The tell-tale hearts: Donor-derived invasive fungal infections among orthotopic heart transplant recipients
- Author: mycolabadmin
- 3/31/2025
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Summary
This case report describes two rare instances where fungal infections were transmitted from organ donors to heart transplant recipients. One involved a Candida infection and the other involved Aspergillus fungus, both causing serious bloodstream and heart infections. The patients required extensive antifungal medications and multiple surgeries to survive their infections, though they experienced significant complications. These cases highlight the importance of careful screening of organ donors for undetected infections.
Background
Donor-derived invasive fungal infections (IFIs) among solid organ transplant recipients are rare but potentially devastating. An estimated 2-3 out of every 10,000 solid organ transplant recipients experienced unexpected donor-derived fungal infections between 2012 and 2017 in the United States.
Objective
To describe two cases of confirmed donor-derived fungal infections in heart transplant recipients: one Candida parapsilosis complex infection and one Aspergillus fumigatus infection, including clinical presentations, diagnostic findings, and management strategies.
Results
Both cases involved donors with undetected fungal endovascular infections that were transmitted to recipients. Recipients developed fungemia, mediastinitis, and required prolonged combination antifungal therapy and surgical interventions. Both patients survived their infections but with substantial morbidity.
Conclusion
Donor-derived IFIs among heart transplant recipients are rare events with often devastating consequences requiring both antifungal therapy and surgical debridement. Meticulous evaluation of donors for unexplained clinical findings and rapid diagnosis in recipients are essential for optimal outcomes.
- Published in:Medical Mycology Case Reports,
- Study Type:Case Report,
- Source: PMID: 40235952, DOI: 10.1016/j.mmcr.2025.100702