Diagnostics for Fungal Infections in Solid Organ Transplants (SOT)

This review examined the literature on the diagnosis of invasive fungal disease (IFD) in patients undergoing solid organ transplants (SOT) to describe the diagnostic options available for this cohort. The tools available for the diagnosis of IFD in SOT patients are similar to those for patients undergoing stem cell transplants. These include (1) direct visualisation by radiography or histopathology, (2) antigenic tests using ELISA or lateral flow devices for fungal antigens, and (3) PCR-based assays that are commercially available for the two primary IFD affecting SOT patients, aspergillosis and candidiasis. Testing recipients and donors for IFD susceptibility may lead to improved prediction of IFD in SOT. The organ being transplanted has a strong bearing on the risk of IFD and the fungi that will cause disease. No single methodology can yield a definitive diagnosis so combinations of diagnostic tests targeted to the specific patient can indicate the probability of IFD.