Mycosis in Organ Transplantation.

概要

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The recipients of organ transplants must take an immunosuppressant the rest of their lives to prevent rejection. Shortage of immunosuppressant will evoke a rejective reaction, but an overdose will increase the risk of infection. The powerful immunosuppressant, ciclosporin which was introduced in 1978, expands the safety range of immunosuppression following an organ transplant. Two hundred and seventy-six kidney transplants had been performed by the end of 1991 in our institution. Mycosis requiring hospital treatment was observed in 19 patients (7.0%) who had a mean age of 32.5 years. Mycosis occurred within 12 months following surgery in 12 (63.2%) of the 19 patients. The main immunosuppressants used were azathioprine and prednisolone for 15 patients, and ciclosporin for the other 4. Eight patients died as a result of mycosis. All of them had been transplanted in an earlier period and their immunosuppressants were azathioprine and prednisolone. The organisms detected in the group of 19 were Candida in 10, Cryptococcus in 7, Aspergillus in 1, and Mucor in 2 patients. Most commonly affected organs were the lung (pneumonia), blood (sepsis), and the central nervous system (meningitis). Recent advances in the diagnosis and treatment of mycosis have reduced the risk of death or loss of a kidney. Early diagnosis and early treatment is most important for good results.
日本医真菌学会の論文