Risk factors of invasive fungal infections in lung transplant recipients: A systematic review and meta-analysis
Issued Date
2022-02-01
Resource Type
ISSN
10532498
eISSN
15573117
Scopus ID
2-s2.0-85120877981
Pubmed ID
34872817
Journal Title
Journal of Heart and Lung Transplantation
Volume
41
Issue
2
Start Page
255
End Page
262
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Heart and Lung Transplantation Vol.41 No.2 (2022) , 255-262
Suggested Citation
Phoompoung P. Risk factors of invasive fungal infections in lung transplant recipients: A systematic review and meta-analysis. Journal of Heart and Lung Transplantation Vol.41 No.2 (2022) , 255-262. 262. doi:10.1016/j.healun.2021.09.014 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/86172
Title
Risk factors of invasive fungal infections in lung transplant recipients: A systematic review and meta-analysis
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
Background: : Invasive fungal infection (IFI) remains a common complication after lung transplantation, causing significant morbidity and mortality. We have attempted to quantify systematically risk factors of IFI in lung transplant recipients. Methods: : Studies were retrieved from Ovid MEDLINE, Ovid Embase, Cochrane database of systematic reviews and Cochrane central register of controlled trials. All case-control and cohort studies evaluating the risk factors of IFI in adult lung transplant recipients were screened. Two researchers reviewed and assessed all studies independently. We pooled the estimated effect of each factor associated with IFI by using a random effect model. Results: : Eight studies were included in the systematic review and 5 studies were eligible for the meta-analysis. Rates of IFI range from 8% to 33% in lung transplant recipients. Independent risk factors for invasive aspergillosis (IA) in lung transplantation include previous fungal colonization (odds ratio [OR] 2.44; 95% confidence interval [CI] 0.08-0.47), cytomegalovirus infection (OR 1.96; 95% CI 1.08-3.56), and single lung transplantation (OR 1.77; 95% CI 1.08-2.91). Pre-emptive antifungal therapy is a protective factor for IA in lung transplant (OR 0.2; 95% CI 0.08-0.47). Conclusion: : Cytomegalovirus infection, previous fungal colonization and single lung transplantation independently increase the risk of IA in lung transplant recipients. Pre-emptive antifungal therapy is a protective factor for IA in the lung transplant population.