Recent Advances in TransplantationCase reportInvasive Tracheobronchial Aspergillosis in a Lung Transplant Recipient Receiving Belatacept as Salvage Maintenance Immunosuppression: A Case Report

- Invasive tracheobronchial aspergillosis is an unusual finding in the late post lung transplant course.
- Belatacept may increase the risk of severe and unusual opportunistic infections among lung transplant recipients by inhibiting protective cytokines.
- Belatacept should be used with caution and as a measure of last resort in lung transplant recipients.

IntroductionThe association between belatacept, a CD28 costimulation blocker, and invasive mycoses is unclear.Case ReportWe describe a patient who initiated belatacept 3 years after lung transplantation and developed invasive tracheobronchial aspergillosis, a disease encountered almost exclusively within the first 6 months after transplantation.ConclusionsBelatacept may have played a causative role. Until more data are available, belatacept should be used cautiously after lung transplantation.