López-Medrano, FranciscoPérez-Sáez, María JoséMontero, Maria MilagroPascual Santos, JulioHorcajada Gallego, Juan PabloAguado, José María2018-05-092018López-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.2017.06.0161198-743Xhttp://hdl.handle.net/10230/34582OBJECTIVES: 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.application/pdfeng© Elsevier http://dx.doi.org/10.1016/j.cmi.2017.06.016Ronyons -- TrasplantacióAspergillosisPulmons -- Malaltiesinfo:eu-repo/semantics/articlehttp://dx.doi.org/10.1016/j.cmi.2017.06.016Kidney transplantationCase-control studyLate invasive pulmonary aspergillosisRisk factorsinfo:eu-repo/semantics/openAccess