Chapter 38 : Invasive Aspergillosis in Solid Organ Transplant Recipients

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Ebook: Choose a downloadable PDF or ePub file. Chapter is a downloadable PDF file. File must be downloaded within 48 hours of purchase

Buy this Chapter
Digital (?) $15.00

Preview this chapter:
Zoom in

Invasive Aspergillosis in Solid Organ Transplant Recipients, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555815523/9781555814380_Chap38-1.gif /docserver/preview/fulltext/10.1128/9781555815523/9781555814380_Chap38-2.gif


This chapter discusses the current status and evolving trends in the epidemiology, risk factors, diagnostic laboratory assays, and the approach to antifungal prophylaxis and treatment of invasive aspergillosis in Solid Organ Transplant (SOT) recipients. Most invasive fungal infections in these high-risk patients occur within the first month posttransplant; the median time to onset of invasive aspergillosis after renal replacement therapy and retransplantation was 13 and 28 days, respectively, in one study. Other factors associated with invasive aspergillosis in liver transplant recipients include transplantation for fulminate hepatic failure, cytomegalovirus (CMV) infection, and prolonged intensive care unit stay. A retrospective survey documented invasive pulmonary aspergillosis in 7.5% (19/251) of lung transplant recipients, of whom 47% (9/19) had disseminated aspergillosis. In a survey of antifungal prophylactic strategies in lung transplant units in the United States, aerosolized amphotericin B was the most frequently employed antifungal prophylactic agent. In order of preference, the prophylactic agents used in lung transplant centers in this study were inhaled amphotericin B (61%), itraconazole (46%), parenteral amphotericin formulations (25%), and fluconazole (21%); many centers used more than one agent. Preemptive therapy, where antifungal prophylaxis is directed towards lung transplant recipients colonized with spp. immediately before or within 6 to 9 months after transplantation, is another approach to the prevention of invasive aspergillosis in lung transplant recipients.

Citation: Sun H, MuÑoz P, Bouza E, Singh N. 2009. Invasive Aspergillosis in Solid Organ Transplant Recipients, p 503-518. In Latgé J, Steinbach W (ed), and Aspergillosis. ASM Press, Washington, DC. doi: 10.1128/9781555815523.ch38

Key Concept Ranking

Fungal Infections
Antifungal Agents
Amphotericin B
Hepatitis C virus
Highlighted Text: Show | Hide
Loading full text...

Full text loading...


