Mucormycosis after Living Donor Kidney Transplantation: AMulticenter Retrospective Study

Background and Aims: Mucormycosis is an extremely rare and potentially fatal complication after kidneytransplantation. Limited data are available on mucormycosis following living donor kidney transplantation. Theaim of this study was to determine the incidence of mucormycosis and to identify the clinical presentation andmortality rate in renal allograft recipients.Methods: We conducted a retrospective survey of 7132 Iranian renal transplant recipients to find those withMucormycosis in eight transplant centers from January 1990 to June 2008. A total of 22 patients had receivedkidneys from living donors were complicated with Mucormycosis. Mean follow up period after diagnosis was9±13 (1-60) months.Results: No significant differences were found between infection occurrence and gender (P=0.6). Patientswith mucormycosis were older than those who had no infection (p=0.02) with the mean age at diagnosis 48 ±13 years. The diagnosis time since transplantation ranged from 1-84 (Median: 12) months. Mucormycosis wasmost likely to occur within 1 year after renal transplantation (n=13). The major form of disease in populationstudied was rhino-cerebral (n =11), followed by pulmonary (n=8), cutaneous (n=2), and disseminated (n=1). Inaddition, 9 patients have had the history of steroid pulse therapy. Diabetes mellitus was seen in 6 recipientswith mucormycosis.Conclusions: To our knowledge, the current study is the largest sample of renal recipients with mucormycosisin living donor renal transplantation. Augmented immunosuppression, especially with corticosteroids, olderage and PTDM were the predisposing factors for the infection.