J Korean Surg Soc.  2010 Oct;79(4):267-274. 10.4174/jkss.2010.79.4.267.

Aspergillosis in Liver Transplant Recipients: A Single Center Experience

• Kim JM
• Kwon CH
• Joh JW
• Song S
• Shin M
• Kim SJ
• Hong SH
• Kim BN
• Lee SK

• KMID: 2145028
• DOI: http://doi.org/10.4174/jkss.2010.79.4.267

Abstract

PURPOSE
The aim of this study was to review the epidemiology, clinical features, diagnosis, and effect of treatments of aspergillosis infections in adult liver transplantation patients.
METHODS
We retrospectively studied the cases of aspergillosis among 625 (164 deceased donor liver transplantation (DDLT), 461 living donor liver transplantation (LDLT)) adult liver transplantation recipients (> or =18 yrs old) operated between May 1996 to May 2008.
RESULTS
Fourteen cases of aspergillosis infection were detected, which consisted of 9 cases of invasive aspergillosis, 5 cases of aspergilloma in maxillary sinuses which occurred before the transplantation. One patient with invasive aspergillosis, who had received liver transplantation overseas and had post-operation care in our center, was also included. Among the 8 cases (1.28%) of invasive aspergillosis (excluding one case operated overseas), 6 cases (3.7%) were DDLT and 2 cases (0.4%) LDLT (P-value<0.05). Among the 6 patients with early onset of invasive aspergillosis, 5 patients (1.8%) had fluconazole and only 1 patient (0.3%) had itraconazole as prophylactic antifungal agent (P-value<0.05). The three cases with localized lesions in the lung survived after lobectomy, but the disseminated and inoperable cases died.
CONCLUSION
The incidence of invasive aspergillosis was lower in LDLT cases and prophylactic itraconazole might be more effective than fluconazole. Paranasal aspergilloma, detected before transplantation had no relation with posttransplant invasive aspergillosis infection. Patients who had localized lesion in the lung, and underwent surgery had better survival than who could not.

Keyword

Liver transplantation; Invasive aspergillosis; Paranasal aspergilloma; Antifungal agents; Lung lobectomy

MeSH Terms

Adult
Antifungal Agents
Aspergillosis
Fluconazole
Humans
Incidence
Itraconazole
Liver
Liver Transplantation
Living Donors
Lung
Maxillary Sinus
Retrospective Studies
Tissue Donors
Transplants
Antifungal Agents
Fluconazole
Itraconazole

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