1. Akerele, T., and, S. Lightman. 2007. Ocular complications in heart, lung and heart-lung recipients. Br. J. Ophthalmol. 91:310312.
2. Altiparmak, M. R.,, S. Apaydin,, S. Trablus,, K. Serdengecti,, R. Ataman,, R. Ozturk, and, E. Erek. 2002. Systemic fungal infections after renal transplantation. Scand. J. Infect. Dis. 34:284288.
3. Ankersmit, H. J.,, R. Deicher,, B. Moser,, I. Teufel,, G. Roth,, S. Gerlitz,, S. Itescu,, E. Wolner,, G. Boltz-Nitulescu, and, J. Kovarik. 2001. Impaired T cell proliferation, increased soluble death-inducing recep- tors and activation-induced T cell death in patients undergoing hae-modialysis. Clin. Exp. Immunol. 125:142148.
4. Anonymous. 2002. Voriconazole. Med. Lett. Drugs Ther. 44:6365.
5. Anttila, V. J.,, A. Piilonen, and, M. Valtonen. 2003. Co-administration of caspofungin and cyclosporine to a kidney transplant patient with pulmonary Aspergillus infection. Scand. J. Infect. Dis. 35:893894.
6. Badiee, P.,, P. Kordbacheh,, A. Alborzi,, S. Malekhoseini,, F. Zeini,, H. Mirhendi, and, M. Mahmoodi. 2007. Prospective screening in liver transplant recipients by panfungal PCR-ELISA for early diagnosis of invasive fungal infections. Liver Transplant. 13:10111016.
7. Balloy, V.,, M. Huerre,, J. P. Latgé, and, M. Chignard. 2005. Differences in patterns of infection and inflammation for corticosteroid treatment and chemotherapy in experimental invasive pulmonary aspergillosis. Infect. Immun. 73:494503.
8. Bonham, C. A.,, E. A. Dominguez,, M. B. Fukui,, D. L. Paterson,, G. A. Pankey,, M. M. Wagener,, J. J. Fung, and, N. Singh. 1998. Central nervous system lesions in liver transplant recipients: prospective assessment of indications for biopsy and implications for management. Transplantation 66:15961604.
9. Briegel, J.,, H. Forst,, B. Spill,, A. Haas,, B. Grabein,, M. Haller,, E. Kilger,, K. W. Jauch,, K. Maag,, G. Ruckdeschel, et al. 1995. Risk factors for systemic fungal infections in liver transplant recipients. Eur. J. Clin. Microbiol. Infect. Dis. 14:375382.
10. Brown, R. S., Jr.,, J. R. Lake,, B. A. Katzman,, N. L. Ascher,, K. A. Somberg,, J. C. Emond, and, J. P. Roberts. 1996. Incidence and significance of Aspergillus cultures following liver and kidney transplantation. Transplantation 61:666669.
11. Cahill, B. C.,, J. R. Hibbs,, K. Savik,, B. A. Juni,, B. M. Dosland,, C. Edin-Stibbe, and, M. I. Hertz. 1997. Aspergillus airway colonization and invasive disease after lung transplantation. Chest 112: 11601164.
12. Calvo, V.,, J. M. Borro,, P. Morales,, A. Morcillo,, R. Vicente,, V. Tar-razona,, F. Paris, et al. 1999. Antifungal prophylaxis during the early postoperative period of lung transplantation. Chest 115: 13011304.
13. Capitano, B.,, B. A. Potoski,, S. Husain,, S. Zhang,, D. L. Paterson,, S. M. Studer,, K. R. McCurry, and, R. Venkataramanan. 2006. Intrapul-monary penetration of voriconazole in patients receiving an oral prophylactic regimen. Antimicrob. Agents Chemother. 50: 18781880.
14. Carby, M. R.,, M. E. Hodson, and, N. R. Banner. 2004. Refractory pulmonary aspergillosis treated with caspofungin after heart-lung transplantation. Transplant. Int. 17:545548.
15. Cenci, E.,, A. Mencacci,, G. Del Sero,, A. Bacci,, C. Montagnoli,, C. F. d’Ostiani,, P. Mosci,, M. Bachmann,, F. Bistoni,, M. Kopf, and, L. Romani. 1999. Interleukin-4 causes susceptibility to invasive pulmonary aspergillosis through suppression of protective type I responses. J. Infect. Dis. 180:19571968.
16. Chandrasekar, P. H., and, J. I. Ito. 2005. Amphotericin B lipid complex in the management of invasive aspergillosis in immunocompromised patients. Clin. Infect. Dis. 40:(Suppl. 6):S392S400.
17. Chandrasekar, P. H., and, J. D. Sobel. 2006. Micafungin: a new echinocandin. Clin. Infect. Dis. 42:11711178.
18. Clancy, C. J.,, R. A. Jaber,, H. L. Leather,, J. R. Wingard,, B. Staley,, L. J. Wheat,, C. L. Cline,, K. H. Rand,, D. Schain,, M. Baz, and, M. H. Nguyen. 2007. Bronchoalveolar lavage galactomannan in diagnosis of invasive pulmonary aspergillosis among solid-organ transplant recipients. J. Clin. Microbiol. 45:17591765.
19. Cofan, F.,, P. Inigo,, M. J. Ricart,, F. Oppenheimer,, J. Vilardell,, J. M. Campistol, and, P. Carretero. 1996. Aspergilosis pulmonar invasiva en el trasplante renal y renopancreatico. Nefrologia XVI:253260.
20. Collins, L. A.,, M. H. Samore,, M. S. Roberts,, R. Luzzati,, R. L. Jenkins,, W. D. Lewis, and, A. W. Karchmer. 1994. Risk factors for invasive fungal infections complicating orthotopic liver transplantation. J. Infect. Dis. 170:644652.
21. Corcoran, T. E.,, R. Venkataramanan,, K. M. Mihelc,, A. L. Marcin-kowski,, J. Ou,, B. M. McCook,, L. Weber,, M. E. Carey,, D. L. Pat-erson,, J. M. Pilewski,, K. R. McCurry, and, S. Husain. 2006. Aerosol deposition of lipid complex amphotericin-B (Abelcet) in lung transplant recipients. Am. J. Transplant. 6:27652773.
22. Cornely, O. A.,, J. Maertens,, M. Bresnik,, R. Ebrahimi,, A. J. Ullmann,, E. Bouza,, C. P. Heussel,, O. Lortholary,, C. Rieger,, A. Boehme,, M. Aoun,, H. A. Horst,, A. Thiebaut,, M. Ruhnke,, D. Reichert,, N. Vi-anelli,, S. W. Krause,, E. Olavarria, and, R. Herbrecht. 2007. Lipo-somal amphotericin B as initial therapy for invasive mold infection: a randomized trial comparing a high-loading dose regimen with standard dosing (AmBiLoad trial). Clin. Infect. Dis. 44:12891297.
23. Cruciani, M.,, C. Mengoli,, M. Malena,, O. Bosco,, G. Serpelloni, and, P. Grossi. 2006. Antifungal prophylaxis in liver transplant patients: a systematic review and meta-analysis. Liver Transplant. 12: 850858.
24. Dale, D. C.,, W. C. Liles,, W. R. Summer, and, S. Nelson. 1995. Review: granulocyte colony-stimulating factor—role and relationships in infectious diseases. J. Infect. Dis. 172:10611075.
25. Dauber, J. H.,, I. L. Paradis, and, J. S. Dummer. 1990. Infectious complications in pulmonary allograft recipients. Clin. Chest Med. 11: 291308.
26. D’Elios, M. M.,, R. Josien,, M. Manghetti,, A. Amedei,, M. de Carli,, M. C. Cuturi,, G. Blancho,, F. Buzelin,, G. del Prete, and, J. P. Sou-lillou. 1997. Predominant Th1 cell infiltration in acute rejection episodes of human kidney grafts. Kidney Int. 51:18761884.
27. Denning, D. W. 1998. Invasive aspergillosis. Clin. Infect. Dis. 26: 781803.
28. Denning, D. W.,, K. A. Marr,, W. M. Lau,, D. P. Facklam,, V. Ratan-atharathorn,, C. Becker,, A. J. Ullmann,, N. L. Seibel,, P. M. Flynn,, J. A. van Burik,, D. N. Buell, and, T. F. Patterson. 2006. Micafungin (FK463), alone or in combination with other systemic antifungal agents, for the treatment of acute invasive aspergillosis. J. Infect. 53: 337349.
29. Denning, D. W.,, P. Ribaud,, N. Milpied,, D. Caillot,, R. Herbrecht,, E. Thiel,, A. Haas,, M. Ruhnke, and, H. Lode. 2002. Efficacy and safety of voriconazole in the treatment of acute invasive aspergillosis. Clin. Infect. Dis. 34:563571.
30. de Pablo, A.,, P. Ussetti,, M. Cruz Carreno,, T. Lazaro,, M. J. Ferreiro,, A. Lopez,, P. Mendaza, and, J. Estada. 2000. Aspergillosis in pulmonary transplantation. Enferm. Infecc. Microbiol. Clin. 18: 209214. (In French.)
