[Risk factors associated with invasive fungal infection in orthotopic liver transplantation].
OBJECTIVE
Invasive fungal infection (IFI) in orthotopic liver transplantation (OLT) influences survival, hence the need for risk predictors. We have determined the incidence and risk factors associated with invasive fungal infection in OLT.


METHODS
165 OLTs performed in 152 receptors from May 1994 to May 1998 at the Hospital Juan Canalejo (La Coruña), were included in the study. Pre-surgical, surgical and post-surgical variables were evaluated. Those variables that independently influenced the development of IFI were determined by multivariate logistic regression.


RESULTS
IFI presented in 7 cases /152 patients (4.6%). In the univariate analysis, IFI was associated with pre-transplantation serum albumin, the number of blood units transfused, mechanical ventilation (OR = 7.56), re-transplantation (OR = 11.10) cytomegalovirus infection (OR = 8.35) and pre-transplantation GOT. In the multivariate analysis, the independent variables predicting IFI were the number of blood units transfused (OR = 1.21; 95% CI, 1.05-1.38), serum albumin pre-transplantation (OR = 0.06; 95% CI, 0.007-0.537) and re-transplantation (HR = 432; 95% CI, 9.80-19 058).


CONCLUSIONS
Pre-transplantation serum albumin, a clear predictor, the number of blood units transfused and re-transplantation are all independent predictors of IFI.
Echániz-Quintana
Ana
A
Servicio de Medicina Interna, Hospital Carlos III, Madrid, España. echaniz.hcii@salud.madrid.org
Pita-Fernández
Salvador
S
Otero-Ferreiro
Alejandra
A
Suárez-López
Francisco
F
Gómez-Gutiérrez
Manuel
M
Guerrero-Espejo
Antonio
A
D005260:Female; D016469:Fungemia / Q000453:epidemiology*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000453:epidemiology*; D009894:Opportunistic Infections / Q000453:epidemiology*; D012307:Risk Factors