Two decades of experience in mucormycosis after kidney transplantation

Ann Transplant. 2011 Jul-Sep;16(3):44-8. doi: 10.12659/aot.881994.

Abstract

Background: Invasive mucormycosis is a very rare infection after kidney transplantation. Here, we report 25 renal transplant recipients with mucormycosis; to our knowledge, this is the largest reported population of mucormycosis in these patients.

Material/methods: In a retrospective study, we collected all kidney transplants with mucormycosis from 9 Transplant Centers of Iran from 1990 to 2010. The definitive diagnosis of mucormycosis was established by obtaining a biopsy specimen of the involved tissue.

Results: The most form of disease was rhino-cerebral (n =13), followed by pulmonary (n=7). Overall mortality rate was 52% (n=13), particularly in recipients with pulmonary infection (100%); however, the mortality rate in rhino-cerebral form of disease was low (30.8%). There was no statistically significant difference in mortality rate between male and female (P=0.8). In addition, no significant differences were seen in mortality rate with age of patients (p=0.8) and time of diagnosis since transplantation (p=0.3). Pulmonary infection was more seen in recipients received azathioprine compared to those on mycophenolate mofetil (p=0.006).

Conclusions: Mucormycosis after renal transplantation has a poor prognosis, particularly patients with pulmonary involvement.

MeSH terms

  • Adult
  • Aged
  • Azathioprine / adverse effects
  • Brain Diseases / etiology
  • Female
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Kidney Transplantation / adverse effects*
  • Lung Diseases, Fungal / etiology
  • Male
  • Middle Aged
  • Mucormycosis / diagnosis
  • Mucormycosis / etiology*
  • Mucormycosis / mortality
  • Mycophenolic Acid / adverse effects
  • Mycophenolic Acid / analogs & derivatives
  • Nose Diseases / etiology
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Young Adult

Substances

  • Immunosuppressive Agents
  • Mycophenolic Acid
  • Azathioprine