31. Dowell, J. A.,, M. Stogniew,, D. Krause, and, B. Damle. 2007a. Ani-dulafungin does not require dosage adjustment in subjects with varying degrees of hepatic or renal impairment. J. Clin. Pharmacol. 47: 461470.
32. Dowell, J. A.,, M. Stogniew,, D. Krause,, T. Henkel, and, B. Damle. 2007b. Lack of pharmacokinetic interaction between anidulafungin and tacrolimus. J. Clin. Pharmacol. 47: 305314.
33. Dowell, J. A.,, M. Stogniew,, D. Krause,, T. Henkel, and, I. E. Weston. 2005. Assessment of the safety and pharmacokinetics of anidulafungin when administered with cyclosporine. J. Clin. Pharmacol. 45: 227233.
34. Dummer, J. S.,, N. Lazariashvilli,, J. Barnes,, M. Ninan, and, A. P. Mil-stone. 2004. A survey of anti-fungal management in lung transplantation. J. Heart Lung Transplant. 23:13761381.
35. Duong, M.,, N. Ouellet,, M. Simard,, Y. Bergeron,, M. Olivier, and, M. G. Bergeron. 1998. Kinetic study of host defense and inflammatory response to Aspergillus fumigatus in steroid-induced immu-nosuppressed mice. J. Infect. Dis. 178:14721482.
36. Ferraris, J. R.,, M. L. Tambutti,, R. L. Cardoni, and, N. Prigoshin. 2004. Conversion from cyclosporine A to tacrolimus in pediatric kidney transplant recipients with chronic rejection: changes in the immune responses. Transplantation 77: 532537.
37. Forestier, E.,, V. Remy,, O. Lesens,, M. Martinot,, Y. Hansman,, B. Ei-senmann, and, D. Christmann. 2005. A case of Aspergillus medias- tinitis after heart transplantation successfully treated with liposomal amphotericin B, caspofungin and voriconazole. Eur. J. Clin. Micro-biol. Infect. Dis. 24: 347349.
38. Fortun, J.,, P. Martin-Davila,, M. E. Alvarez,, A. Sanchez-Sousa,, L. Ga-jate,, R. Barcena,, J. Nuno, and, S. Moreno. 2007. Aspergillus galac-tomannan antigen in liver transplant recipients (LTR): a high false-positive rate in serum samples obtained during the first week post-transplantation, abstr. K-2167. Abstr. 47th Intersci. Conf. Antimicrob. Agents Chemother, Chicago, IL.
39. Fortun, J.,, P. Martin-Davila,, M. E. Alvarez,, A. Sanchez-Sousa,, C. Quereda,, E. Navas,, R. Barcena,, E. Vicente,, A. Candelas,, A. Hon-rubia,, J. Nuno,, V. Pintado, and, S. Moreno. 2001. Aspergillus antigenemia sandwich-enzyme immunoassay test as a serodiagnostic method for invasive aspergillosis in liver transplant recipients. Transplantation 71:145149.
40. Fortun, J.,, P. Martin-Davila,, S. Moreno,, R. Barcena,, E. de Vicente,, A. Honrubia,, M. Garcia,, J. Nuno,, A. Candela,, M. Uriarte, and, V. Pintado. 2003a. Prevention of invasive fungal infections in liver transplant recipients: the role of prophylaxis with lipid formulations of amphotericin B in high-risk patients. J. Antimicrob. Chemother. 52:813819.
41. Fortun, J.,, P. Martin-Davila,, S. Moreno,, E. De Vicente,, J. Nuno,, A. Candelas,, R. Barcena, and, M. Garcia. 2002. Risk factors for invasive aspergillosis in liver transplant recipients. Liver Transplant. 8: 10651070.
42. Fortun, J.,, P. Martin-Davila,, M. A. Sanchez,, V. Pintado,, M. E. Alvarez,, A. Sanchez-Sousa, and, S. Moreno. 2003b. Voriconazole in the treatment of invasive mold infections in transplant recipients. Eur. J. Clin. Microbiol. Infect. Dis. 22:408413.
43. Gallis, H. A.,, R. A. Berman,, T. R. Cate,, J. D. Hamilton,, J. C. Gun-nells, and, D. L. Stickel. 1975. Fungal infection following renal transplantation. Arch. Intern. Med. 135:11631172.
44. Garrido, J.,, J. L. Lerma,, M. Heras,, P. J. Labrador,, P. Garcia,, A. Bon-dia,, L. Corbacho, and, J. M. Tabernero. 2003. Pseudoaneurysm of the iliac artery secondary to Aspergillus infection in two recipients of kidney transplants from the same donor. Am. J. Kidney Dis. 41: 488492.
45. Gavalda, J.,, O. Len,, R. San Juan,, J. M. Aguado,, J. Fortun,, C. Lum-breras,, A. Moreno,, P. Munoz,, M. Blanes,, A. Ramos,, G. Rufi,, M. Gurgui,, J. Torre-Cisneros,, M. Montejo,, M. Cuenca-Estrella,, J. L. Rodriguez-Tudela, and, A. Pahissa. 2005. Risk factors for invasive aspergillosis in solid-organ transplant recipients: a case-control study. Clin. Infect. Dis. 41:5259.
46. Gaviria, J. M.,, J. A. van Burik,, D. C. Dale,, R. K. Root, and, W. C. Liles. 1999. Comparison of interferon-gamma, granulocyte colony-stimulating factor, and granulocyte-macrophage colony-stimulating factor for priming leukocyte-mediated hyphal damage of opportunistic fungal pathogens. J. Infect. Dis. 179:10381041.
47. George, M. J.,, D. R. Snydman,, B. G. Werner,, J. Griffith,, M. E. Fal-agas,, N. N. Dougherty,, R. H. Rubin, et al. 1997. The independent role of cytomegalovirus as a risk factor for invasive fungal disease in orthotopic liver transplant recipients. Am. J. Med. 103:106113.
48. Gil-Lamaignere, C.,, M. Simitsopoulou,, E. Roilides,, A. Maloukou,, R. M. Winn, and, T. J. Walsh. 2005. Interferon-gamma and granulocyte-macrophage colony-stimulating factor augment the activity of polymorphonuclear leukocytes against medically important zygomycetes. J. Infect. Dis. 191:11801187.
49. Gonwa, T. A.,, M. A. McBride,, K. Anderson,, M. L. Mai,, H. Wadei, and, N. Ahsan. 2006. Continued influence of preoperative renal function on outcome of orthotopic liver transplant (OLTX) in the US: where will MELD lead us? Am. J. Transplant. 6:26512659.
50. Gras, J.,, A. Cornet,, D. Latinne, and, R. Reding. 2004. Evidence that Th1/Th2 immune deviation impacts on early graft acceptance after pediatric liver transplantation: results of immunological monitoring in 40 children. Am. J. Transplant. 4:444.
51. Grazziutti, M. L.,, J. H. Rex,, R. E. Cowart,, E. J. Anaissie,, A. Ford, and, C. A. Savary. 1997. Aspergillus fumigatus conidia induce a Th1-type cytokine response. J. Infect. Dis. 176:15791583.
52. Groetzner, J.,, I. Kaczmarek,, T. Wittwer,, J. Strauch,, B. Meiser,, T. Wahlers,, S. Daebritz, and, B. Reichart. 2008. Caspofungin as first-line therapy for the treatment of invasive aspergillosis after thoracic organ transplantation. J. Heart Lung Transplant. 27:16.
53. Grossi, P.,, R. De Maria,, A. Caroli,, M. S. Zaina,, L. Minoli, et al. 1992. Infections in heart transplant recipients: the experience of the Italian heart transplantation program. J. Heart Lung Transplant. 11: 847866.
54. Grossi, P.,, C. Farina,, R. Fiocchi,, D. Dalla Gasperina, et al. 2000. Prevalence and outcome of invasive fungal infections in 1,963 thoracic organ transplant recipients: a multicenter retrospective study. Transplantation 70:112116.
55. Guillemain, R.,, V. Lavarde,, C. Amrein,, P. Chevalier,, A. Guinvarc’h, and, D. Glotz. 1995. Invasive aspergillosis after transplantation. Transplant. Proc. 27:13071309.
56. Gustafson, T. L.,, W. Schaffner,, G. B. Lavely,, C. W. Stratton,, H. K. Johnson, and, R. H. Hutcheson, Jr. 1983. Invasive aspergillosis in renal transplant recipients: correlation with corticosteroid therapy. J. Infect. Dis. 148:230238.
57. Hamacher, J.,, A. Spiliopoulos,, A. M. Kurt,, L. P. Nicod, et al. 1999. Pre-emptive therapy with azoles in lung transplant patients. Eur. Respir. J. 13:180186.
