BACKGROUND: Aspergillus infection remains a major cause of morbidity and mortality after lung transplantation. Therefore, some strategies have been attempted, one of which is nebulized amphotericin B (nAB); however, the efficacy of this prophylaxis has not been shown clearly. The aim is to study whether nAB can protect against Aspergillus infection in lung transplant recipients. PATIENTS AND METHODS: A study of risk factors was conducted in 55 consecutive lung allograft recipients. Twenty-three potential risk factors were analyzed. In 44 (80%) patients, nAB was indicated as prophylaxis. Multivariate analysis using logistic regression was performed. RESULTS: Eighteen of the 55 patients (33%) developed infection due to Aspergillus spp. Multivariate analysis showed nAB to be a preventive factor (odds ratio: 0.13; 95% confidence interval [CI] 0.02-0.69; p < 0.05) and cytomegalovirus (CMV) disease was an independent risk factor for developing Aspergillus infection (odds ratio: 5.1; 95% CI 1.35-19.17; p < 0.05). Only 1 patient required withdrawal of the prophylaxis owing to bronchospasm. nAB was well-tolerated in the remaining patients with only a few, mild, easily controlled side effects. CONCLUSIONS: The present results show that nAB prophylaxis may be efficient and safe in preventing Aspergillus infection in lung-transplanted patients, and CMV disease increases the probability of Aspergillus infection.
BACKGROUND:Aspergillus infection remains a major cause of morbidity and mortality after lung transplantation. Therefore, some strategies have been attempted, one of which is nebulized amphotericin B (nAB); however, the efficacy of this prophylaxis has not been shown clearly. The aim is to study whether nAB can protect against Aspergillus infection in lung transplant recipients. PATIENTS AND METHODS: A study of risk factors was conducted in 55 consecutive lung allograft recipients. Twenty-three potential risk factors were analyzed. In 44 (80%) patients, nAB was indicated as prophylaxis. Multivariate analysis using logistic regression was performed. RESULTS: Eighteen of the 55 patients (33%) developed infection due to Aspergillus spp. Multivariate analysis showed nAB to be a preventive factor (odds ratio: 0.13; 95% confidence interval [CI] 0.02-0.69; p < 0.05) and cytomegalovirus (CMV) disease was an independent risk factor for developing Aspergillus infection (odds ratio: 5.1; 95% CI 1.35-19.17; p < 0.05). Only 1 patient required withdrawal of the prophylaxis owing to bronchospasm. nAB was well-tolerated in the remaining patients with only a few, mild, easily controlled side effects. CONCLUSIONS: The present results show that nAB prophylaxis may be efficient and safe in preventing Aspergillus infection in lung-transplanted patients, and CMV disease increases the probability of Aspergillus infection.
Authors: S S Weigt; R M Elashoff; C Huang; A Ardehali; A L Gregson; B Kubak; M C Fishbein; R Saggar; M P Keane; R Saggar; J P Lynch; D A Zisman; D J Ross; J A Belperio Journal: Am J Transplant Date: 2009-05-13 Impact factor: 8.086
Authors: Takeshi Nakajima; Vyachesav Palchevsky; David L Perkins; John A Belperio; Patricia W Finn Journal: Semin Immunopathol Date: 2011-01-27 Impact factor: 9.623
Authors: Michael Liu; Sarah Worley; George B Mallory; Sarah Arrigain; John Robertson; Marc G Schecter; Okan Elidemir; Lara A Danziger-Isakov Journal: J Heart Lung Transplant Date: 2009-09-26 Impact factor: 10.247
Authors: Lara A Danziger-Isakov; Sarah Worley; Susana Arrigain; Paul Aurora; Manfred Ballmann; Debra Boyer; Carol Conrad; Irmgard Eichler; Okan Elidemir; Samuel Goldfarb; George B Mallory; Marian G Michaels; Peter Michelson; Peter J Mogayzel; Daiva Parakininkas; Melinda Solomon; Gary Visner; Stuart Sweet; Albert Faro Journal: J Heart Lung Transplant Date: 2008-04-24 Impact factor: 10.247
Authors: Lara A Danziger-Isakov; Sarah Worley; Marian G Michaels; Susana Arrigain; Paul Aurora; Manfred Ballmann; Debra Boyer; Carol Conrad; Irmgard Eichler; Okan Elidemir; Samuel Goldfarb; George B Mallory; Peter J Mogayzel; Daiva Parakininkas; Melinda Solomon; Gary Visner; Stuart Sweet; Albert Faro Journal: Transplantation Date: 2009-05-27 Impact factor: 4.939