title: Outcome of mucormycosis in liver transplantation: four cases and a review of literature.
abstract: Mucormycosis is a rare but highly invasive fungal infection that occurs in transplant recipients. The literature contains descriptions of 12 cases of mucormycosis after orthotopic liver transplantation (OLT). This report describes the fatal courses in four patients at our center who developed mucormycosis after liver transplantation. Of 51 liver transplant recipients who received grafts between December 1993 and April 2003, 4 (7.8%; 3 males and 1 female) developed mucormycosis. The primary liver diseases in the four cases were Wilson's disease, autoimmune hepatitis, primary biliary cirrhosis, and cryptogenic cirrhosis. Three of the transplants were harvested by another team and shipped to our center. We concluded that selection of poor transplant candidates, prolonged antibiotic therapy and/or hospitalization prior to OLT, and breaks in aseptic technique during harvesting, shipping, and during operation are the main reasons for the high incidence of mucormycosis in our OLT patients.
authors.affiliation: Transplant Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran. davarih@sums.ac.ir
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Davari
authors.forename: Seyed Ali
authors.initials: SA
authors.lastname: Malekhossini
authors.forename: Heshmato-allah
authors.initials: HA
authors.lastname: Salahi
authors.forename: Ali
authors.initials: A
authors.lastname: Bahador
authors.forename: Mehdi
authors.initials: M
authors.lastname: Saberifirozi
authors.forename: Bita
authors.initials: B
authors.lastname: Geramizadeh
authors.forename: Seyed Masoud
authors.initials: SM
authors.lastname: Lahsaee
authors.forename: Mohammad Bagher
authors.initials: MB
authors.lastname: Khosravi
authors.forename: Mohammad Hadi
authors.initials: MH
authors.lastname: Imanieh
authors.forename: Mohammad Hadi
authors.initials: MH
authors.lastname: Bagheri
mesh_terms: D000293:Adolescent; D000328:Adult; D017809:Fatal Outcome; D005260:Female; D019693:Hepatitis, Autoimmune / Q000601:surgery; D006527:Hepatolenticular Degeneration / Q000601:surgery; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery; D008105:Liver Cirrhosis, Biliary / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009091:Mucormycosis / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D013902:Radiography, Thoracic; D014463:Ultrasonography