Öz
Solid organ transplantasyonu (SOT) son dönem organ yetmezliği olan hastaların yaşam kalitesini ve sağkalım süresini arttıran bir tedavi yöntemidir. Bu hasta gruplarına verilen immünsüpresif tedaviler invazif fungal enfeksiyonların (İFİ) gelişmesine yatkınlık oluşturabilmektedir. SOT alıcılarında İFİ insidansı, transplante edilen organa bağlı olup %5-42 arasında değişmektedir. Transplant yapılan organa göre değişmekle birlikte en sık izole edilen fungal etken Candida spp. olup bunu Aspergillus spp. takip etmektedir. Gelişen İFİ’lere bağlı mortalite oranları yüksek olabilmektedir. Bundan dolayı SOT alıcılarında antifungal profilaksi gerekebilmektedir. Randomize kontrollü çalışmaların yetersiz olması nedeniyle birçok transplantasyon merkezi kendi deneyimleri doğrultusunda antifungal stratejilerini belirlemektedir. Tüm SOT alıcılarına antifungal profilaksi uygulanırsa ilaç direnci ve ilaç etkileşimleri gibi durumlar görülebilir. Bu yüzden İFİ gelişme riski yüksek olan kişilerin belirlenmesi gerekir. Bu derlemede karaciğer, böbrek, ince barsak, pankreas, kalp, akciğer transplant alıcılarında İFİ ile ilişkili epidemiyolojik özellikler, risk faktörleri, literatür verileri ve antifungal profilaksi rejimleri derlenmiştir.
Anahtar Kelimeler: Solid organ transplantasyonu, antifungal profilaksi, invazif fungal enfeksiyon, posakonazole, amfoterisin B
Kaynakça
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