Antifungal prophylaxis during the early postoperative period of lung transplantation

Introduction: Fungal infections occur frequently in lung transplant patient s, with the highest risk being in the early postoperative period (the initi al hospitalization after lung transplantation). Aspergillus is responsible for more than half of all fungal infections, and Aspergillus has even been considered a contraindication for lung transplantation because of its diffi cult therapy and frequently fatal outcome. The aim of this article is to ev aluate the success of an antifungal prophylaxis protocol to prevent fungal infection in the immediate postoperative period in lung transplant recipien ts, Material and Methods: From March 1994 to March 1997, we performed 52 lung t ransplants in 31 men and 21 women who received antifungal prophylaxis with fluconazole, 400 mg/d, and aerosolized amphotericin B, 0.6 mg/kg/d, during the postoperative period. Results: The mean(a SD) postoperative period duration was 49 +/- 27.5 days. No fungal infections were observed during this period, and all patients pr ovided negative cultures. We also found no toxicity related to antifungal d rugs, The dose of cyclosporine was easily adjusted in every recipient accor ding to blood levels so that effective immunosuppression was not compromise d. Discussion: In our study, the removal of the lungs and antifungal prophylax is with fluconazole and aerosolized amphotericin B prevented fungal infecti on in the postoperative period in all 52 lung easily adjusted in every tran splant recipients.