Significance of serum β-D-glucan levels in recipients of living donor liver transplantation.
OBJECTIVE
Early identification and treatment of fungal infections is essential for recipients of liver transplants, but the sensitivity of surveillance culture is insufficient. Measurement of the serum level of β-D-glucan is a rapid diagnostic strategy for invasive fungal infection. We aimed to evaluate the significance of serum β-D-glucan levels in transplant recipients after living donor liver transplantation (LDLT).


METHODS
We retrospectively analyzed the clinical and laboratory data of 100 consecutive adult transplant recipients after LDLT performed between August 1997 and August 2009.


RESULTS
Seventy-one had high serum β-D-glucan levels (>20 pg/ml) after LDLT. Nearly half (47.2%) of the episodes of increase occurred within the first 5 days after surgery. The mortality rate of the recipients with high serum β-D-glucan levels was similar to that of the recipients without high levels. However, in terms of the time line of increase, the recipients with high serum β-D-glucan levels from 15 days onward after surgery showed a significantly higher mortality rate than those with high levels before 15 days after surgery (33.3 and 4.3%, respectively; p < 0.001).


CONCLUSIONS
High serum levels of β-D-glucan at late time points after LDLT indicate established fungal infection and higher mortality.
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
Kosho
K
Yamanouchi
Mitsuhisa
M
Takatsuki
Masaaki
M
Hidaka
Akihiko
A
Soyama
Takashi
T
Kanematsu
Susumu
S
Eguchi
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000097:blood / Q000175:diagnosis* / Q000382:microbiology; D006801:Humans; D016031:Liver Transplantation / Q000502:physiology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000097:blood / Q000175:diagnosis* / Q000382:microbiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D055815:Young Adult; D047071:beta-Glucans / Q000097:blood*
D015415:Biomarkers; D047071:beta-Glucans