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Fungal infection in patients after liver transplantation in years 2003 to 2012

Chun-Hua Yang, Xiao-Shun He, Juan Chen, Bin Ouyang, Xiao-Feng Zhu, Min-Ying Chen, Wen-Feng Xie, Li Chen, Dong-Hua Zheng, Yun Zhong, Xue-Xia Chen, Xiang-Dong Guan

Ann Transplant 2012; 17(4): 59-63

DOI: 10.12659/AOT.883695


Background:    Fungal infections after liver transplantation have received considerable interests because of their association with substantial morbidity and mortality. This study investigated risk factors of fungal infection after liver transplantation.
    Material/Methods:    Retrospective analysis was performed based on clinical data from 120 patients with fungal infection after liver transplantation from January 1, 2003 to May 30, 2012. 2 test was used to analyze risk factors for fungal infections.
    Results:    The fungal infection rate after liver transplantation is 13.5% (120/886) and the case fatality rate reaches 70.8%; most are infected by Candida albicans (67.5%), with infection located in the lung (73.3%). Acute physiology and chronic health evaluation scores of the infected group are higher than those of the control group 24 hours after the surgery (27.1±5.2 vs. 21.9±5.0). The percentage of primary liver cancer patients in the infected group was lower than in the control group (26.7% vs. 45.8%). Compared to the control group, the infected group had a higher percentage of patients with HBV, gestational diabetes mellitus, and multiple organ dysfunction syndrome. Percentages of patients with long continuous parenteral nutrition time, poorly controlled high blood sugar, long-term mechanical ventilation, and antibiotics use were higher in the infected group than in the control group.
    Conclusions:    Preoperative original attack, postoperative critical condition, chronically high blood sugar, long-term use of antibiotics, and mechanical ventilation are probably vital risk factors for fungal infection after liver transplantation.

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