Invasive Fungal Infections in Pediatric Solid Organ Transplant Patients: Epidemiology and Management

Abstract

Invasive fungal infections are important causes of morbidity and mortality in pediatric patients undergoing solid organ transplantation (SOT). Invasive candidiasis, cryptococcosis, and mold infections such as aspergillosis and mucormycosis are among the most prevalent fungal infections in this population. Invasive candidiasis is more common in high-risk liver transplantation as well as of pancreas and small bowel. Invasive aspergillosis is more frequent in transplantation of lungs followed by heart and liver. Invasive fungal infections constitute an important barrier to short- and long-term survival of the allograft and patient. Advances in pediatric infectious diseases supportive care have contributed substantially to the improved survival, outcome, and reduction of suffering caused by these infectious complications. The current prophylactic and treatment strategies vary widely in transplantation centers given the lack of clinical trials and scant epidemiological data in pediatric SOT recipients.