Fungal Infection and Prevention in Lung Transplant

Purpose of Review: We reviewed common fungal infections and prevention in lung transplant. We paid special attention to the impact of diagnostic and pharmacologic advances on preventative and treatment strategies. Recent Findings: Lung transplant recipients receiving anti-mold agents appear to have a survival benefit compared to those not receiving anti-mold agents, but patients may be selected to receive medications by data not captured. Pre-emptive strategies aimed at preventing invasive mold infections may leave lung transplant patients vulnerable to invasive candidiasis in the early post-transplant period. Summary: Lung transplant recipients are susceptible to fungal infections. No uniformly accepted prophylactic strategy exists. While universal prophylaxis with systemic azole agents has gained traction, evidence is limited regarding its efficacy. Pre-emptive strategies for prevention of fungal infections have had mixed success in single-center cohorts and are limited by currently available tests to detect early infection. More studies are needed to determine the optimal preventative strategy.