58. Hebert, M. F.,, R. W. Townsend,, S. Austin,, G. Balan,, D. K. Blough,, D. Buell,, J. Keirns, and, I. Bekersky. 2005. Concomitant cyclospor-ine and micafungin pharmacokinetics in healthy volunteers. J. Clin. Pharmacol. 45:954960.
59. Hellinger, W. C.,, H. Bonatti,, J. D. Yao,, S. Alvarez,, L. M. Brumble,, M. R. Keating,, J. C. Mendez,, D. J. Kramer,, R. C. Dickson,, D. M. Harnois,, J. R. Spivey,, C. B. Hughes,, J. H. Nguyen, and, J. L. Steers. 2005. Risk stratification and targeted antifungal prophylaxis for prevention of aspergillosis and other invasive mold infections after liver transplantation. Liver Transplant. 11: 656662.
60. Helmi, M.,, R. B. Love,, D. Welter,, R. D. Cornwell, and, K. C. Meyer. 2003. Aspergillus infection in lung transplant recipients with cystic fibrosis: risk factors and outcomes comparison to other types of transplant recipients. Chest 123:800808.
61. Herbrecht, R.,, D. W. Denning,, T. F. Patterson,, J. E. Bennett,, R. E. Greene,, J. W. Oestmann,, W. V. Kern,, K. A. Marr,, P. Ribaud,, O. Lortholary,, R. Sylvester,, R. H. Rubin,, J. R. Wingard,, P. Stark,, C. Durand,, D. Caillot,, E. Thiel,, P. H. Chandrasekar,, M. R. Hodges,, H. T. Schlamm,, P. F. Troke, and, B. de Pauw. 2002. Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis. N. Engl. J. Med. 347:408415.
62. Hodge, S.,, G. Hodge,, R. Flower, and, P. Han. 1999. Methyl-prednisolone up-regulates monocyte interleukin-10 production in stimulated whole blood. Scand. J. Immunol. 49:548553.
63. Hummel, M.,, S. Schuler,, U. Weber,, G. Schwertlick,, S. Hempel,, D. Theiss,, W. Rees,, J. Mueller, and, R. Hetzer. 1993. Aspergillosis with Aspergillus osteomyelitis and diskitis after heart transplantation: surgical and medical management. J. Heart Lung Transplant. 12: 599603.
64. Hummel, M.,, U. Thalmann,, G. Jautzke,, F. Staib,, M. Seibold, and, R. Hetzer. 1992. Fungal infections following heart transplantation. Mycoses 35:2334.
65. Husain, S.,, E. J. Kwak,, A. Obman,, M. M. Wagener,, S. Kusne,, J. E. Stout,, K. R. McCurry, and, N. Singh. 2004. Prospective assessment of Platelia Aspergillus galactomannan antigen for the diagnosis of invasive aspergillosis in lung transplant recipients. Am. J. Transplant. 4:796802.
66. Husain, S.,, D. L. Paterson,, S. Studer,, J. Pilewski,, M. Crespo,, D. Zal-donis,, K. Shutt,, D. L. Pakstis,, A. Zeevi,, B. Johnson,, E. J. Kwak, and, K. R. McCurry. 2006. Voriconazole prophylaxis in lung transplant recipients. Am. J. Transplant. 6:30083016.
67. Husain, S.,, D. L. Paterson,, S. M. Studer,, M. Crespo,, J. Pilewski,, M. Durkin,, J. L. Wheat,, B. Johnson,, L. McLaughlin,, C. Bentsen,, K. R. McCurry, and, N. Singh. 2007. Aspergillus galactomannan antigen in the bronchoalveolar lavage fluid for the diagnosis of invasive aspergillosis in lung transplant recipients. Transplantation 83: 13301336.
68. Husni, R. N.,, S. M. Gordon,, D. L. Longworth,, A. Arroliga,, P. C. Stillwell,, R. K. Avery,, J. R. Maurer,, A. Mehta, and, T. Kirby. 1998. Cytomegalovirus infection is a risk factor for invasive aspergillosis in lung transplant recipients. Clin. Infect. Dis. 26:753755.
69. Iversen, M.,, C. M. Burton,, S. Vand,, L. Skovfoged,, J. Carlsen,, N. Milman,, C. B. Andersen,, M. Rasmussen, and, M. Tvede. 2007. As-pergillus infection in lung transplant patients: incidence and prognosis. Eur. J. Clin. Microbiol. Infect. Dis. 26:879886.
70. Joseph, J. M.,, R. Jain, and, L. H. Danziger. 2007. Micafungin: a new echinocandin antifungal. Pharmacotherapy 27:5367.
71. Kanj, S. S.,, K. Welty-Wolf,, J. Madden,, V. Tapson,, M. A. Baz,, R. D. Davis, and, J. R. Perfect. 1996. Fungal infections in lung and heart-lung transplant recipients. Report of 9 cases and review of the literature. Medicine (Baltimore) 75:142156.
72. Kartsonis, N. A.,, A. J. Saah,, C. Joy Lipka,, A. F. Taylor, and, C. A. Sable. 2005. Salvage therapy with caspofungin for invasive aspergillosis: results from the caspofungin compassionate use study. J. Infect. 50:196205.
73. Kawagishi, N.,, K. Satoh,, Y. Enomoto,, Y. Akamatsu,, S. Sekiguchi,, K. Fujimori, and, S. Satomi. 2006. Risk factors and impact of beta-D glucan on invasive fungal infection for the living donor liver transplant recipients. Tohoku J. Exp. Med. 209:207215.
74. Kramer, M.,, M. R. Kramer,, H. Blau,, J. Bishara,, R. Axer-Siegel, and, D. Weinberger. 2006. Intravitreal voriconazole for the treatment of endogenous Aspergillus endophthalmitis. Ophthalmology 113: 11841186.
75. Kramer, M. R.,, D. W. Denning,, S. E. Marshall,, D. J. Ross,, G. Berry,, N. J. Lewiston,, D. A. Stevens, and, J. Theodore. 1991. Ulcerative tracheobronchitis after lung transplantation. A new form of invasive aspergillosis. Am. Rev. Respir. Dis. 144:552556.
76. Kusne, S.,, J. Torre-Cisneros,, R. Manez,, W. Irish,, M. Martin,, J. Fung,, R. L. Simmons, and, T. E. Starzl. 1992. Factors associated with invasive lung aspergillosis and the significance of positive Aspergillus culture after liver transplantation. J. Infect. Dis. 166:13791383.
77. Kwak, E.,, K. Abu-Elmagd,, J. Bond,, M. F. Zak,, M. McHenry, and, S. Kusne. 2002. Invasive fungal infections in adult small bowel transplant recipients, abstr. K-1231. 42nd Intersci. Conf. Antimicrob. Agents Chemother., San Diego, CA.
78. Kwak, E. J.,, S. Husain,, A. Obman,, L. Meinke,, J. Stout,, S. Kusne,, M. M. Wagener, and, N. Singh. 2004. Efficacy of galactomannan antigen in the Platelia Aspergillus enzyme immunoassay for diagnosis of invasive aspergillosis in liver transplant recipients. J. Clin. Micro-biol. 42:435438.
79. Laursen, A. L.,, S. C. Mogensen,, H. M. Andersen,, P. L. Andersen, and, S. Ellermann-Eriksen. 2001. The impact of CMV on the respiratory burst of macrophages in response to Pneumocystis carinii. Clin. Exp. Immunol. 123:239246.
80. Leather, H.,, R. M. Boyette,, L. Tian, and, J. R. Wingard. 2006. Phar-macokinetic evaluation of the drug interaction between intravenous itraconazole and intravenous tacrolimus or intravenous cyclosporin A in allogeneic hematopoietic stem cell transplant recipients. Biol. Blood Marrow Transplant. 12:325334.
81. Levin, T.,, B. Suh,, D. Beltramo, and, R. Samuel. 2004. Aspergillus me-diastinitis following orthotopic heart transplantation: case report and review of the literature. Transplant. Infect. Dis. 6:129131.
82. Lieschke, G. J., and, A. W. Burgess. 1992. Granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor (2). N. Engl. J. Med. 327:99106.
83. Linden, P.,, P. Williams, and, K. M. Chan. 2000. Efficacy and safety of amphotericin B lipid complex injection (ABLC) in solid-organ transplant recipients with invasive fungal infections. Clin. Transplant. 14:329339.
84. Linden, P. K.,, K. Coley,, P. Fontes,, J. J. Fung, and, S. Kusne. 2003. Invasive aspergillosis in liver transplant recipients: outcome comparison of therapy with amphotericin B lipid complex and a historical cohort treated with conventional amphotericin B. Clin. Infect. Dis. 37:1725.
