Analysis of Risk Factors for Invasive Mold Infections in Lung Transplant Recipients

Abstract

Purpose The purpose of this study is to identify risk factors associated with the development of IMI compared to mold colonization. Methods A single-center, retrospective chart review was conducted on patients who received a lung transplant (LTr) between January 2012 and January 2016. Patients colonized with molds or who had IMI at any point were included for comparison of risk factors and outcomes. Targeted antifungal prophylaxis with voriconazole for 3 months was initiated for patients colonized before transplant or those who had positive donor cultures. Results A total of 150 patients were transplanted within the time period and 94 met inclusion criteria; 81 (54%) were colonized and 13 (8.7%) had IMI. IMI were more common in males; 65% vs 23%, p Conclusion A relatively low incidence of IMI developed even with the conservative approach of targeted prophylaxis compared to the reported incidence of approximately 12% in the literature. Median time to development of IMI occurred later than 3 months; thus patients with mold colonizations prior to transplant may warrant longer durations of systemic prophylaxis.