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Invasive aspergillosis in liver transplant recipients, an infectious complication with low incidence but significant mortality

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World Journal of Transplantation 2023年第5期13卷 264-275页

作者： azam farahani Fereshteh Ghiasvand Setareh Davoudi Zahra Ahmadinejad Department of Infectious Diseases Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehran ***Iran Liver Transplantation Research Center Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehran ***Iran

BACKGROUND Infections,including invasive fungal infections(IFIs),are among the leading causes of mortality in liver transplant recipients during the first year *** To investigate the epidemiology,clinical manifestations,risk factors,treatment outcomes,and mortality rate of post-liver transplantation invasive aspergillosis(IA).METHODS In this case-control study,22 patients with IA were identified by reviewing the archived and electronic medical records of 850 patients who received liver transplants at the Imam Khomeini Hospital complex in Tehran,Iran,between 2014 and *** control group comprised 38 patients without IA infection matched for age and *** information obtained included the baseline characteristics of liver transplant patients,operative reports,post-transplantation characteristics of both groups and information about the fungal infection of the patient *** The prevalence rate of IA among liver transplant recipients at Imam Khomeini Hospital was 2.7%.The risk factors of IA among studied patients included high serum creatinine levels before and post-transplant,renal replacement therapy,antithymocyte globulin induction therapy,post-transplant bile leakage,posttransplant hepatic artery thrombosis,repeated surgery within 30 d after the transplant,bacterial pneumonia before the aspergillosis diagnosis,receiving systemic antibiotics before the aspergillus infection,cytomegalovirus infection,and duration of post-transplant hospitalization in the intensive care *** most prevalent form of infection was invasive pulmonary aspergillosis,and the most common chest computed tomography scan findings were nodules,pleural effusion,and the halo *** the case group,prophylactic antifungal therapy was administered more frequently than in the control *** antifungal therapy response rate at 12 wk was 63.7%.The 3-and 12-mo mortality rates of the patients with IA were 36.4%and 45.4%,respectively(compared with the mortality rate o

关键词： Aspergillosis Cytomegalovirus infection Immunosuppression therapy Liver transplantation Risk factors Fungal infections Fungal pneumonia

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