85. Lionakis, M. S., and, D. P. Kontoyiannis. 2003. Glucocorticoids and invasive fungal infections. Lancet 362:18281838.
86. Lodge, B. A.,, E. D. Ashley,, M. P. Steele, and, J. R. Perfect. 2004. Aspergillus fumigatus empyema, arthritis, and calcaneal osteomyelitis in a lung transplant patient successfully treated with posacon-azole. J. Clin. Microbiol. 42:13761378.
87. Loire, R.,, A. Tabib, and, O. Bastien. 1993. Fatal aspergillosis after cardiac transplantation. About 26 cases. Ann. Pathol. 13: 157163. (In French.)
88. Loria, K. M.,, M. H. Salinger,, T. G. Frohlich,, M. D. Gendelman,, F. V. Cook, and, C. E. Arentzen. 1992. Primary cutaneous aspergillosis in a heart transplant recipient treated with surgical excision and oral itraconazole. J. Heart Lung Transplant. 11:156159.
89. Maertens, J.,, I. Raad,, G. Petrikkos,, M. Boogaerts,, D. Selleslag,, F. B. Petersen,, C. A. Sable,, N. A. Kartsonis,, A. Ngai,, A. Taylor,, T. F. Patterson,, D. W. Denning, and, T. J. Walsh. 2004. Efficacy and safety of caspofungin for treatment of invasive aspergillosis in patients refractory to or intolerant of conventional antifungal therapy. Clin. Infect. Dis. 39:15631571.
90. Mamishi, S.,, K. Zomorodian,, F. Saadat,, M. Gerami-Shoar,, B. Tara-zooie, and, S. A. Siadati. 2005. A case of invasive aspergillosis in CGD patient successfully treated with amphotericin B and INF-gamma. Ann. Clin. Microbiol. Antimicrob. 4:4.
91. Marty, F. M.,, C. M. Lowry,, C. S. Cutler,, B. J. Campbell,, K. Fiumara,, L. R. Baden, and, J. H. Antin. 2006. Voriconazole and sirolimus coadministration after allogeneic hematopoietic stem cell transplantation. Biol. Blood Marrow Transplant. 12:552559.
92. Mathis, A. S.,, N. K. Shah, and, G. S. Friedman. 2004. Combined use of sirolimus and voriconazole in renal transplantation: a report of two cases. Transplant. Proc. 36:27082709.
93. Maurer, J. R.,, D. E. Tullis,, R. F. Grossman,, H. Vellend,, T. L. Winton, and, G. A. Patterson. 1992. Infectious complications following isolated lung transplantation. Chest 101:10561059.
94. McAdams, H. P.,, J. J. Erasmus, and, S. M. Palmer. 2001. Complications (excluding hyperinflation) involving the native lung after single-lung transplantation: incidence, radiologic features, and clinical importance. Radiology 218:233241.
95. Mehrad, B.,, G. Paciocco,, F. J. Martinez,, T. C. Ojo,, M. D. Iannettoni, and, J. P. Lynch III. 2001. Spectrum of Aspergillus infection in lung transplant recipients: case series and review of the literature. Chest 119:169175.
96. Metin, K. S.,, B. S. Ugurlu,, B. Kabakci,, N. O. Sariosmanoglu,, E. Ha-zan, and, O. Oto. 2005. Surgical resection for successful treatment of invasive pulmonary aspergillosis: report of 3 cases. Scand. J. Infect. Dis. 37:694696.
97. Monforte, V.,, A. Roman,, J. Gavalda,, C. Bravo,, L. Tenorio,, A. Ferrer,, J. Maestre, and, F. Morell. 2001. Nebulized amphotericin B prophylaxis for Aspergillus infection in lung transplantation: study of risk factors. J. Heart Lung Transplant. 20:12741281.
98. Montoya, J. G.,, S. V. Chaparro,, D. Celis,, J. A. Cortes,, A. N. Leung,, R. C. Robbins, and, D. A. Stevens. 2003. Invasive aspergillosis in the setting of cardiac transplantation. Clin. Infect. Dis. 37:(Suppl. 3):S281S292.
99. Morgan, J.,, K. A. Wannemuehler,, K. A. Marr,, S. Hadley,, D. P. Kon-toyiannis,, T. J. Walsh,, S. K. Fridkin,, P. G. Pappas, and, D. W. Warnock. 2005. Incidence of invasive aspergillosis following he-matopoietic stem cell and solid organ transplantation: interim results of a prospective multicenter surveillance program. Med. Mycol. 43:(Suppl. 1):S49S58.
100. Munoz, P.,, L. Alcala,, M. Sanchez Conde,, J. Palomo,, J. Yanez,, T. Pelaez, and, E. Bouza. 2003. The isolation of Aspergillus fumigatus from respiratory tract specimens in heart transplant recipients is highly predictive of invasive aspergillosis. Transplantation 75: 326329.
101. Munoz, P.,, J. Palomo,, P. Guembe,, M. Rodriguez-Creixems,, P. Gijon, and, E. Bouza. 2000. Lung nodular lesions in heart transplant recipients. J. Heart Lung Transplant. 19:660667.
102. Munoz, P.,, C. Rodriguez,, E. Bouza,, J. Palomo,, J. F. Yanez,, M. J. Dominguez, and, M. Desco. 2004. Risk factors of invasive aspergillosis after heart transplantation: protective role of oral itraconazole prophylaxis. Am. J. Transplant. 4:636643.
103. Munoz, P.,, N. Singh, and, E. Bouza. 2006. Treatment of solid organ transplant patients with invasive fungal infections: should a combination of antifungal drugs be used? Curr. Opin. Infect. Dis. 19: 365370.
104. Munoz, P.,, J. Torre,, E. Bouza,, A. Moreno,, A. Echantz,, J. Fortun,, C. Lumbreras,, J. M. Aguado,, I. Losada,, V. Cuervas,, M. Gurgui,, J. M. Cisneros,, M. Montejo, and, C. Farinas. 1996. Invasive aspergillosis in transplant recipients. A large multicenter study, p. 242. Abstr. 36th Intersci. Conf. Antimicrob. Agents Chemother., New Orleans, LA.
105. Nagai, H.,, J. Guo,, H. Choi, and, V. Kurup. 1995. Interferon-gamma and tumor necrosis factor-alpha protect mice from invasive aspergillosis. J. Infect. Dis. 172:15541560.
106. Osawa, M.,, Y. Ito,, T. Hirai,, R. Isozumi,, S. Takakura,, Y. Fujimoto,, Y. Iinuma,, S. Ichiyama,, K. Tanaka, and, M. Mishima. 2007. Risk factors for invasive aspergillosis in living donor liver transplant recipients. Liver Transplant. 13:566570.
107. Palmer, S. M.,, R. H. Drew,, J. D. Whitehouse,, V. F. Tapson,, R. D. Davis,, R. R. McConnell,, S. S. Kanj, and, J. R. Perfect. 2001. Safety of aerosolized amphotericin B lipid complex in lung transplant recipients. Transplantation 72:545548.
108. Panackal, A. A.,, A. Dahlman,, K. T. Keil,, C. L. Peterson,, L. Mascola,, S. Mirza,, M. Phelan,, B. A. Lasker,, M. E. Brandt,, J. Carpenter,, M. Bell,, D. W. Warnock,, R. A. Hajjeh, and, J. Morgan. 2003. Outbreak of invasive aspergillosis among renal transplant recipients. Transplantation 75:10501053.
109. Paradowski, L. J. 1997. Saprophytic fungal infections and lung transplantation—revisited. J. Heart Lung Transplant. 16:524531.
110. Pasic, S.,, M. Abinun,, B. Pistignjat,, B. Vlajic,, J. Rakic,, L. Sarjanovic, and, N. Ostojic. 1996. Aspergillus osteomyelitis in chronic granu-lomatous disease: treatment with recombinant gamma-interferon and itraconazole. Pediatr. Infect. Dis. J. 15:833834.
111. Paterson, D. L., and, N. Singh. 1999. Invasive aspergillosis in transplant recipients. Medicine (Baltimore) 78:123138.
112. Paya, C. V. 2001. Prevention of fungal and hepatitis virus infections in liver transplantation. Clin. Infect. Dis. 33:(Suppl. 1):S47S52.
113. Peterson, P. K.,, R. Ferguson,, D. S. Fryd,, H. H. Balfour, Jr.,, J. Ry-nasiewicz, and, R. L. Simmons. 1982. Infectious diseases in hospitalized renal transplant recipients: a prospective study of a complex and evolving problem. Medicine (Baltimore) 61:360372.
114. Petrovic, J.,, A. Ngai,, S. Bradshaw,, A. Williams-Diaz,, A. Taylor,, C. Sable,, S. Vuocolo, and, N. Kartsonis. 2007. Efficacy and safety of caspofungin in solid organ transplant recipients. Transplant. Proc. 39:31173120.
