title: [Mold infections in lung transplants].
abstract: Invasive infections by molds, mainly Aspergillus infections, account for more than 10% of infectious complications in lung transplant recipients. These infections have a bimodal presentation: an early one, mainly invading bronchial airways, and a late one, mostly focused on lung or disseminated. The Aspergillus colonization at any time in the post-transplant period is one of the major risk factors. Late colonization, together with chronic rejection, is one of the main causes of late invasive forms. A galactomannan value of 0.5 in bronchoalveolar lavage is currently considered a predictive factor of pulmonary invasive infection. There is no universal strategy in terms of prophylaxis. Targeted prophylaxis and preemptive treatment instead of universal prophylaxis, are gaining more followers. The therapeutic drug monitoring level of azoles is highly recommended in the treatment. Monotherapy with voriconazole is the treatment of choice in invasive aspergillosis; combined antifungal therapies are only recommended in severe, disseminated, and other infections due to non-Aspergillus molds.
authors.affiliation: Unidad de Trasplante Pulmonar, Hospital Universitario La Fe, Instituto de Investigación Sanitaria La Fe, Valencia, España. Electronic address: sole_amp@gva.es.
authors.forename: Amparo
authors.initials: A
authors.lastname: Solé
authors.affiliation: Servicio de Neumología, Unidad de Trasplante Pulmonar, Hospital Puerta de Hierro, Madrid, España.
authors.forename: Piedad
authors.initials: P
authors.lastname: Ussetti
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry; D016469:Fungemia / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D005690:Galactose / Q000031:analogs & derivatives; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D055744:Invasive Pulmonary Aspergillosis / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D008172:Lung Diseases, Fungal / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D016040:Lung Transplantation; D008351:Mannans / Q000032:analysis; D009181:Mycoses / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control; D011183:Postoperative Complications / Q000188:drug therapy / Q000382:microbiology* / Q000517:prevention & control; D012307:Risk Factors
chemical_list: D000935:Antifungal Agents; D015415:Biomarkers; D007166:Immunosuppressive Agents; D008351:Mannans; C012990:galactomannan; D005690:Galactose
keywords: Aspergillus; Chronic rejection; Factores de riesgo; Infección por mohos; Lung transplant; Mold infections; Rechazo crónico; Risk factors; Trasplante pulmonar