{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T04:12:57Z","timestamp":1768795977890,"version":"3.49.0"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,1,12]],"date-time":"2015-01-12T00:00:00Z","timestamp":1421020800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["KL2 TR000143"],"award-info":[{"award-number":["KL2 TR000143"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Fungal infections remain a substantial cause of mortality in lung transplant (<jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>x) recipients, yet no comprehensive consensus guidelines have been established for antifungal prophylaxis and treatment of <jats:italic>Aspergillus<\/jats:italic> infection in these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross\u2010sectional study surveyed the directors from 27 of 64 (45.5%) active <jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>x centers in the United States to examine clinical practice variations in <jats:italic>Aspergillus<\/jats:italic> prophylaxis and treatment of colonization and invasive aspergillosis (<jats:styled-content style=\"fixed-case\">IA<\/jats:styled-content>) in <jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>x recipients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Antifungal prophylaxis increased from 52.3% in 2011 to 77.8% in 2013, with the most common agent being inhaled amphotericin B (61.9%), followed by oral voriconazole (51.9%). A total of 74.1% of centers treat <jats:italic>Aspergillus<\/jats:italic> airway colonization, with 80.0% of centers using oral voriconazole. All centers treat <jats:styled-content style=\"fixed-case\">IA<\/jats:styled-content>, with 92.6% using oral voriconazole. The duration of <jats:italic>Aspergillus<\/jats:italic> prophylaxis and treatment of colonization or <jats:styled-content style=\"fixed-case\">IA<\/jats:styled-content> varied widely across centers from 3\u00a0months to &gt;1\u00a0year. A total of 51.9% of centers reported internal practice variations in the treatment of <jats:styled-content style=\"fixed-case\">IA<\/jats:styled-content>. Factors guiding treatment decisions included microbiologic culture and sensitivity (74.1%), ease of administration (59.3%), interaction with other medications (55.5%), side effect profile (51.8%), and center guidelines (48.1%). Although 85.2% of <jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>x centers recommended routine skin cancer screening for <jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>x recipients, only 44.4% of <jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>x centers reported having a dedicated transplant dermatologist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Most active <jats:styled-content style=\"fixed-case\">US LT<\/jats:styled-content>x centers currently employ antifungal prophylaxis and treat <jats:italic>Aspergillus<\/jats:italic> colonization and <jats:styled-content style=\"fixed-case\">IA<\/jats:styled-content>, although choice of agent, route of administration, and duration of therapy across and within centers continue to differ substantially. The number of transplant dermatologists available among <jats:styled-content style=\"fixed-case\">US LT<\/jats:styled-content>x centers is limited. Overall, a strong need exists for more comprehensive consensus guidelines to direct antifungal prophylaxis and treatment of <jats:italic>Aspergillus<\/jats:italic> infection in <jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>x recipients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.12337","type":"journal-article","created":{"date-parts":[[2015,1,12]],"date-time":"2015-01-12T13:39:59Z","timestamp":1421069999000},"page":"14-20","source":"Crossref","is-referenced-by-count":31,"title":["Practice variation in <i>Aspergillus<\/i> prophylaxis and treatment among lung transplant centers: a national survey"],"prefix":"10.1111","volume":"17","author":[{"given":"S.Y.","family":"He","sequence":"first","affiliation":[{"name":"Department of Dermatology University of California, San Francisco (UCSF) San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Z.H.","family":"Makhzoumi","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of California, San Francisco (UCSF) San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.P.","family":"Singer","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care, Allergy and Sleep Medicine Department of Medicine UCSF San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.V.","family":"Chin\u2010Hong","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine UCSF San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.T.","family":"Arron","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of California, San Francisco (UCSF) San Francisco California 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