[Diagnosis and treatment of invasive aspergillosis infection following orthotopic liver transplantation].
OBJECTIVE
To explore the treatment and appropriate management of invasive aspergillosis infection following orthotopic liver transplantation.


METHODS
The clinical data of 576 cases who underwent orthotopic liver transplantation consecutively between January 2000 and January 2005 were analyzed retrospectively.


RESULTS
The prevalence of invasive aspergillosis infection was 1.74 (9/576), included 8 cases with pulmonary aspergillosis and 1 case with cerebral aspergillosis. The interval between transplantation and diagnosis were from 10 days to 2 months. Persistent or discontinuous low fever maybe the main clinical presentation after operation. Liposomal amphotericin B (AmBisome) is the mainly treatment for invasive aspergillosis infections, 5 patients were cured and 2 patients developed multi-organ aspergillosis infection died.


CONCLUSIONS
The clinical features of invasive aspergillosis infection following orthotopic liver transplantation were un-typical presentations in the early stage and easy to disseminate. Appropriate modification of immunosuppression therapy and early, high dose and long-term application of antifungal treatment is effective and safe to cure the disease.
Yi
Shu-hong
SH
Liver Transplantation Center, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China.
Chen
Gui-hua
GH
Lu
Min-qiang
MQ
Yang
Yang
Y
Cai
Chang-jie
CJ
Xu
Chi
C
Li
Hua
H
Wang
Gen-shu
GS
Yi
Hui-min
HM
D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects; D008172:Lung Diseases, Fungal / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D020953:Neuroaspergillosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D011183:Postoperative Complications; D012189:Retrospective Studies
D000935:Antifungal Agents; D000666:Amphotericin B