Cryptococcosis in Patients With Cirrhosis of the Liver and Posttransplant Outcomes.
Transplantation
; 99(10): 2132-41, 2015 Oct.
Article
en En
| MEDLINE
| ID: mdl-25806406
ABSTRACT
BACKGROUND:
The outcomes and optimal management of cirrhotic patients who develop cryptococcosis before transplantation are not fully known.METHODS:
We conducted a multicenter study involving consecutive patients with cirrhosis and cryptococcosis between January 2000 and March 2014. Data collected were generated as standard of care.RESULTS:
In all, 112 patients were followed until death or up to 9 years. Disseminated disease and fungemia were present in 76.8% (86/112) and 90-day mortality was 57.1% (64/112). Of the 39 patients listed for transplant, 20.5% (8) underwent liver transplantation, including 2 with active but unrecognized disease before transplantation. Median duration of pretransplant antifungal therapy and posttransplant therapy was 43 days (interquartile range, 8-130 days) and 272 days (interquartile range, 180-630 days), respectively. Transplantation was associated with lower mortality (P = 0.002). None of the transplant recipients developed disease progression during the median follow-up of 3.5 years with a survival rate of 87.5%.CONCLUSIONS:
Cryptococcosis in patients with cirrhosis has grave prognosis. Our findings suggest that transplantation after recent cryptococcal disease may not be a categorical exclusion and may be cautiously undertaken in liver transplant candidates who are otherwise deemed clinically stable.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Trasplante de Hígado
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Criptococosis
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Cirrosis Hepática
Tipo de estudio:
Clinical_trials
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Etiology_studies
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Prognostic_studies
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Risk_factors_studies
Idioma:
En
Revista:
Transplantation
Año:
2015
Tipo del documento:
Article