侵入性真菌感染:肝移植后的早期杀手
Robert Breitkopf1, Benedikt Treml1, Zoran Bukumiric2
1Department of Anesthesia and Intensive Care Medicine, Medical University Innsbruck, 6020 Innsbruck, Austria.
Journal of fungi (Basel, Switzerland)
|June 27, 2023
概括
正位体肝移植 (OLT) 存活率受到感染的影响. 侵入性真菌感染显著增加了OLT后的死亡风险,突出了改善抗真菌策略的需要.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 移植手术 移植手术
- 传染性疾病 传染性疾病
背景情况:
- 肝移植是对末期肝病和某些癌症的关键治疗方法.
- 关于移植后不良结果的预测因素和风险因素的数据有限.
- 这项研究调查了死因风险因素和90天的死亡率后的正位体肝移植 (OLT),专注于真菌感染.
研究的目的:
- 为了确定潜在的死亡风险因素后OLT.
- 报告OLT接受者的90天死亡率.
- 评估真菌感染在OLT后结果中的特定作用.
主要方法:
- 在欧洲高等大学中心对接受OLT患者的病历进行了回顾性审查.
- 包括接受首次OLT的成年患者.
- 分析死亡率数据和侵入性真菌感染的发病率.
主要成果:
- 在214名成年OLT接受者中,8% (17名患者) 在90天内死亡.
- 侵袭性真菌感染发生在12% (26名患者) 尽管采取了抗真菌预防措施.
- 多变量分析显示,侵袭性真菌感染患者的死亡风险增加了近五倍 (HR 4.6) (p=0.032).
结论:
- 在OLT后的短期死亡率主要与传染病和手术并发症有关.
- 突破性真菌感染对OLT接受者来说是一个日益严重的担忧.
- 侵入性真菌感染可能是可修改的风险因素,需要进一步研究最佳的外科手术期间的抗真菌预防.
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