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- W4387080928 abstract "Abstract Introduction Invasive fungal infections (IFI) remain a rare yet dreaded complication following pancreas transplantation. Current guidelines recommend antifungal prophylaxis in patients with 1 or more risk factors. At our center, single dose antifungal prophylaxis is administered in the operating room (OR) but none subsequently, regardless of risk factors. Here we evaluate the 1-year incidence, outcome and risk factors associated with IFI following pancreas transplantation. Methods A retrospective, single-center cohort study was conducted in patients who underwent pancreas transplantation between 01/01/2009, and 12/31/2019. Records were manually reviewed, and cases were adjudicated using consensus definitions. The 1-year cumulative incidence, mortality and risk factors were analyzed by Kaplan-Meier method and differences between populations were assessed with Fisher test and Mann-Whitney U test. Results 369 recipients were included. 12 IFIs were identified: candidiasis (8), aspergillosis (2), histoplasmosis (1) and cryptococcosis (1). Intrabdominal infections were the most common presentation (5), followed by bloodstream infections (3), disseminated disease (2), pulmonary disease (1) and invasive fungal sinusitis (1). Median time to IFI was 64 days [IQR: 30-234 days]. 1-year cumulative incidence was 3.25% (95% CI:1.86-5.65). There were no significant differences between patients with or without IFI regarding type of transplant (p=0.17), post-transplant dialysis (p=0.3), rejection (p=0.5), CMV serostatus (p=0.45) or reoperation (p=0.19). For patients with IFI, the 1-year graft and patient survival rates were 58% vs 95% (p<0.0001) and 75% vs 98.6% (p<0.001) respectively. Conclusion Our study suggests that the use of a single dose antifungal prophylaxis administered in the OR but none subsequently does not result in an increased incidence of IFI following pancreas transplantation." @default.
- W4387080928 created "2023-09-28" @default.
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- W4387080928 date "2023-09-26" @default.
- W4387080928 modified "2023-09-28" @default.
- W4387080928 title "Epidemiology and Risk Factors for Invasive Fungal Infections in Pancreas Transplant in the Absence of Post-operative Antifungal Prophylaxis" @default.
- W4387080928 doi "https://doi.org/10.1093/ofid/ofad478" @default.
- W4387080928 hasPublicationYear "2023" @default.
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