IRS Among Solid Organ Transplant Recipients

In an observational study, immune reconstitution syndrome occurred in 13 of 89 SOT recipients with cryptococcosis and was associated with central nervous system disease and calcineurin-inhibitor discontinuation.

Up to 5% of solid organ transplant (SOT) recipients develop cryptococcosis. Reducing or even discontinuing immunosuppressive therapy in SOT patients who develop opportunistic mycoses is common practice. However, this reversal — particularly if rapid — can help shift the host immune response to one that favors inflammation, potentially leading to immune reconstitution syndrome (IRS).

To explore this phenomenon, researchers conducted an observational study involving patients at several transplantation centers. IRS was defined as new or worsening clinical disease that could not be explained by a newly acquired infection, and a lack of evidence of microbial persistence.

Among 89 SOT recipients with cryptococcosis, IRS occurred in 13 (15%) at a me…

Reviewing Author

Neil M. Ampel, MD

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Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

IRS Among Solid Organ Transplant Recipients

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Reviewing Author