title: Candida albicans arteritis transmitted by conservative liquid after renal transplantation: a report of four cases and review of the literature.
abstract: BACKGROUND
  Mycotic arteritis and/or aneurysms are infrequent complications of renal transplantation. They are mostly secondary to bacterial infection and rarely to Candida albicans. We report four cases of mycotic arteritis due to C. albicans after renal transplantation but which have been inoculated during organ harvesting or conservation.
  
  
  METHODS
  In all the four cases corresponding to two independent donors, C. albicans was isolated few days later in the systematic culture of the conservative liquid. We also review the clinical features and outcomes of 13 cases previously reported in the literature.
  
  
  RESULTS
  In two cases, the diagnosis of fungal arteritis was confirmed only during autopsy after the patient's death due to massive bleeding. In the other two cases, the diagnosis was made on the arterial section of the anastomotic wall after detransplantation for massive bleeding for arterial leakage although an immediate antifungal treatment with fluconazole and caspofungin was given and was found to be inefficient.
  
  
  CONCLUSIONS
  This is a serious complication of renal transplantation because it leads to graft loss in the majority of the cases and even to death in a few cases despite an efficient and rapid treatment. Routine fungal cultures of preservation media are important for early diagnosis and timely surgical interventions are life-saving.
authors.affiliation: Nephrology Unit, Bicetre Hospital Le Kremlin Bicetre, Paris, France.
authors.forename: Hoa
authors.initials: H
authors.lastname: Mai
authors.forename: Laure
authors.initials: L
authors.lastname: Champion
authors.forename: Nacera
authors.initials: N
authors.lastname: Ouali
authors.forename: Alexandre
authors.initials: A
authors.lastname: Hertig
authors.forename: Marie-Noelle
authors.initials: MN
authors.lastname: Peraldi
authors.forename: Denis
authors.initials: D
authors.lastname: Glotz
authors.forename: Eric
authors.initials: E
authors.lastname: Rondeau
authors.forename: Marie-Alyette
authors.initials: MA
authors.lastname: Costa
authors.forename: Renaud
authors.initials: R
authors.lastname: Snanoudj
authors.forename: Gérard
authors.initials: G
authors.lastname: Benoit
authors.forename: Bernard
authors.initials: B
authors.lastname: Charpentier
authors.forename: Antoine
authors.initials: A
authors.lastname: Durrbach
mesh_terms: D000328:Adult; D001167:Arteritis / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology; D002176:Candida albicans; D002177:Candidiasis / Q000175:diagnosis / Q000473:pathology / Q000635:transmission*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D019188:Organ Preservation Solutions; D011183:Postoperative Complications / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology; D012077:Renal Artery / Q000382:microbiology* / Q000473:pathology
chemical_list: D019188:Organ Preservation Solutions