Risk factors for invasive aspergillosis in living donor liver transplant recipients.
Invasive aspergillosis (IA) is a severe complication of liver transplantation. Risk factors for IA after deceased donor liver transplantation (DDLT) have been presented in several reports, but are not well established for living donor liver transplant recipients. Here, a retrospective case-control study was performed. Five cases with IA were investigated after living donor liver transplantation (LDLT) between January 1999 and December 2002 at Kyoto University Hospital. For comparison, living donor liver transplant recipients without IA were taken as controls. These patients had undergone LDLT 1 month before or after each IA case and had the same survival times as the latter. We evaluated the clinical and laboratory findings for both groups up until their demise. Patients with IA after LDLT had a very poor prognosis. By univariate analysis, risk factors for IA were preoperative intensive care unit stay (P = 0.02) and preoperative steroid administration (P = 0.02). Preoperative steroid administration for fulminant hepatitis possibly predisposed to the development of IA after LDLT.
Osawa
Makoto
M
Department of Respiratory Medicine, Graduate School of Kyoto University, Kyoto, Japan.
Ito
Yutaka
Y
Hirai
Toyohiro
T
Isozumi
Rie
R
Takakura
Shunji
S
Fujimoto
Yasuhiro
Y
Iinuma
Yoshitsugu
Y
Ichiyama
Satoshi
S
Tanaka
Koichi
K
Mishima
Michiaki
M
D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000453:epidemiology* / Q000473:pathology* / Q000517:prevention & control; D001424:Bacterial Infections / Q000517:prevention & control; D002511:Cephalosporins / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy; D008103:Liver Cirrhosis / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects* / Q000276:immunology* / Q000473:pathology; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000382:microbiology* / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D000666:Amphotericin B; C045693:flomoxef