Faculty, Staff and Student Publications

Language

English

Publication Date

1-1-2025

Journal

Transplant Infectious Disease

DOI

10.1111/tid.70077

PMID

40625116

PMCID

PMC12289323

PubMedCentral® Posted Date

7-24-2025

PubMedCentral® Full Text Version

Author MSS

Abstract

Background: Updated benchmark data on invasive fungal disease (IFD) in solid organ transplantation (SOT) and hematopoietic cell transplantation (HCT) recipients are necessary to increase clinical recognition and inform treatment and prevention strategies. We estimated IFD incidence and potential risk factors in transplant recipients in a large US commercial health insurance database.

Methods: We observed patients who received SOT or HCT during 2018-2022 until IFD development, disenrollment, or database end date (July 31, 2023). We calculated incidence (per 1000 person-years) and time to IFD development, comparing demographic features and underlying conditions for IFD versus non-IFD patients.

Results: Overall, 9143 patients received an SOT (5667 kidney, 2025 liver, 759 heart, 650 lung, 39 pancreas, 3 intestine), and 5693 patients received an HCT (3519 autologous, 2114 allogeneic, 60 unspecified type). Among SOT patients, 360 developed an IFD (incidence: 21.0 [per 1000 person-years]). Mold infections had the highest incidence (7.1), followed by unspecified mycoses (3.9) and endemic mycoses (3.3). Among HCT patients, 292 developed an IFD (incidence: 28.5), with higher incidence among allogeneic (58.4) versus autologous (12.8) HCT recipients; among all HCT recipients, unspecified mycoses had the highest incidence (8.3), then pneumocystosis (7.6), and mold infections (6.7). Median time to IFD was 173.5 days for SOT recipients and 197.5 days for HCT recipients. IFD risk varied substantially by transplant type, region, and certain underlying conditions.

Conclusion: Our results suggest that IFDs remain an important cause of infection among SOT and HCT recipients, particularly later in the posttransplant period, and highlight the need for prevention strategies.

Keywords

Hematopoietic Stem Cell Transplantation, United States, Humans, Male, Female, Adult, Middle Aged, Invasive Fungal Infections, Organ Transplantation, Databases, Factual, Risk Factors, Infant, Newborn, Infant, Child, Preschool, Child, Adolescent, Young Adult, Aged, aspergillosis, candidiasis, cryptococcosis, invasive fungal disease, pneumocystosis, solid organ transplantation, stem cell transplantation

Published Open-Access

yes

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