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肺移植前或后的真菌定植对生存率或慢性肺移植功能障碍的发展没有负面影响。

Fungal colonization before or after lung transplantation has no negative impact on survival or the development of chronic lung allograft dysfunction.

作者信息

Bodén Embla, Sveréus Fanny, Niroomand Anna, Akbarshahi Hamid, Ingemansson Richard, Larsson Hillevi, Lindstedt Sandra, Olm Franziska

机构信息

Department of Clinical Sciences, Lund University, 22184 Lund, Sweden.

Wallenberg Center for Molecular Medicine, Lund University, 22184 Lund, Sweden.

出版信息

JHLT Open. 2025 Feb 7;8:100225. doi: 10.1016/j.jhlto.2025.100225. eCollection 2025 May.

Abstract

INTRODUCTION

Long-term survival following lung transplantation (LTx) faces impediments due to chronic lung allograft dysfunction (CLAD), while infections hinder short-term survival. Fungal colonization and invasive fungal infections (IFI) are common within the first year after LTx. There is ongoing debate regarding the impact of such events on CLAD development and mortality. This study aims to investigate this matter further.

METHODS

A total of 134 LTx recipients transplanted between 2011 and 2020 were included. The median follow-up time was 3.9 years. Fungal colonization and IFI were defined according to international consensus guidelines and were noted if present within the first 12 months after LTx.

RESULTS

Postoperative fungal colonization was found in 101 patients, and 14 patients had an IFI within twelve months of transplantation. Nineteen patients were neither colonized nor infected. Out of the 115 patients with colonization or IFI, 61 patients had growth of a yeast such as species (spp.). Fifty-six patients were colonized prior to LTx. Being colonized with fungus before or within the first 12 months post-LTx did not significantly affect survival or CLAD development.

CONCLUSIONS

The results of the current study indicate that fungal colonization either pre-transplantation or within the first 12 months after does not correlate with increased risks of mortality or CLAD development. These findings show that while fungal colonization is a common occurrence in LTx recipients, it does not predispose the patients of the cohort to adverse outcomes.

摘要

引言

肺移植(LTx)后的长期生存面临慢性肺移植功能障碍(CLAD)的阻碍,而感染则影响短期生存。真菌定植和侵袭性真菌感染(IFI)在肺移植后的第一年内很常见。关于这些事件对CLAD发展和死亡率的影响一直存在争议。本研究旨在进一步调查此事。

方法

纳入了2011年至2020年间进行肺移植的134名受者。中位随访时间为3.9年。真菌定植和IFI根据国际共识指南进行定义,并记录肺移植后前12个月内是否存在。

结果

101例患者术后出现真菌定植,14例患者在移植后12个月内发生IFI。19例患者既未定植也未感染。在115例有定植或IFI的患者中,61例患者培养出酵母样菌。56例患者在肺移植前已被定植。肺移植前或移植后12个月内被真菌定植对生存或CLAD发展没有显著影响。

结论

本研究结果表明,移植前或移植后12个月内的真菌定植与死亡率增加或CLAD发展无关。这些发现表明,虽然真菌定植在肺移植受者中很常见,但它并不会使该队列中的患者易出现不良后果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b18/11935453/fe13f083149b/gr1.jpg

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