115. Pfeiffer, C. D.,, J. P. Fine, and, N. Safdar. 2006. Diagnosis of invasive aspergillosis using a galactomannan assay: a meta-analysis. Clin. Infect. Dis. 42:14171427.
116. Rasmussen, C.,, C. Garen,, S. Brining,, R. L. Kincaid,, R. L. Means, and, A. R. Means. 1994. The calmodulin-dependent protein phosphatase catalytic subunit (calcineurin A) is an essential gene in Aspergillus nidulans. EMBO J. 13:25452552.
117. Rea, F.,, G. Marulli,, M. Loy,, L. Bortolotti,, C. Giacometti,, M. Schia-von, and, F. Calabrese. 2006. Salvage right pneumonectomy in a patient with bronchial-pulmonary artery fistula after bilateral se- quential lung transplantation. J. Heart Lung Transplant. 25: 13831386.
118. Reed, A.,, J. B. Herndon,, N. Ersoz,, T. Fujikawa,, D. Schain,, P. Lipori,, A. Hemming,, Q. Li,, E. Shenkman, and, B. Vogel. 2007. Effect of prophylaxis on fungal infection and costs for high-risk liver transplant recipients. Liver Transplant. 13: 17431750.
119. Reichenspurner, H.,, P. Gamberg,, M. Nitschke,, H. Valantine,, S. Hunt,, P. E. Oyer, and, B. A. Reitz. 1997. Significant reduction in the number of fungal infections after lung-, heart-lung, and heart transplantation using aerosolized amphotericin B prophylaxis. Transplant. Proc. 29: 627628.
120. Rex, J. H.,, J. E. Bennett,, J. I. Gallin,, H. L. Malech,, E. S. DeCarlo, and, D. A. Melnick. 1991. In vivo interferon-gamma therapy augments the in vitro ability of chronic granulomatous disease neutro-phils to damage Aspergillus hyphae. J. Infect. Dis. 163: 849852.
121. Roilides, E.,, C. Blake,, A. Holmes,, P. A. Pizzo, and, T. J. Walsh. 1996. Granulocyte-macrophage colony-stimulating factor and interferon-gamma prevent dexamethasone-induced immunosuppression of antifungal monocyte activity against Aspergillus fumigatus hyphae. J. Med. Vet. Mycol. 34: 6369.
122. Roilides, E.,, A. Dimitriadou-Georgiadou,, T. Sein,, I. Kadiltsoglou, and, T. J. Walsh. 1998. Tumor necrosis factor alpha enhances antifun-gal activities of polymorphonuclear and mononuclear phagocytes against Aspergillus fumigatus. Infect. Immun. 66: 59996003.
123. Root, R. K., and, D. C. Dale. 1999. Granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor: comparisons and potential for use in the treatment of infections in nonneutropenic patients. J. Infect. Dis. 179:(Suppl. 2):S342S352.
124. Rowe, J. M.,, J. W. Andersen,, J. J. Mazza,, J. M. Bennett,, E. Paietta,, F. A. Hayes,, D. Oette,, P. A. Cassileth,, E. A. Stadtmauer, and, P. H. Wiernik. 1995. A randomized placebo-controlled phase III study of granulocyte-macrophage colony-stimulating factor in adult patients (>55 to 70 years of age) with acute myelogenous leukemia: a study of the Eastern Cooperative Oncology Group (E1490). Blood 86: 457462.
125. Ruffini, E.,, S. Baldi,, M. Rapellino,, A. Cavallo,, A. Parola,, F. Robbiano,, N. Cappello, and, M. Mancuso. 2001. Fungal infections in lung transplantation. Incidence, risk factors and prognostic significance. Sarcoidosis Vasc. Diffuse Lung Dis. 18: 181190.
126. Saad, A. H.,, D. D. DePestel, and, P. L. Carver. 2006. Factors influencing the magnitude and clinical significance of drug interactions between azole antifungals and select immunosuppressants. Phar-macotherapy 26: 17301744.
127. Sable, C. A.,, B. Y. Nguyen,, J. A. Chodakewitz, and, M. J. DiNubile. 2002. Safety and tolerability of caspofungin acetate in the treatment of fungal infections. Transplant. Infect. Dis. 4: 2530.
128. Safieddine, N.,, B. M. Taylor, and, C. M. Guiraurdon. 2002. Small bowel infarction secondary to aspergillosis in a post-cardiac transplant patient: a case report. J. Heart Lung Transplant. 21: 935937.
129. Sandur, S.,, S. M. Gordon,, A. C. Mehta, and, J. R. Maurer. 1999. Native lung pneumonectomy for invasive pulmonary aspergillosis following lung transplantation: a case report. J. Heart Lung Transplant. 18: 810813.
130. Saner, F.,, J. Gensicke,, P. Rath,, N. Fruhauf,, Y. Gu,, A. Paul,, A. Radtke,, M. Malago, and, C. Broelsch. 2006. Safety profile of concomitant use of caspofungin and cyclosporine or tacrolimus in liver transplant patients. Infection 34: 328332.
131. Sansone-Parsons, A.,, G. Krishna,, M. Martinho,, B. Kantesaria,, S. Ge-lone, and, T. G. Mant. 2007. Effect of oral posaconazole on the pharmacokinetics of cyclosporine and tacrolimus. Pharmacotherapy 27: 825834.
132. Sanz-Rodriguez, C,, M. Lopez-Duarte,, M. Jurado,, J. Lopez,, R. Ar-ranz,, J. M. Cisneros,, M. L. Martino,, P. J. Garcia-Sanchez,, P. Morales,, T. Olive,, M. Rovira, and, C. Solano. 2004. Safety of the concomitant use of caspofungin and cyclosporin A in patients with invasive fungal infections. Bone Marrow Transplant. 34: 1320.
133. Saulsbury, F. T. 2001. Successful treatment of Aspergillus brain abscess with itraconazole and interferon-gamma in a patient with chronic granulomatous disease. Clin. Infect. Dis. 32:E137E139.
134. Saxena, P.,, B. Clarke, and, J. Dunning. 2007. Aspergillus endocarditis of the mitral valve in a lung-transplant patient. Tex. Heart Inst. J. 34:9597.
135. Scherer, M.,, H. G. Fieguth,, T. Aybek,, Z. Ujvari,, A. Moritz, and, G. Wimmer-Greinecker. 2005. Disseminated Aspergillus fumigatus infection with consecutive mitral valve endocarditis in a lung transplant recipient. J. Heart Lung Transplant. 24:22972300.
136. Schwartz, S.,, M. Ruhnke,, P. Ribaud,, L. Corey,, T. Driscoll,, O. A. Cornely,, U. Schuler,, I. Lutsar,, P. Troke, and, E. Thiel. 2005. Improved outcome in central nervous system aspergillosis, using vor-iconazole treatment. Blood 106:26412645.
137. Selby, R.,, C. B. Ramirez,, R. Singh,, I. Kleopoulos,, S. Kusne,, T. E. Starzl, and, J. Fung. 1997. Brain abscess in solid organ transplant recipients receiving cyclosporine-based immunosuppression. Arch. Surg. 132:304310.
138. Sherman-Weber, S.,, P. Axelrod,, B. Suh,, S. Rubin,, D. Beltramo,, J. Manacchio,, S. Furukawa,, T. Weber,, H. Eisen, and, R. Samuel. 2004. Infective endocarditis following orthotopic heart transplantation: 10 cases and a review of the literature. Transplant. Infect. Dis. 6:165170.
139. Shlobin, O. A.,, L. K. Dropulic,, J. B. Orens,, J. F. McDyer,, J. V. Conte,, S. Y. Yang, and, R. Girgis. 2005. Mediastinal mass due to Aspergillus fumigatus after lung transplantation: a case report. J. Heart Lung Transplant. 24:19911994.
140. Singh, N. 2000. Antifungal prophylaxis for solid organ transplant recipients: seeking clarity amidst controversy. Clin. Infect. Dis. 31: 545553.
141. Singh, N.,, P. M. Arnow,, A. Bonham,, E. Dominguez,, D. L. Paterson,, G. A. Pankey,, M. M. Wagener, and, V. L. Yu. 1997. Invasive aspergillosis in liver transplant recipients in the 1990s. Transplantation 64:716720.
142. Singh, N.,, R. K. Avery,, P. Munoz,, T. L. Pruett,, B. Alexander,, R. Jacobs,, J. G. Tollemar,, E. A. Dominguez,, C. M. Yu,, D. L. Paterson,, S. Husain,, S. Kusne, and, P. Linden. 2003. Trends in risk profiles for and mortality associated with invasive aspergillosis among liver transplant recipients. Clin. Infect. Dis. 36:4652.
