidomycosis. Rare instances of aspergillosis and other mycoses, including agents of mucormycosis may also be transmitted from infected donors. Appropriate diagnostic evaluation and prompt initiation of appropriate antifungal therapy are warranted if donor-derived fungal infections are a consideration. This document discusses the characteristics, evaluation and approach to the management of donor-derived fungal infections in organ transplant recipients.
供体来源的真菌感染可与移植受者的严重并发症相关。大多数供体来源的念珠菌病发生于肾移植受者中，污染的保存液是常见的来源。有隐球菌病的供体，包括那些有未被识别的隐球菌性脑膜脑炎的供体，可能会通过移植物传播感染。供体中活动性组织胞浆菌病或未被诊断且推测无症状的感染，在死亡时尚未解决，可导致受体内的供体来源组织胞浆菌病。来自流行地区的有活动性或隐匿性感染的潜在供体也可传播球孢子菌病。罕见的曲霉病和其他真菌病，包括毛霉病的病原体也可能从受感染的供体传播。如果考虑供体来源的真菌感染，则需要进行适当的诊断评估和及时开始适当的抗真菌治疗。本文讨论了器官移植受者中供体来源的真菌感染的特征、评估和处理方法。
