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Invasive Fungal Infections With Good Survival Following Liver Transplant: A Single-Center Experience From a Developing Country Publisher Pubmed



Ebrahimi A1 ; Dashti H1, 2 ; Mohammadpour Z1 ; Ahmadinejad Z1, 3
Authors
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Authors Affiliations
  1. 1. Liver Transplantation Research Center, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex, Tehran, Iran
  2. 2. Department of Hepatobiliary and Liver Transplantation, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex, Tehran, Iran
  3. 3. Department of Infectious Disease, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex, Tehran, Iran

Source: Experimental and Clinical Transplantation Published:2020


Abstract

Objectives: Invasive fungal infection following liver transplant is considered as one of the important factors influencing morbidity and mortality among liver transplant recipients. The aim of the present study was to describe the prevalence of invasive fungal infections and their predisposing factors in a single-center cohort of patients who received liver transplant. Materials and Methods: For this study, 250 adult patients undergoing orthotopic liver transplant between March 2010 and March 2015 were enrolled. All patients were followed prospectively for infections. Results: The diagnosis of invasive fungal infection was made in 15 patients (6%). One patient had 2 episodes of fungal infection, and reoperation was performed for 3 patients. Invasive aspergillosis developed in 8 patients (53.3%), followed by Candida species infection in 3 patients (20%) and cryptococcosis in 2 patients (13.3%). The main predisposing factors were renal failure (12/15) and positive history of rejection (11/15). Other risk factors for development of invasive fungal infections were choledochojejunostomy in 3 patients (20%), bile leaks in 3 patients (20%), and pretransplant steroid use in 2 patients (11.8%). Two patients (13.3%) died due to invasive fungal infections. Conclusions: In this single-center series of liver transplant recipients, the incidence of invasive fungal infections was relatively low, probably due to the universal prophylaxis with fluconazole and limited use of the broad-spectrum antibiotics. Early diagnosis and treatment of invasive fungal infections could lead to a better prognosis for liver transplant recipients with invasive fungal infections. © Baskent University 2020.