Table 6.

Etiological and clinical characteristics of IFI according to the type of SOT

Type of transplant	Incidence of IFI (%)	Usual etiologic agent (s)	Variables portending higher risk of IA	Mortality(%) of IA
Renal	0–20	76%–95% Candida (mainly urinary tract infections), 0%–25% Aspergillus	Graft failure requiring hemodialysis, high level and prolonged duration of corticosteroids	77
Heart	5–20	70%–90% Aspergillus, 8%–25% Candida	Isolation of Aspergillus species in respiratory tract cultures, reoperation, post-transplant hemodialysis, CMV disease	78
Liver	5–40	35%–0% Candida, 9%–45% Aspergillus	Retransplantation, renal failure (particularly requiring renal replacement therapy), fulminant hepatic failure as an indication for transplantation, primary allograft failure, high transfusion requirements, use of monoclonal antibodies,	87
Lung/Heart–Lung	10–45	43%–72% Candida, 25%–50% Aspergillus	Single lung transplant, CMV infection, rejection and augmented immunosuppression, obliterative bronchitis, Aspergillus colonization, acquired hypogammaglobulinemia, presence of bronchial stents, reperfusion injury, airway ischemia	68
Pancreas (+kidney)	10–40	>90% Candida, 0%–3% Aspergillus	Similar factors to the liver and kidney transplant, graft lost (vascular graft thrombosis, post-reperfusion pancreatitis), enteric drainage, alemtuzumab-containing immunosuppresive regimen	100
Small bowel	30–60	80%–100% Candida, 0%–5% Aspergillus	Not clearly determined, similar factors to others intraabdominal SOT recipients; Graft rejection/dysfunction, enhanced immunosuppression, anastomotic disruption, multi-visceral transplant	66

Abbreviations: SOT, solid organ transplantation/solid organ transplant recipients; IFI, invasive fungal infection; IA, invasive aspergillosis; CMV, cytomegalovirus.