Candida albicans arteritis transmitted by conservative liquid after renal transplantation: a report of four cases and review of the literature.
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.
Mai
Hoa
H
Nephrology Unit, Bicetre Hospital Le Kremlin Bicetre, Paris, France.
Champion
Laure
L
Ouali
Nacera
N
Hertig
Alexandre
A
Peraldi
Marie-Noelle
MN
Glotz
Denis
D
Rondeau
Eric
E
Costa
Marie-Alyette
MA
Snanoudj
Renaud
R
Benoit
Gérard
G
Charpentier
Bernard
B
Durrbach
Antoine
A
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
D019188:Organ Preservation Solutions