143. Singh, N., and, J. Heitman. 2004. Antifungal attributes of immuno-suppressive agents: new paradigms in management and elucidating the pathophysiologic basis of opportunistic mycoses in organ transplant recipients. Transplantation 77:795800.
144. Singh, N., and, S. Husain. 2003. Aspergillus infections after lung transplantation: clinical differences in type of transplant and implications for management. J. Heart Lung Transplant. 22:258266.
145. Singh, N.,, A. P. Limaye,, G. Forrest,, N. Safdar,, P. Munoz,, K. Pursell,, S. Houston,, F. Rosso,, J. G. Montoya,, P. Patton,, R. Del Busto,, J. M. Aguado,, R. A. Fisher,, G. B. Klintmalm,, R. Miller,, M. M. Wagener,, R. E. Lewis,, D. P. Kontoyiannis, and, S. Husain. 2006a. Combination of voriconazole and caspofungin as primary therapy for invasive aspergillosis in solid organ transplant recipients: a prospective, multicenter, observational study. Transplantation 81:320326.
146. Singh, N.,, A. P. Limaye,, G. Forrest,, N. Safdar,, P. Munoz,, K. Pursell,, S. Houston,, F. Rosso,, J. G. Montoya,, P. R. Patton,, R. Del Busto,, J. M. Aguado,, M. M. Wagener, and, S. Husain. 2006b. Late-onset invasive aspergillosis in organ transplant recipients in the current era. Med. Mycol. 44:445449.
147. Singh, N., and, D. L. Paterson. 2005. Aspergillus infections in transplant recipients. Clin. Microbiol. Rev. 18:4469.
148. Singh, N.,, D. L. Paterson,, T. Gayowski,, M. M. Wagener, and, I. R. Marino. 2001. Preemptive prophylaxis with a lipid preparation of amphotericin B for invasive fungal infections in liver transplant recipients requiring renal replacement therapy. Transplantation 71: 910913.
149. Singh, N.,, T. L. Pruett,, S. Houston,, P. Munoz,, T. V. Cacciarelli,, M. M. Wagener, and, S. Husain. 2006c. Invasive aspergillosis in the recipients of liver retransplantation. Liver Transplant. 12: 12051209.
150. Singh, N.,, M. M. Wagener,, T. V. Cacciarelli, and, J. Levitsky. 2008. Antifungal management practices in liver transplant recipients. Am. J. Transplant. 8:426431.
151. Singhal, S.,, R. W. Ellis,, S. G. Jones,, S. J. Miller,, N. C. Fisher,, J. G. Hastings, and, D. J. Mutimer. 2000. Targeted prophylaxis with amphotericin B lipid complex in liver transplantation. Liver Transplant. 6:588595.
152. Sole, A.,, P. Morant,, M. Salavert,, J. Peman, and, P. Morales. 2005. Aspergillus infections in lung transplant recipients: risk factors and outcome. Clin. Microbiol. Infect. 11:359365.
153. Steinbach, W. J.,, R. A. Cramer, Jr.,, B. Z. Perfect,, Y. G. Asfaw,, T. C. Sauer,, L. K. Najvar,, W. R. Kirkpatrick,, T. F. Patterson,, D. K. Benjamin, Jr.,, J. Heitman, and, J. R. Perfect. 2006. Calcineurin controls growth, morphology, and pathogenicity in Aspergillus fumigatus. Eukaryot. Cell 5:10911103.
154. Stevens, D. 2006. Th1/Th2 in aspergillosis. Med. Mycol. 44:S229S235.
155. Sugiyama, M.,, M. Funauchi,, T. Yamagata,, Y. Nozaki,, B. S. Yoo,, S. Ikoma,, K. Kinoshita, and, A. Kanamaru. 2004. Predominant inhibition of Th1 cytokines in New Zealand Black/White F1 mice treated with FK506. Scand. J. Rheumatol. 33:108114.
156. Summers, S. A.,, A. Dorling,, J. J. Boyle, and, S. Shaunak. 2005. Cure of disseminated cryptococcal infection in a renal allograft recipient after addition of gamma-interferon to anti-fungal therapy. Am. J. Transplant. 5:20672069.
157. Torre-Cisneros, J.,, O. L. Lopez,, S. Kusne,, A. J. Martinez,, T. E. Starzl,, R. L. Simmons, and, M. Martin. 1993. CNS aspergillosis in organ transplantation: a clinicopathological study. J. Neurol. Neurosurg. Psychiatry 56:188193.
158. Vagefi, P. A.,, A. B. Cosimi,, L. C. Ginns, and, C. N. Kotton. 2008. Cutaneous Aspergillus ustus in a lung transplant recipient: emergence of a new opportunistic fungal pathogen. J. Heart Lung Transplant. 27:131134.
159. Vazquez, J. A. 2005. Anidulafungin: a new echinocandin with a novel profile. Clin. Ther. 27:657673.
160. Veroux, M.,, D. Corona,, M. Gagliano,, M. Sorbello,, M. Macarone,, M. Cutuli,, G. Giuffrida,, G. Morello,, A. Paratore, and, P. Veroux. 2007. Voriconazole in the treatment of invasive aspergillosis in kidney transplant recipients. Transplant. Proc. 39: 18381840.
161. Vora, S.,, S. Chauhan,, E. Brummer, and, D. A. Stevens. 1998. Activity of voriconazole combined with neutrophils or monocytes against Aspergillus fumigatus: effects of granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor. Antimicrob. Agents Chemother. 42: 22992303.
162. Walsh, T. J.,, E. J. Anaissie,, D. W. Denning,, R. Herbrecht,, D. P. Kon-toyiannis,, K. A. Marr,, V. A. Morrison,, B. H. Segal,, W. J. Steinbach,, D. A. Stevens,, J. A. van Burik,, J. R. Wingard, and, T. F. Patterson. 2008. Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America. Clin. Infect. Dis. 46: 327360.
163. Walsh, T. J.,, I. Raad,, T. F. Patterson,, P. Chandrasekar,, G. R. Don-owitz,, R. Graybill,, R. E. Greene,, R. Hachem,, S. Hadley,, R. Her-brecht,, A. Langston,, A. Louie,, P. Ribaud,, B. H. Segal,, D. A. Stevens,, J. A. van Burik,, C. S. White,, G. Corcoran,, J. Gogate,, G. Krishna,, L. Pedicone,, C. Hardalo, and, J. R. Perfect. 2007. Treatment of invasive aspergillosis with posaconazole in patients who are refractory to or intolerant of conventional therapy: an externally controlled trial. Clin. Infect. Dis. 44:212.
164. Weclawiak, H.,, C. Garrouste,, N. Kamar,, M. D. Linas,, P. Tall,, C. Dambrin,, D. Durand, and, L. Rostaing. 2007. Aspergillus fumigatus-related spondylodiscitis in a heart transplant patient successfully treated with voriconazole. Transplant. Proc. 39:26272628.
165. Weiland, D.,, R. M. Ferguson,, P. K. Peterson,, D. C. Snover,, R. L. Simmons, and, J. S. Najarian. 1983. Aspergillosis in 25 renal transplant patients. Epidemiology, clinical presentation, diagnosis, and management. Ann. Surg. 198:622629.
166. Weimer, R.,, A. Melk,, V. Daniel,, S. Friemann,, W. Padberg, and, G. Opelz. 2000. Switch from cyclosporine A to tacrolimus in renal transplant recipients: impact on Th1, Th2, and monokine responses. Hum. Immunol. 61:884897.
167. Westney, G. E.,, S. Kesten,, A. De Hoyos,, C. Chapparro,, T. Winton, and, J. R. Maurer. 1996. Aspergillus infection in single and double lung transplant recipients. Transplantation 61:915919.
168. White, M. H.,, E. J. Anaissie,, S. Kusne,, J. R. Wingard,, J. W. Hiemenz,, A. Cantor,, M. Gurwith,, C. Du Mond,, R. D. Mamelok, and, R. A. Bowden. 1997. Amphotericin B colloidal dispersion vs. amphoter-icin B as therapy for invasive aspergillosis. Clin. Infect. Dis. 24: 635642.
169. Wieland, T.,, A. Liebold,, M. Jagiello,, G. Retzl, and, D. E. Birnbaum. 2005. Superiority of voriconazole over amphotericin B in the treatment of invasive aspergillosis after heart transplantation. J. Heart Lung Transplant. 24: 102104.
170. Wimberley, S. L.,, M. T. Haug III,, K. M. Shermock,, A. Qu,, J. R. Maurer,, A. C. Mehta,, R. J. Schilz, and, S. M. Gordon. 2001. Enhanced cyclosporine-itraconazole interaction with cola in lung transplant recipients. Clin. Transplant. 15:116122.


