{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T12:11:02Z","timestamp":1779970262459,"version":"3.53.1"},"reference-count":17,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"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":["Mycoses"],"published-print":{"date-parts":[[2026,5]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Invasive fungal infections (IFIs) represent a major complication after intestine transplantation, with reported incidence rates between 40% and 49%. These infections are associated with high morbidity and allograft loss. This study evaluates the impact of post\u2010transplant IFIs on graft outcomes in intestine transplant recipients.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted a retrospective cohort study of 152 patients who underwent intestine transplantation from 2008 to 2022. The primary outcome was IFI, defined as proven or probable by EORTC\/MSGERC criteria. The secondary outcome was a composite of allograft failure or death. Analyses were conducted using multivariable Cox proportional hazards models, with non\u2010baseline variables incorporated as time\u2010dependent exposures.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 152 intestine transplant recipients, 56 (36.8%) developed post\u2010transplant IFI. Median time to IFI was 83.5\u2009days (IQR 19.5\u2013444.2), with\n Candida<\/jats:italic>\n infections occurring early and non\u2010\n Candida<\/jats:italic>\n infections occurring later.\n Candida<\/jats:italic>\n species accounted for 73% of IFIs, most commonly\n \n C. glabrata<\/jats:italic>\n <\/jats:styled-content>\n ,\n \n C. albicans<\/jats:italic>\n <\/jats:styled-content>\n , and\n \n C. parapsilosis<\/jats:italic>\n <\/jats:styled-content>\n , with 29.3% showing fluconazole resistance. Most infections were intra\u2010abdominal and bloodstream. Redo transplantation (HR 2.44, 95% CI 1.20\u20134.95;\n p<\/jats:italic>\n \u2009=\u20090.014), anastomotic leak (HR 2.23, 95% CI 1.02\u20134.90;\n p<\/jats:italic>\n \u2009=\u20090.045), and augmented immunosuppression (HR 4.73, 95% CI 1.94\u201311.53;\n p<\/jats:italic>\n \u2009<\u20090.001) were independent predictors of Candida IFI. IFI was associated with a markedly increased risk of allograft loss or death (HR 3.67, 95% CI 2.30\u20135.83;\n p<\/jats:italic>\n \u2009<\u20090.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Post\u2010transplant IFIs are common and associated with allograft loss or mortality in intestine transplant recipients. Early recognition and aggressive management of IFIs remain critical to improving transplant outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/myc.70180","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:31:43Z","timestamp":1777368703000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Invasive Fungal Infections After Intestine Transplantation: Epidemiology and Outcomes"],"prefix":"10.1111","volume":"69","author":[{"given":"Mayyadah H.","family":"Alabdely","sequence":"first","affiliation":[{"name":"Department of Infectious Disease Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Lum","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blanca E.","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Center for Pediatric Infectious Disease, Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Fujiki","sequence":"additional","affiliation":[{"name":"Center for Gut Rehabilitation and Transplantation, Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2098-2868","authenticated-orcid":false,"given":"Zachary A.","family":"Yetmar","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":[[2026,4,28]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2005.01207.x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.2165\/11315510-000000000-00000"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12603"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1292625"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3062.2010.00542.x"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1086\/651262"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2010.03354.x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz1008"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12660"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3062.2010.00492.x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02474-10"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12613"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bj.2024.100719"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13623"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13544"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1086\/592690"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid0703.017302"}],"container-title":["Mycoses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/myc.70180","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/myc.70180","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/myc.70180","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T11:54:35Z","timestamp":1779969275000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/myc.70180"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,28]]},"references-count":17,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1111\/myc.70180"],"URL":"https:\/\/doi.org\/10.1111\/myc.70180","archive":["Portico"],"relation":{},"ISSN":["0933-7407","1439-0507"],"issn-type":[{"value":"0933-7407","type":"print"},{"value":"1439-0507","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,28]]},"assertion":[{"value":"2026-02-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70180"}}