A Risk Profile for Invasive Aspergillosis in Liver Transplant Recipients

Rosenhagen, M.; Feldhues, Rita; Schmidt, Jan; Hoppe-Tichy, Torsten; Geiss, Heinrich K.

doi:10.1007/s15010-008-8124-x

Cited by 49 publications

(73 citation statements)

References 39 publications

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“…1,7,9,10 Similarly, our study found that fungal infections occur more often in recipients with a retransplant.…”

Section: Discussionsupporting

confidence: 76%

“…1,2,4,[8][9][10] In some of these reports, age was not found to be a significant factor for developing invasive fungal infections. 1,9,10 In contrast with previous reports, we found significant differences between recipients with and without invasive fungal infections. Liver transplant recipients with an older age at transplant showed a higher incidence of invasive fungal infections compared with patients with a younger age at transplant.…”

Section: Discussionmentioning

confidence: 94%

“…infections has been higher in recent years, ranging from 1% to 40% in liver transplant recipients. 1,2,5,[7][8][9][10] Rabkin and associates reported 90 patients with liver transplants between 1994 to 1997. In their study, 35 of 90 recipients (38%) developed invasive fungal infections.…”

Section: Discussionmentioning

confidence: 99%

“…1,5,10 Renal failure leading to invasive fungal infections causes functional changes of granulocytes and macrophages. 2,5 Singh and associates found 22 of 26 patients with invasive aspergillosis had renal insufficiency before transplant, with the median serum creatinine level of 265.2 μmol/L (3.0 g/dL).…”

Section: Discussionmentioning

confidence: 99%

“…5 Similar findings were reported by Rabkin and associates and Rosenhagen and associates. 1,10 They found serum creatinine levels in liver transplant recipients with invasive fungal infections were higher than they were in recipients without invasive fungal infection. We saw that renal insufficiency before transplant (defined as serum creatinine > 132.6 μmol/L [1.5 mg/dL]) was present in 3 of 10 liver recipients with invasive fungal infection and in 8 of 295 controls.…”

Section: Discussionmentioning

confidence: 99%

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Untitled

2014

Exp Clin Transplant

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Objectives: We sought to assess the incidence of invasive fungal infections and identify the risk factors and outcome of invasive fungal infections in liver transplant recipient. Materials and Methods: A retrospective analysis was made of 408 patients who received a liver transplant between January 1990 to December 2012 at Başkent University in Ankara, Turkey. Only 305 of 408 patients were included. Demographic and clinical findings were reviewed, and these findings were compared between patients with or without invasive fungal infections. Results: Ten of 408 liver transplant patients (2.5%) developed invasive fungal infections. Aspergillus was the most common cause of invasive fungal infections (n=8), followed by Candida (n=1), and Cryptococcus neoformans (n=1). Pulmonary involvement was dominant in all patients (n=10), and only 1 patient had disseminated fungal infection (cryptococcosis). The mean time from transplant to invasive fungal infection diagnosis was 32 ± 19.2 days. Most patients with invasive fungal infection (9/10) died. Mean survival time between diagnosis of fungal infection and death was 24.2 ± 27.3 days in all 10 patients. Fungal infections occurred significantly more frequently in patients with older transplant age, diabetes mellitus, cytomegalovirus infection, renal insufficiency. In addition, other risk factors included long stays in the surgical intensive care unit, the overall length of stay in hospital, and having preoperative high creatinine level. Conclusions: Invasive fungal infections were associated with increased morbidity and mortality among liver transplant recipients, with Aspergillus spp. being the most common pathogen in our series. Because of its high mortality rate, it is important to follow up transplant patients for the development of invasive fungal infections.

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“…1,7,9,10 Similarly, our study found that fungal infections occur more often in recipients with a retransplant.…”

Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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2014

Exp Clin Transplant

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Pathogenesis of Aspergillosis in Humans

Dimοpoulos

Matthaiou

Moussas

et al. 2015

Human Emerging and Re‐emerging Infections

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Efficacy and cost‐effectiveness of voriconazole prophylaxis for prevention of invasive aspergillosis in high‐risk liver transplant recipients

Balogh¹,

Burroughs²,

Boktour³

et al. 2016

Liver Transpl

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Aspergillus infection remains a significant and deadly complication after liver transplantation (LT). We sought to determine whether the antifungal prophylactic use of voriconazole reduces the incidence of invasive aspergillosis (IA) in high-risk LT recipients without prohibitively increasing cost. During the study era (April 2008 to April 2014), 339 deceased donor LTs were performed. Of those patients, 174 high-risk recipients were administered antifungal prophylaxis with voriconazole. The median biological Model for End-Stage Liver Disease score at the time of LT was 33 (range, 18-49) with 56% requiring continuous renal replacement therapy and 50% requiring ventilatory support immediately before transplantation.

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A Risk Profile for Invasive Aspergillosis in Liver Transplant Recipients

Cited by 49 publications

References 39 publications

Untitled

Untitled

Pathogenesis of Aspergillosis in Humans

Efficacy and cost‐effectiveness of voriconazole prophylaxis for prevention of invasive aspergillosis in high‐risk liver transplant recipients

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