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

作　　者：Azam Farahani Fereshteh Ghiasvand Setareh Davoudi Zahra Ahmadinejad 

机构地区：[1]Department of Infectious Diseases,Imam Khomeini Hospital Complex,Tehran University of Medical Sciences,Tehran 1478714466,Iran [2]Liver Transplantation Research Center,Imam Khomeini Hospital Complex,Tehran University of Medical Sciences,Tehran 1478714466,Iran

出　　处：《World Journal of Transplantation》2023年第5期264-275,共12页世界移植杂志

摘　　要：BACKGROUND Infections,including invasive fungal infections(IFIs),are among the leading causes of mortality in liver transplant recipients during the first year posttransplantation.AIM 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 2019.The control group comprised 38 patients without IA infection matched for age and sex.The 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 group.RESULTS 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 unit.The 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 sign.In the case group,prophylactic antifungal therapy was administered more frequently than in the control group.The 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 of the control group in 12 mo,which was zero).CON

关 键 词：ASPERGILLOSIS Cytomegalovirus infection Immunosuppression therapy Liver transplantation Risk factors Fungal infections Fungal pneumonia 

分 类 号：R57[医药卫生—消化系统]