{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:45:06Z","timestamp":1791499506217,"version":"4.3.4"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T00:00:00Z","timestamp":1695686400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Invasive fungal infections (IFIs) remain a rare yet dreaded complication following pancreas transplantation. Current guidelines recommend antifungal prophylaxis in patients with 1 or more risk factors. At our center, single-dose antifungal prophylaxis is administered in the operating room but none subsequently, regardless of risk factors. Here we evaluate the 1-year incidence, outcome, and risk factors associated with IFI following pancreas transplantation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective, single-center cohort study was conducted in patients who underwent pancreas transplantation between 1 January 2009 and 31 December 2019. Records were manually reviewed, and cases were adjudicated using consensus definitions. The 1-year cumulative incidence, mortality, and risk factors were analyzed by Kaplan-Meier method and differences between populations were assessed with Fisher test and Mann-Whitney U test.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Three hundred sixty-nine recipients were included. Twelve IFIs were identified: candidiasis (8), aspergillosis (2), histoplasmosis (1), and cryptococcosis (1). Intra-abdominal infections were the most common presentation (5), followed by bloodstream infections (3), disseminated disease (2), pulmonary disease (1), and invasive fungal sinusitis (1). Median time to IFI was 64 days (interquartile range, 30\u2013234 days). One-year cumulative incidence was 3.25% (95% confidence interval, 1.86%\u20135.65%). There were no significant differences between patients with or without IFI regarding type of transplant (P = .17), posttransplant dialysis (P = .3), rejection (P = .5), cytomegalovirus serostatus (P = .45), or reoperation (P = .19). For patients with IFI, the 1-year graft and patient survival rates were 58% versus 95% (P &amp;lt; .0001) and 75% versus 98.6% (P &amp;lt; .001), respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our study suggests that the use of a single-dose antifungal prophylaxis administered in the operating room but none subsequently does not result in an increased incidence of IFI following pancreas transplantation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofad478","type":"journal-article","created":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T21:36:17Z","timestamp":1695850577000},"source":"Crossref","is-referenced-by-count":3,"title":["Epidemiology and Risk Factors for Invasive Fungal Infections in Pancreas Transplant in the Absence of Postoperative Antifungal Prophylaxis"],"prefix":"10.1093","volume":"10","author":[{"given":"Jessica","family":"Zachary","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Indiana University Health , Indianapolis, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne M","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Indiana University Health , Indianapolis, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asif","family":"Sharfuddin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Indiana University School of Medicine , Indianapolis, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Yaqub","sequence":"additional","affiliation":[{"name":"Department of Medicine, Indiana University School of Medicine , Indianapolis, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Lutz","sequence":"additional","affiliation":[{"name":"Department of Surgery, Indiana University School of Medicine , Indianapolis, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Powelson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Indiana University School of Medicine , Indianapolis, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan A","family":"Fridell","sequence":"additional","affiliation":[{"name":"Department of Surgery, Indiana University School of Medicine , Indianapolis, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8531-3537","authenticated-orcid":false,"given":"Nicolas","family":"Barros","sequence":"additional","affiliation":[{"name":"Department of Medicine, Indiana University School of Medicine , Indianapolis, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,9,26]]},"reference":[{"issue":"Suppl 3","key":"2023113021345269200_ofad478-B1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/ajt.16738","article-title":"World Consensus Group on Pancreas Transplantation. First world consensus conference on pancreas transplantation: part I\u2014methods and results of literature search","volume":"21","author":"Boggi","year":"2021","journal-title":"Am J Transplant"},{"issue":"Suppl 3","key":"2023113021345269200_ofad478-B2","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1111\/ajt.16750","article-title":"First World Consensus Conference on Pancreas Transplantation: part II\u2014recommendations","volume":"21","author":"Boggi","year":"2021","journal-title":"Am J Transplant"},{"key":"2023113021345269200_ofad478-B3"},{"key":"2023113021345269200_ofad478-B4","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1111\/j.1399-0012.2005.00378.x","article-title":"Pancreas transplant outcomes for United States (US) and non-US cases as reported to the United Network for Organ Sharing (UNOS) and the International Pancreas Transplant Registry (IPTR) as of June 2004","volume":"19","author":"Gruessner","year":"2005","journal-title":"Clin 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Delden","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2023113021345269200_ofad478-B8","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1111\/j.1432-2277.2006.00293.x","article-title":"Infectious complications following 72 consecutive enteric-drained pancreas transplants","volume":"19","author":"Berger","year":"2006","journal-title":"Transpl Int"},{"key":"2023113021345269200_ofad478-B9","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1097\/TP.0b013e3181d54bb9","article-title":"Epidemiology of infections requiring hospitalization during long-term follow-up of pancreas transplantation","volume":"89","author":"Rostambeigi","year":"2010","journal-title":"Transplantation"},{"key":"2023113021345269200_ofad478-B10","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1086\/651262","article-title":"Invasive fungal infections among organ transplant recipients: results of the Transplant-Associated Infection Surveillance Network (TRANSNET)","volume":"50","author":"Pappas","year":"2010","journal-title":"Clin Infect Dis"},{"key":"2023113021345269200_ofad478-B11","doi-asserted-by":"crossref","first-page":"e13623","DOI":"10.1111\/ctr.13623","article-title":"Candida infections in solid organ transplantation: guidelines from the American Society of Transplantation Infectious Diseases Community of Practice","volume":"33","author":"Aslam","year":"2019","journal-title":"Clin Transplant"},{"key":"2023113021345269200_ofad478-B12","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1007\/978-3-030-25869-6_43","volume-title":"Emerging transplant infections: clinical challenges and implications","author":"Barros","year":"2021"},{"key":"2023113021345269200_ofad478-B13","doi-asserted-by":"crossref","first-page":"2682","DOI":"10.1016\/j.transproceed.2012.09.059","article-title":"Risk factors, clinical characteristics, and outcomes of invasive fungal infections in solid organ transplant recipients","volume":"44","author":"Bodro","year":"2012","journal-title":"Transplant Proc"},{"key":"2023113021345269200_ofad478-B14","doi-asserted-by":"crossref","first-page":"3000","DOI":"10.1111\/ajt.14921","article-title":"Steroid-free three-drug maintenance regimen for pancreas transplant alone: comparison of induction with rabbit antithymocyte globulin +\/- rituximab","volume":"18","author":"Fridell","year":"2018","journal-title":"Am J Transplant"},{"key":"2023113021345269200_ofad478-B15","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1097\/01.tp.0000228904.01482.88","article-title":"Steroid withdrawal for pancreas after kidney transplantation in recipients on maintenance prednisone immunosuppression","volume":"82","author":"Fridell","year":"2006","journal-title":"Transplantation"},{"key":"2023113021345269200_ofad478-B16","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1093\/cid\/ciz1008","article-title":"Revision and update of the consensus definitions of 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