Aspergillus Infection Complicating Cardiac Transplantation

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Abstract
During the initial two-year period of the cardiac transplant program at Stanford University Hospital, a 28% incidence of invasive pulmonary aspergillosis was observed. The diagnosis was based on postmortem findings in two patients, and on isolation of the fungus from percutaneous lung aspirates or transtracheal aspirates in the other three.Aspergilluswas isolated from multiple cultures of sputum from four of the five patients. Local or systemic amphotericin B therapy or both was administered to three patients, and in two of them long-term treatment and necessary. Among the multiple underlying predisposing factors responsible for the high incidence of aspergillosis in cardiac transplant patients, pulmonary factors relatively unique to cardiac transplantation as well as immunosuppression appeared to play major roles.