[Prevention of mycotic infections in liver transplant recipients: comparison of two chemoprophylactic protocols].
BACKGROUND
The aim of the study was to compare and evaluate the efficacy of two chemoprophylactic protocols against mycotic infections in a liver transplant recipients population.


METHODS
single-blind, randomized.


METHODS
Liver transplant Center of a National Health System teaching hospital.


METHODS
Eighty-eight consecutive patients submitted to liver transplantation were enrolled in the study. Immediately before surgery they were randomized to receive sequential treatment with intravenous liposomal amphotericine B + oral itraconazole or intravenous fluconazole + oral itraconazole. Intravenous drugs were administered in the first postoperative week, and oral treatments for the following three weeks. In addition to analyzing the frequency and incidence of colonization, local and disseminated infection of mycotic origin, the causes of death and the possible risk factors for mycotic disease have been examined.


RESULTS
Eighty-five patients completed the study. No significative difference was evident in the two groups as regards to single organ and systemic fungal infection rate. Two out of a total of 5 deaths were related to mycotic disease. Pre-transplant fungal colonization, more severe liver disease indicating the transplant procedure and the rejection of the graft were all risk factors for the development of mycotic infection.


CONCLUSIONS
The two protocols used in the study showed and equal efficacy in preventing fungal infections in liver transplant recipients.
Biancofiore
G
G
I UO Anestesia e Rianimazione, UTI Postchirurgica e Trapianti, Azienda Ospedaliera Pisana, Università degli Studi, Pisa, Italy.
Baldassarri
R
R
Bindi
M L
ML
Mosca
C
C
Filipponi
F
F
Mosca
F
F
Vagelli
A
A
D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000209:etiology / Q000517:prevention & control*; D016037:Single-Blind Method
D000935:Antifungal Agents
Prevenzione delle infezioni micotiche nei pazienti sottoposti a trapianto epatico: confronto tra due protocolli di chemioprofilassi.