Overview: fungal infections in the transplant patient.
Fungal infection remains a major hurdle in solid organ transplantation. A variety of new antifungal agents have become available and new diagnostic tools are in development. This conference was convened to review current approaches to the prevention and treatment of fungal infection in transplantation. Among the keys to successful management of fungal infection are identification of patients at risk for infection (stratification), eradication or control of established infection in advance of transplantation, the demonstration of cure by radiologic and histopathologic means, and the use of surgical debridement, reduction in immune suppression, and fungicidal therapies whenever possible. The absence of sensitive diagnostic tools and standardization of antifungal susceptibility testing for the filamentous fungi are identified as major impediments to care in this area.
Fishman
J A
JA
Harvard Medical School, Transplant Infectious Diseases and Compromised Host Program, Infectious Disease Division, Transplant Unit, Massachusetts General Hospital, Boston, Massachusetts, USA. jfishman@partners.org
D000666:Amphotericin B / Q000494:pharmacology / Q000633:toxicity; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000633:toxicity; D000935:Antifungal Agents / Q000145:classification / Q000494:pharmacology / Q000627:therapeutic use*; D001393:Azoles / Q000494:pharmacology / Q000633:toxicity; D015984:Causality; D054714:Echinocandins; D005656:Fungal Proteins; D005658:Fungi / Q000187:drug effects; D006801:Humans; D009181:Mycoses / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D016377:Organ Transplantation / Q000009:adverse effects* / Q000473:pathology; D010455:Peptides; D010456:Peptides, Cyclic; D011183:Postoperative Complications / Q000382:microbiology; D012307:Risk Factors; D013997:Time Factors; D014180:Transplantation / Q000592:standards; D014777:Virus Diseases / Q000150:complications
D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D001393:Azoles; D054714:Echinocandins; D005656:Fungal Proteins; D010455:Peptides; D010456:Peptides, Cyclic; D000666:Amphotericin B; C007572:echinocandin B