Outcome of renal transplantation in eight patients with Candida sp. contamination of preservation fluid.
The complications of kidney graft preservation fluid infected by Candida sp. may range in severity from trivial infections to life-threatening complications, including graft arteritis and anastomotic rupture. Mandatory nephrectomy has recently been proposed as a means of preventing arterial wall rupture in such cases. We describe the clinical features and outcome of renal transplantation from a cadaveric donor in eight recipients with preservation fluid testing positive for Candida sp. Six patients were treated with antifungal drugs. After 1-2 years of follow-up, including regular imaging, none of the patients had developed arterial aneurysm, and all had a functional allograft and were alive. The contamination of renal graft preservation fluid with Candida sp. may be uneventful and should not systematically lead to removal of the graft. Until other risk factors for vascular complications have been determined, early antifungal treatment and repeated radiological monitoring are advisable for the prevention and/or early detection of such complications.
Matignon
M
M
Nephrology Unit, Henri Mondor Hospital, AP-HP, Institut Francilien de Techerche en Néphrologie et Transplantation (IFRNT) and Paris XII University, Créteil, France.
Botterel
F
F
Audard
V
V
Dunogue
B
B
Dahan
K
K
Lang
P
P
Bretagne
S
S
Grimbert
P
P
D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use*; D002102:Cadaver; D002175:Candida / Q000302:isolation & purification*; D002177:Candidiasis / Q000517:prevention & control*; D002439:Cefotaxime / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D019188:Organ Preservation Solutions; D011183:Postoperative Complications / Q000382:microbiology / Q000517:prevention & control*; D012189:Retrospective Studies; D014019:Tissue Donors; D019737:Transplants / Q000382:microbiology*; D016896:Treatment Outcome; D014640:Vancomycin / Q000627:therapeutic use
D000935:Antifungal Agents; D019188:Organ Preservation Solutions; D014640:Vancomycin; D002439:Cefotaxime