Prophylaxis of invasive mycoses in solid organ transplantation

Abstract

Solid organ transplantation is emerging as a life-saving procedure for increasing numbers of patients and invasive fungal infections are a significant cause of mortality and morbidity for patients undergoing these procedures. This paper will review the latest data pertinent to the development of effective regimens aimed at preventing invasive mycoses in the solid organ transplantation population. Risks for developing invasive fungal infections are continuing to evolve, leading to shifts in the epidemiology of invasive mycoses occurring after transplantation. For instance, risks for the development of invasive candidiasis in the immediate postoperative period following orthotopic liver transplantation have decreased dramatically while the incidence of invasive aspergillosis appears to be on the rise. New agents have recently been approved for use in the United States and may have a role in prophylactic strategies aimed at preventing these fungal infections. An understanding of these issues is crucial to the development of targeted prophylactic regimens for the successful prevention of invasive fungal infections in the solid organ transplant recipient.