Invasive mold infections (IMI) are rare but severe complications after heart transplantation. This multicenter case control study aimed to update risk factors and outcomes in this population. Conducted across 14 French centers (2008-2022), it included 120 cases of probable or proven IMI (EORTC/MSGERC 2020 criteria) matched to 120 controls, corresponding to the next transplant patient in the same center. Conditional logistic regression identified risk factors for infection, and Cox regression assessed mortality predictors within 90 days. The mean 1 year post transplant incidence of IMI was 3.1% (94/3073). The median delay between transplantation and IMI onset was 121 days (Q1-Q3: 43-285) and the 3 month mortality among infected patients was 25% (30/120). In multivariable analysis, age >60 years (aOR 2.44, 95%CI 1.38-4.32), prolonged ICU stay >15 days (aOR 2.66, 95%CI 1.24-5.71), and surgical revision (aOR 2.88, 95%CI 1.04-8.00) were independently associated with IMI. Among infected patients, hemodialysis (4.57, 95% CI: 2.47-8.45, p < 0.001) and disseminated infection (aHR 2.43, 95% CI: 1.25-4.71, p = 0.009) predicted 90-day mortality. These factors could help identify heart transplant recipients at higher risk of fungal infection and guide future prophylaxis studies.
Hoellinger et al. (Thu,) studied this question.
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