Increased fungal burden in the gastrointestinal tract of brain-dead organ donors.

Approximately 3% of organ transplant recipients will be diagnosed with an invasive fungal infection (IFI), with 10%-47% being fatal. The source of IFI is typically not known, but IMPORTANCE: Invasive fungal infections pose a significant risk to organ donor recipients, and the sources of these fungal infections are mostly unknown. Our study investigated fungal differences in the gastrointestinal tract between two types of organ donors: brain-dead and donation by circulatory death, for the first time. We found that brain-dead donors had a significant increase in the frequency and abundance of fungi throughout the gastrointestinal tract. We speculate that differences in care, such as corticosteroid administration and feeding methods before organ procurement, may begin to explain the difference in fungal presence between the donors. We propose further studies into the administration of steroids and delivery of nutrients to organ donors before procurement to impact fungal load and reduce life-threatening invasive fungal infections in the recipients.