Publicaciones científicas

Risk factors associated with early invasive pulmonary aspergillosis in kidney transplant recipients: results from a multinational matched case-control study

López-Medrano F (1), Silva JT (1), Fernández-Ruiz M (1), Carver PL (2), van Delden C (3), Merino E (4), Pérez-Saez MJ (5), Montero M (6), Coussement J (7), de Abreu Mazzolin M (8), Cervera C (9), Santos L (10), Sabé N (11), Scemla A (12), Cordero E (13), Cruzado-Vega L (14), Martín PL (15), Len Ó (16), Rudas E (17), Ponce de León A (18), Arriola M (19), Lazurica R (20), David M (21), González-Rico C (22), Henríquez-Palop F (23), Fortún J (24), Nucci M (25), Manuel O (26), Paño-Pardo JR (27), Montejo M (28), Muñoz P (29), Sánchez-Sobrino B (30), Mazuecos A (31), Pascual J (5), Horcajada JP (6), Lecompte T (3), Lumbreras C (1), Moreno A (9), Carratalà J (11), Blanes M (32), Hernández D (17), Hernández-Méndez EA (18), Fariñas MD (22), Perelló-Carrascosa M (33), Morales JM (34), Andrés A (34), Aguado JM (1); Spanish Network for Research in Infectious Diseases REIPI); Group for the Study of Infection in Transplant Recipients (GESITRA); Spanish Society of Clinical Microbiology and Infectious Diseases (SEIMC); Study Group for Infections in Compromised Hosts (ESGICH); European Society of Clinical Microbiology and Infectious Diseases (ESCMID); Swiss Transplant Cohort Study (STCS).
(1) Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i+12), Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain.
(2) University of Michigan Health System, Ann Harbor, Michigan.
(3) Service of Infectious Diseases, Department of Medical Specialities, University Hospitals Geneva, Geneva, Switzerland.
(4) Unit of Infectious Diseases, Hospital Universitario General, Alicante, Spain.
(5) Department of Nephrology, Hospital del Mar, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.
(6) Department of Infectious Diseases, Hospital del Mar, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.
(7) Department of Nephrology, Dialysis and Kidney Transplantation, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
(8) Division of Nephology, Department of Medicine, Universidade Federal de São Paulo-UNIFESP and Hospital do Rim e Hipertensão, Fundação Oswaldo Ramos, São Paulo, Brazil.
(9) Department of Infectious Diseases, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, Barcelona, Spain.
(10) Unit of Renal Transplantation, Department of Urology and Kidney Transplantation, Coimbra Hospital and Universitary Centre, Coimbra, Portugal.
(11) Department of Infectious Diseases, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain.
(12) Service de Néphrologie et Transplantation Adulte, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes Sorbonne Paris Cité, RTRS Centaure, Paris, France.
(13) Unit of Infectious Diseases, Hospitales Universitarios "Vigen del Rocío", Instituto de Biomedicina de Sevilla (IBIS), Seville, Spain.
(14) Department of Nephrology, Hospital Universitario "La Fe", Valencia, Spain.
(15) Department of Nephrology, Clínica Universitaria de Navarra, Pamplona, Spain.
(16) Department of Infectious Diseases, Hospital Universitari Vall d'Hebrón, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.
(17) Department of Nephrology, Hospital Universitario "Carlos Haya", Málaga, Spain.
(18) Department of Transplantation, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", México DF, México.
(19) Clínica de Nefrología, Urología y Enfermedades Cardiovasculares, Santa Fe, Argentina.
(20) Department of Nephrology, University Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain.
(21) Department of Microbiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
(22) Department of Infectious Diseases, University Hospital "Marqués de Valdecilla", Santander, Spain.
(23) Department of Nephrology, University Hospital "Doctor Negrín", Las Palmas de Gran Canaria, Spain.
(24) Department of Infectious Diseases, University Hospital "Ramón y Cajal", Madrid, Spain.
(25) Department of Internal Medicine, Hematology Service and Mycology Laboratory, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil.
(26) Department of Infectious Diseases and Transplantation Center, University Hospital (CHUV) and University of Lausanne, Switzerland.
(27) Department of Internal Medicine, Hospital Universitario "La Paz", School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
(28) Department of Infectious Diseases, Hospital Universitario Cruces, Barakaldo, Bilbao, Spain.
(29) Department of Microbiology and Infectious Diseases, Hospital General Universitario "Gregorio Marañón", Madrid, Spain.
(30) Department of Nephrology, Hospital Universitario Puerta de Hierro-Majadahonda, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
(31) Department of Nephrology, Hospital Universitario "Puerta del Mar", Cádiz, Spain.
(32) Unit of Infectious Diseases, Hospital Universitario "La Fe", Valencia, Spain.
(33) Department of Nephrology, Hospital Universitari Vall d'Hebrón, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.
(34) Department of Nephrology, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i+12), Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain. 

Revista: American Journal of Transplantation

Fecha: 27/01/2016

Nefrología

RESUMEN

Risk factors for invasive pulmonary aspergillosis (IPA) after kidney transplantation (KT) have been poorly explored. We performed a multinational case-control study that included 51 KT recipients diagnosed with early (first 180 post-transplant days) IPA in 19 institutions between 2000 and 2013.

Controls recipients were matched (1:1 ratio) by center and date of transplantation. Overall mortality among cases was 60.8% and 25.0% of survivors experienced graft loss. Pre-transplant diagnosis of chronic pulmonary obstructive disease (COPD) (odds ratio [OR]: 9.96; 95% confidence interval [CI]: 1.09-90.58; P-value = 0.041) and delayed graft function (OR: 3.40; 95% CI: 1.08-10.73; P-value = 0.037) were identified as independent risk factors for IPA among those variables already available in the immediate peri-transplant period. The development of bloodstream infection (OR: 18.76; 95% CI: 1.04-339.37; P-value = 0.047) and acute graft rejection (OR: 40.73, 95% CI: 3.63-456.98; P-value = 0.003) within the three months prior to the diagnosis of IPA acted as risk factors during the subsequent period.

In conclusion, pre-transplant COPD, impaired graft function and the occurrence of serious post-transplant infections may be useful to identify KT recipients at the highest risk for early IPA. Futures studies should explore the potential benefit of anti-mold prophylaxis in this group.

CITA DEL ARTÍCULO  Am J Transplant. 2016 Jan 27. doi: 10.1111/ajt.13735.

tal vezLE INTERESE

¿QUÉ TECNOLOGÍA UTILIZAMOS?

La Clínica es el hospital privado con mayor dotación tecnológica de España, todo en un único centro.

Imagen de un PET, tecnología de vanguardia en la Clínica Universidad de Navarra

NUESTROS
PROFESIONALES

Los profesionales de la Clínica realizan una labor continuada de investigación y formación, siempre en beneficio del paciente.

Imagen profesionales de la Clínica Universidad de Navarra

POR QUÉ VENIR
A LA CLÍNICA

Conozca por qué somos diferentes a otros centros sanitarios. Calidad, rapidez, comodidad y resultados.

Imagen del edificio de la Clínica Universidad de Navarra