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[Invasive mycoses in liver transplantation]
J Romanyk1, A del Palacio, C Fiaño
1Servicio de Microbiología, Hospital 12 de Octubre, Madrid.
Enfermedades Infecciosas Y Microbiologia Clinica
|June 1, 1991
Summary
Deep fungal infections are a significant risk following liver transplantation, often occurring within the first month. Multiple abdominal surgeries and antibiotic use are key risk factors for these severe post-transplant complications.
Area of Science:
- Medical Mycology
- Transplantation Surgery
- Infectious Diseases
Background:
- Orthotopic liver transplantation is a complex procedure with potential for serious complications.
- Deep mycoses, fungal infections affecting internal organs, pose a significant threat to transplant recipients.
- Understanding the incidence and risk factors for these infections is crucial for improving patient outcomes.
Observation:
- A study of 73 liver transplant recipients identified 5 cases of deep mycoses within the first month post-transplantation.
- Infections included candidiasis, invasive aspergillosis, and invasive pulmonary aspergillosis.
- Key clinical risk factors identified were previous broad-spectrum antibiotic use and multiple abdominal laparotomies.
Findings:
- The incidence of deep mycoses was observed in this cohort of liver transplant patients.
- Previous broad-spectrum antibiotic use and multiple abdominal laparotomies were strongly associated with deep mycoses.
- Bacterial sepsis and Cytomegalovirus viremia were also noted as significant co-occurring infections.
Implications:
- Early identification and management of risk factors like antibiotic exposure and surgical history are critical.
- Prophylactic strategies against fungal infections may be warranted in high-risk liver transplant patients.
- Multifactorial causes of mortality highlight the complexity of managing post-transplant complications.