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Multinational case-control study of risk factors for the development of late invasive pulmonary aspergillosis following kidney transplantation

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dc.contributor.author López-Medrano, Francisco
dc.contributor.author Pérez-Sáez, María José
dc.contributor.author Montero, Maria Milagro
dc.contributor.author Pascual Santos, Julio
dc.contributor.author Horcajada Gallego, Juan Pablo
dc.contributor.author Aguado, José María
dc.date.accessioned 2018-05-09T07:36:00Z
dc.date.issued 2018
dc.identifier.citation López-Medrano F, Fernández-Ruiz M, Silva JT, Carver PL, van Delden C, Merino E. et al. Multinational case-control study of risk factors for the development of late invasive pulmonary aspergillosis following kidney transplantation. Clin Microbiol Infect. 2018 Feb;24(2):192-198. DOI: 10.1016/j.cmi.2017.06.016
dc.identifier.issn 1198-743X
dc.identifier.uri http://hdl.handle.net/10230/34582
dc.description.abstract OBJECTIVES: To assess the risk factors for development of late-onset invasive pulmonary aspergillosis (IPA) after kidney transplantation (KT). METHODS: We performed a multinational case-control study that retrospectively recruited 112 KT recipients diagnosed with IPA between 2000 and 2013. Controls were matched (1:1 ratio) by centre and date of transplantation. Immunosuppression-related events (IREs) included the occurrence of non-ventilator-associated pneumonia, tuberculosis, cytomegalovirus disease, and/or de novo malignancy. RESULTS: We identified 61 cases of late (>180 days after transplantation) IPA from 24 participating centres (accounting for 54.5% (61/112) of all cases included in the overall study). Most diagnoses (54.1% (33/61)) were established within the first 36 post-transplant months, although five cases occurred more than 10 years after transplantation. Overall mortality among cases was 47.5% (29/61). Compared with controls, cases were significantly older (p 0.010) and more likely to have pre-transplant chronic obstructive pulmonary disease (p 0.001) and a diagnosis of bloodstream infection (p 0.016) and IRE (p <0.001) within the 6 months prior to the onset of late IPA. After multivariate adjustment, previous occurrence of IRE (OR 19.26; 95% CI 2.07-179.46; p 0.009) was identified as an independent risk factor for late IPA. CONCLUSION: More than half of IPA cases after KT occur beyond the sixth month, with some of them presenting very late. Late IPA entails a poor prognosis. We identified some risk factors that could help the clinician to delimit the subgroup of KT recipients at the highest risk for late IPA.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Elsevier
dc.rights © Elsevier http://dx.doi.org/10.1016/j.cmi.2017.06.016
dc.subject.other Ronyons -- Trasplantació
dc.subject.other Aspergillosis
dc.subject.other Pulmons -- Malalties
dc.title Multinational case-control study of risk factors for the development of late invasive pulmonary aspergillosis following kidney transplantation
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1016/j.cmi.2017.06.016
dc.subject.keyword Kidney transplantation
dc.subject.keyword Case-control study
dc.subject.keyword Late invasive pulmonary aspergillosis
dc.subject.keyword Risk factors
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/acceptedVersion
dc.embargo.liftdate 2019-02-28


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