[Clinical analysis of aspergillosis in orthotopic liver transplant recipients].
OBJECTIVE
To assess the clinical features of aspergillosis and its diagnosis, prophylaxis and treatment in patients after orthotopic liver transplantation (OLT), and to improve the prognosis of the recipients.


METHODS
Medical records of consecutive patients who underwent OLT in our liver transplant center from May 2002 to May 2004 were analyzed retrospectively. Those with aspergillus infection complications were studied in detail regarding their infected organs, related factors, treatments and prognoses.


RESULTS
17 out of 207 recipients of OLT were detected with aspergillosis. The incidence was 8.21 percent. 5 patients infected with superficial aspergillus survived. Of the 12 cases with deep aspergillus infection, 3 with infection limited to the sites of their incisions survived, 2 of the 3 patients with infection in their lungs, and 1 of the 2 patients with it in their livers died, and 4 recipients with multi-organ aspergillus infection died. Among the 7 cases that died, 5 had severe hepatitis, 1 had post-hepatitis liver cirrhosis and 1 had primary liver carcinoma.


CONCLUSIONS
Long-term (> or = 3 weeks) broad-spectrum antibiotics and immunosupression were involved in aspergillus infection in our OLT patients. Patients with chronic severe hepatitis had a higher risk of having aspergillus infection. Amphotericin B is still the best choice for treating aspergillosis. Prophylactic administration of anti-fungal medicine, surveillance of fungal infections as a routine, and treatment of the infection in time may help to improve the prognosis of OLT recipients with aspergillosis.
Liu
Zhen-wen
ZW
Liver Transplantation Institute of the General Hospital of Chinese People's Armed Police Forces, Beijing 100039, China. wlzouah@sina.com
Zou
Wei-long
WL
Zhu
Xiao-dan
XD
Zhang
Xiang-lan
XL
Liu
Yu
Y
Shen
Zhong-yang
ZY
D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D002681:China / Q000453:epidemiology; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000601:surgery* / Q000821:virology; D008113:Liver Neoplasms / Q000209:etiology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
D000935:Antifungal Agents; D000666:Amphotericin B