The looming threat of invasive fungal infections in heart transplant recipients: Will it be the last of us.

Patients with mechanical circulatory support (MCS) devices and those who undergo heart transplants are at risk for invasive fungal infections (IFI). Though Candida and Aspergillus spp. account for most infections, the evolving epidemiology of resistant-Candida spp. such as Candida auris, endemic mycoses, and other molds impacted by climate change, threaten MCS and transplant patients. Fungal diagnostics are overall limited, and current, widely used antifungal agents are suboptimal with significant toxicities. However, innovative diagnostic strategies coupled with novel antifungal agents for prevention and treatment of invasive fungal disease encourage optimism for MCS and transplant patients and clinicians.