Invasive Candida infections in low risk liver transplant patients given no antifungal prophylaxis in the post-operative period.
Transplant Proc
; 46(7): 2312-3, 2014 Sep.
Article
in En
| MEDLINE
| ID: mdl-25242776
ABSTRACT
BACKGROUND:
In recent years the incidence of invasive fungal infections (IFIs) in post liver transplant (LT) has reduced to about 5%, however the majority of IFIs develops early in the post-transplant course. Candida species are the most frequent causative pathogens followed by Aspergillus species. Mortality for invasive candidiasis is still 40-50%. For this reason universal prophylaxis is still considered useful and is adopted by different LT centers, although it is not justified by available data. The aim of study is to evaluate Candida infection incidence and mortality in low risk patients and therefore not subjected to antifungal prophylaxis in the immediate post-LT.METHODS:
The patient is defined low risk if without any risk factor for IFIs as reported in literature and according to our center protocol described below. We analyzed retrospectively the records (with 90 days follow-up) of all adult patients underwent to LT at our center in 2011-2012.RESULTS:
At our center between 2011 and 2012, 247 LT in 232 adult patients were performed 137 patients (59%) received prophylaxis with Amphotericin B lipid complex or liposomal Amphotericin B, 95 patients (41%) didn't receive any prophylaxis. In these latter patients was observed only one case of Candida oesophagitis at the second month post-LT. The incidence of invasive candidiasis was 0%, and there wasn't mortality ascribed to Candida infection.CONCLUSIONS:
It is possible to identify low risk patients for IFIs post-LT and the no prophylaxis policy in the early LT course appears safe and feasible.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Postoperative Care
/
Candidiasis
/
Amphotericin B
/
Liver Transplantation
/
Antifungal Agents
Type of study:
Etiology_studies
/
Evaluation_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Transplant Proc
Year:
2014
Document type:
Article