Generic image for table
Table 1.

Epidemiologic characteristics of invasive aspergillosis in transplant recipients

Citation: Sun H, MuÑoz P, Bouza E, Singh N. 2009. Invasive Aspergillosis in Solid Organ Transplant Recipients, p 503-518. In Latgé J, Steinbach W (ed), and Aspergillosis. ASM Press, Washington, DC. doi: 10.1128/9781555815523.ch38
Generic image for table
Table 2.

Risk factors for invasive aspergillosis in organ transplant recipients

Citation: Sun H, MuÑoz P, Bouza E, Singh N. 2009. Invasive Aspergillosis in Solid Organ Transplant Recipients, p 503-518. In Latgé J, Steinbach W (ed), and Aspergillosis. ASM Press, Washington, DC. doi: 10.1128/9781555815523.ch38
Generic image for table
Table 3.

Performance characteristics of the galactomannan enzyme immunoassay in studies in SOT recipients

Citation: Sun H, MuÑoz P, Bouza E, Singh N. 2009. Invasive Aspergillosis in Solid Organ Transplant Recipients, p 503-518. In Latgé J, Steinbach W (ed), and Aspergillosis. ASM Press, Washington, DC. doi: 10.1128/9781555815523.ch38
Generic image for table
Table 4.

Proposed treatment of invasive aspergillosis in organ transplant recipients

Citation: Sun H, MuÑoz P, Bouza E, Singh N. 2009. Invasive Aspergillosis in Solid Organ Transplant Recipients, p 503-518. In Latgé J, Steinbach W (ed), and Aspergillosis. ASM Press, Washington, DC. doi: 10.1128/9781555815523.ch38
Generic image for table
Table 5.

Outcomes with the newer triazoles, echinocandins, and lipid formulations of amphotericin B as treatment for invasive aspergillosis in organ transplant recipients

Citation: Sun H, MuÑoz P, Bouza E, Singh N. 2009. Invasive Aspergillosis in Solid Organ Transplant Recipients, p 503-518. In Latgé J, Steinbach W (ed), and Aspergillosis. ASM Press, Washington, DC. doi: 10.1128/9781555815523.ch38

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error