Journal Article

Early conservative intervention for candida contamination of preservative fluid without allograft nephrectomy

Guillaume Canaud, Marc-Olivier Timsit, Julien Zuber, Marie-Elisabeth Bougnoux, Arnaud Méjean, Eric Thervet, Renaud Snanoudj, Rebecca Sberro, Frank Martinez, Christophe Legendre and Marie-France Mamzer-Bruneel

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 24, issue 4, pages 1325-1327
Published in print April 2009 | ISSN: 0931-0509
Published online November 2008 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfn622
Early conservative intervention for candida contamination of preservative fluid without allograft nephrectomy

Show Summary Details

Preview

Background. Fungal contamination of kidney allograft preservative fluid can lead to renal arteritis and arterial wall rupture.

Methods. We have evaluated a conservative management strategy based onearly antifungal therapy, rigorous morphological monitoring of the graft artery and surgical second look (SSL). Since November 2004, preservative fluid was routinely cultured on specific media for all kidney transplant recipients.

Results. In 8/474 cases, results were positive for Candida (albicans 5, glabrata 2, tropicalis 1). Two patients also had candida infection of drainage fluid leading to the diagnosis of operative site infection. Radiological and surgical examinations of the renal graft artery were normal in all cases and nephrectomy was not required. At 12 months, all patients were alive with a functioning allograft.

Conclusion. Early antifungal therapy with microbiological and morphological follow-up should be recommended as soon as contamination is detected, but SSL is advised only in patients with risk factors for arterial anomalies.

Keywords: arteritis; candida; management nephrectomy; rupture

Journal Article.  1295 words.  Illustrated.

Subjects: Nephrology

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.