Efficiency and Safety of Inhaled Amphotericin B Lipid Complex (Abelcet) in the Prophylaxis of Invasive Fungal Infections Following Lung Transplantation

Borro, J.M.; Solé, Amparó; Torre, Mercedes de la; Pastor, A.; Fernández, Ramiro; Saura, A.; Delgado, Manuel; Monte, E.; González, D.

doi:10.1016/j.transproceed.2008.09.020

Cited by 87 publications

(80 citation statements)

References 23 publications

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“…All patients received antibacterial prophylaxis with amoxicillin and clavulanic acid, modified after transplantation according to the postoperative cultures of bronchial aspirate. In addition, all patients received antiviral prophylaxis with valganciclovir for 3-6 mo depending on their Cytomegalovirus (CMV) serology risk; antifungal prophylaxis with fluconazole, followed by amphotericin B lipid complex as described elsewhere [21] , and trimethoprim with sulfamethoxazole on alternate days were prescribed to prevent infection by Pneumocystis carinii.…”

Section: General Care Protocol For Lung Transplant Recipientsmentioning

confidence: 99%

Single-lung transplantation in emphysema: Retrospective study analyzing survival and waiting list mortality

Borro¹,

Delgado²,

Coll³

et al. 2016

WJT

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AIM:To performed remains a subject of debate and is the principal aim of the study. METHODS:This retrospective analysis included 73 patients with emphysema (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012). The outcomes of patients undergoing single-lung transplantation (SL) (n = 40) or double-lung transplant (DL) (n = 33) were compared in a Cox multivariate analysis to study the impact of the technique, postoperative complications and acute and chronic rejection on survival rates. Patients were selected for inclusion in the waiting list according to the International Society of Heart Lung Transplantation criteria. Pre and postoperative rehabilitation and prophylaxis, surgical technique and immunosuppressive treatment were similar in every patients. Lung transplantation waiting list information on a national level and retrospective data on emphysema patient survival transplanted in Spain during the study period, was obtained from the lung transplantation registry managed by the National Transplant Organization (ONT). RESULTS:Both groups were comparable in terms of gender and clinical characteristics. We found significant differences in the mean age between the groups, the DL patients being younger as expected from the inclusion criteria. Perioperative complications occurred in 27.6% SL vs 54% DL (P = 0.032). Excluding perioperative mortality, median survival was 65.3 mo for SL and 59.4 mo for DL (P = 0.96). Bronchiolitis obliterans and overall 5-year survival were similar in both groups. Bacterial Core tip: This is a retrospective and comparative study of 2 cohort of patients with advanced-stage emphysema who were performed uni or bilateral lung transplant. The results of this study support the realization of singlelung transplantation in most of the cases of emphysema because it is technically simpler, it has less risk of surgical sutures, and finally it has less immediate postoperative complications. Single and double lung transplantation has a similar long-term survival. Moreover, if a second transplant is needed in the long-term, the contralateral transplantation has the same initial transplant survival if the patient remains in a similar clinical situation. Survival Spanish national register does not show difference between the two techniques too, supporting the results of our relatively small series. This strategy of performing single lung transplantation in most of the cases of emphysema would encourage and enhance the use of donors thanks to the twining procedure, and would decrease mortality in the waiting list as shown in the National Transplant Organization patients analysed. Proper pre and postoperative prophylaxis and postoperative early extubation protocol is essential to achieve good results.Borro JM, Delgado M, Coll E, Pita S. Singlelung transplantation in emphysema: Retrospective study analyzing survival and waiting list mortality. World J Transplant 2016; 6(2): 347355 Available from:

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Section: General Care Protocol For Lung Transplant Recipientsmentioning

confidence: 99%

Single-lung transplantation in emphysema: Retrospective study analyzing survival and waiting list mortality

Borro¹,

Delgado²,

Coll³

et al. 2016

WJT

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“…However, there is no uniform approach to the prevention of these fungal infections (8)(9)(10). (11)(12)(13)(14)(15) Figure 1).…”

Section: Lung Transplantation Is a Complex Procedures Indicated In Patmentioning

confidence: 99%

Antifungal Prophylaxis with Voriconazole or Itraconazole in Lung Transplant Recipients: Hepatotoxicity and Effectiveness

Cadena

Levine

Angel

et al. 2009

American Journal of Transplantation

104

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Invasive fungal infections (IFI) are common after lung transplantation and there are limited data for the use of antifungal prophylaxis in these patients. Our aim was to compare the safety and describe the effectiveness of universal prophylaxis with two azole regimens in lung transplant recipients. This is a retrospective study in lung transplant recipients from July 2003 to July 2006 who received antifungal prophylaxis with itraconazole or voriconazole plus inhaled amphotericin B to compare the incidence of hepatotoxicity. Secondary outcomes include describing the incidence of IFI, clinical outcomes after IFI and mortality.Sixty-seven consecutive lung transplants received antifungal prophylaxis, 32 itraconazole and 35 voriconazole and inhaled amphotericin B. There were no significant differences between groups in the acute physiology and chronic health evaluation (APACHE) score at the time of transplantation, demographic characteristics, comorbidities and concomitant use of hepatotoxic medications. Hepatotoxicity occurred in 12 patients receiving voriconazole and inhaled amphotericin B and in no patients receiving itraconazole (p < 0.001). There was no significant difference between groups with regard to the percentage of transplants with IFI, but one case of zygomycosis occurred in a transplant treated with voriconazole. Voriconazole prophylaxis after lung transplantation was associated with a higher incidence of hepatotoxicity and similar clinical effectiveness when compared to itraconazole.

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“…Several prophylactic strategies with antifungal drugs have been reported to result in a decreased incidence and mortality of fungal disease in lung transplantation recipients [40][41][42]43 ]. However, there has not been a uniform approach, data are limited and, in addition, there is a considerable variation in antifungal prophylaxis practices among lung transplantation centres throughout the world.…”

Section: Prophylaxis/preemptive Therapymentioning

confidence: 99%

Fungal infections after lung transplantation

Solé¹,

Salavert

2009

Current Opinion in Pulmonary Medicine

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Efficiency and Safety of Inhaled Amphotericin B Lipid Complex (Abelcet) in the Prophylaxis of Invasive Fungal Infections Following Lung Transplantation

Cited by 87 publications

References 23 publications

Single-lung transplantation in emphysema: Retrospective study analyzing survival and waiting list mortality

Single-lung transplantation in emphysema: Retrospective study analyzing survival and waiting list mortality

Antifungal Prophylaxis with Voriconazole or Itraconazole in Lung Transplant Recipients: Hepatotoxicity and Effectiveness

Fungal infections after lung transplantation

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