{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T16:14:38Z","timestamp":1789748078388,"version":"4.0.1"},"reference-count":11,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2025,8]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Invasive fungal infections (IFI) post\u2010orthotopic heart transplant (OHT) have not been well studied due to limited information in large databases. The goal of the study is to describe the incidence and risk factors for IFI.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In this retrospective cohort study, we analyzed risk factors associated with IFI among OHT recipients in our center in the period 2010\u20132020. Patients were divided into two groups for comparison: IFI within the first year after transplant, and no IFI. We compared the groups to determine independent risk factors for IFI.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Out of 548 included patients, 29 patients experienced 29 IFI (incidence = 5.3%; 95% CI 3.7\u20137.5). Median (interquartile range) time to IFI was 44 days (10\u2013238.5).\n Candida<\/jats:italic>\n was the most identified pathogen (51%), followed by\n Aspergillus<\/jats:italic>\n (27%) and\n Cryptococcus<\/jats:italic>\n (9%). In multivariable logistic regression analyses, pretransplant fungal colonization\/infection (odds ratio, [OR] 27, 95% CI 1.2\u2013315), post\u2010transplant reoperation (OR 5.8, 95% CI 2.2\u201315), and extracorporeal membrane oxygenation (ECMO) (OR 3.1, 95% CI 1.1\u20139.0) were associated with increased odds of IFI. Compared to patients without IFI, 1\u2010year survival of patients with IFI was significantly worse (76\u00a0vs. 97%,\n p<\/jats:italic>\n < 0.01).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n We conclude there are specific, identifiable risk factors during the pre\u2010 and post\u2010transplant periods associated with increased odds of IFI. These merit study of targeted antifungal prophylaxis with agents offering broad yeast and mold activity in OHT patients with certain risk factors.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ctr.70248","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T11:24:57Z","timestamp":1754047497000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Invasive Fungal Infections in Orthotopic Heart Transplant Patients: Incidence and Risk Factors in the Modern Era"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0885-4217","authenticated-orcid":false,"given":"Lana","family":"Hasan","sequence":"first","affiliation":[{"name":"Department of Infectious Disease Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9772-3200","authenticated-orcid":false,"given":"Lalithaa","family":"Thirunavukarasu Murugan","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eileen","family":"Hsich","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Zhen\u2010Yu","family":"Tong","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9862-1929","authenticated-orcid":false,"given":"Kyle D.","family":"Brizendine","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,1]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14561"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2021.07.015"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399\u20103046.2010.01415.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12650"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1086\/651262"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2014.09.036"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13714"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20106143.2004.00390.x"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz1008"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e31829e6d7b"},{"issue":"6","key":"e_1_2_10_12_1","first-page":"399","article-title":"Fungal Infection in Heart\u2010Lung Transplant Recipients Receiving Single\u2010Agent Prophylaxis With Itraconazole","volume":"9","author":"Hayes D.","year":"2011","journal-title":"Experimental and Clinical Transplantation"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.70248","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ctr.70248","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.70248","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T11:15:48Z","timestamp":1783941348000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.70248"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":11,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1111\/ctr.70248"],"URL":"https:\/\/doi.org\/10.1111\/ctr.70248","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]},"assertion":[{"value":"2025-02-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70248"}}