Abstract

The aim of the study was to evaluate the influence of fungal infections on early and late function of allografts as well as the process of acute rejection.
Material/Methods: A group of 1301 organ transplant recipients: liver (LTx), kidney (KTx), pancreas + kidney (SPkTx) treated in Hospital-Lindley'a Campus at Warsaw Medical University in 2003-2006 was studied. The group of 213 patients with diabetes mellitus was carefully analyzed and divided into three groups: 1. type 1 diabetes patients with KTx or SPKTx, 2. type 2 diabetes patients with KTx or LTx transplants, 3. Recipients with post-transplant diabetes.The following clinical samples were examined: blood, urine, faecal samples, throat, mouth lesions, surgical site swabs, punctuates.
Results: There were 77 patients with acute transplant rejection within the
analyzed group of 213 diabetic recipients. In 54 recipients acute rejection was diagnosed on the basis of biopsy and histopathological examination, and in 23 patients on the basis of clinical symptoms. Fungal infection was confirmed in 29 allograft recipients. Co-existence of acute transplant rejec tion or clinical
worsening of renal function with co-existent fungal infection was observed in 17 patients.
Conclusions: 1. Direct influence of fungal infection on acute transplant rejection initiation was not confirmed in the study. 2. In the course of fungal infection, clinical symptoms of renal transplant failure were present, but changes typical for acute rejection in histopathological examination were not observed. 3. We have observed that incidence of acute rejection and subsequent introduction of adequate immunosuppression in allograft recipients induced fungal systemic infections.

Keywords: Kidney Transplantation, Liver Transplantation, Pancreas Transplantation