Opportunistic fungal infections like Aspergillosis are life-threatening complications; they are a major cause of morbidity and mortality in organ transplant recipients. The infection risk from a deceased donor is directly related to the time the deceased donor spends in the intensive care unit. After transplant, a latent or subclinically present microorganism in the donor organ leads to symptoms in the recipient. We report 2 cases of renal aspergillum in recipients of a deceased-donor renal transplant. A 19-year-old patient and 29-year-old patient, both with end-stage renal disease, underwent a renal transplant from an 18-year-old deceased donor who had died of a subarachnoid hemorrhage. The donor’s length of the stay in the intensive care unit was 9 days. Neither patient had a complication postoperatively. Both patients were discharged with normal renal functions. Five months later, during control ultrasonography and computed tomography, we diagnosed solid and hypoechoic lesions in the renal graft. An ultrasound-guided renal graft biopsy was done. The histopathology examination revealed Aspergillosis fumigates. At diagnosis, the results of renal function tests were normal in both patients. Consecutive therapy with Varicanasole, caspofungin, and amphotericin B was used for 70 days. In addition, intralesional 50 mg amphotericin B was administrated 5 times in both patients. Despite these therapies, clinical and radiologic variables were poor. We decided to do a graft nephrectomy. Before nephrectomy, the patients’ mean serum creatinine levels were 1.7 and 2.9 mg/dL. After nephrectomy, antifungal therapy was continued for 1 week. Patients’ mean serum C-reactive protein values decreased to 10 and 25 mg/L. Both patients were discharged without surgical complications to a routine hemodialysis program. In conclusion; opportunistic fungal infections like Aspergillosis, viruses, and parasites are transported from subclinical infected donors to recipients of organ transplants. When deceased-donor organs are used, patients should be frequently tested for latent infections.
Volume : 6
Issue : 4
Pages : 134
Department of General Surgery and Transplantation, Baskent University Faculty of Medicine, Ankara, Turkey