Infectious complications in liver transplant recipients on tacrolimus. Prospective analysis of 88 consecutive liver transplants.
This prospective study characterizes the incidence, etiology, timing, risk factors, and outcome of the infectious complications after 88 consecutive liver transplantations in 79 patients receiving tacrolimus (FK506) as primary immunosuppression with a median follow-up of 880 days. Infections occurred in 59% (47/79) of the patients, and 39% had major infections. Of the major infections, 55% were bacterial, 22% were viral, and 22% were fungal. Bacteremia accounted for 30% of major bacterial infections. Sixty percent of bacteremias occurring within the first 3 months were catheter related, while 75% of those occurring more than 3 months after transplant were of a biliary source. Patients with recurrent hepatitis C virus hepatitis and patients requiring dialysis after transplant had a significantly higher rate of infections as compared with other patients. Overall mortality was 18%, and 29% of all deaths were associated with infection. Only invasive aspergillosis was associated with infectious mortality. Our data suggest that the potent immunosuppressive agent FK506 is not associated with a higher incidence of infectious complications as compared with previous studies using CsA.
Singh
N
N
Veterans Affairs Medical Center, Pittsburgh, Pennsylvania.
Gayowski
T
T
Wagener
M
M
Yu
V L
VL
D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000209:etiology; D005260:Female; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D015994:Incidence; D007239:Infections / Q000209:etiology*; D016031:Liver Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016559:Tacrolimus / Q000627:therapeutic use*; D016896:Treatment Outcome; D014777:Virus Diseases / Q000209:etiology
D016559:Tacrolimus