title: Diagnosis and treatment of fungal infection after liver transplantation.
abstract: BACKGROUND
  Liver transplantation is the most effective treatment for end-stage liver diseases; however, infections after transplantation can seriously affect the patient's health. The aim of this research was to investigate the diagnosis and treatment of fungal infection following liver transplantation.
  
  
  METHODS
  Clinical data for 232 liver transplant patients at risk of fungal infection were examined for the presence of fungus in the blood, fluid, sputum, urine and stools of patients and by chest or abdominal CT scans. Patients diagnosed with a fungal infection were treated with Fluconazole or, if this was not effective, Voriconazole or Amphotericin B. Immunosuppressive therapy was also reviewed.
  
  
  RESULTS
  Thirty-seven of 232 (15.9%) patients were diagnosed with a fungal infection, which occurred 4 to 34 days post-transplantation. Candida infections were diagnosed in 23 cases (62.2%) and Aspergillus infections in 12 cases (32.4%). Twenty-one cases were effectively treated with Fluconazole, 11 cases with Voriconazole, and two cases with Amphotericin B; however, three cases were not effectively treated with any of the antifungal agents. Overall, treatment was effective in 91.9% of patients.
  
  
  CONCLUSIONS
  Fungal infection has a significant influence on survival rate after liver transplantation. Imaging studies, and pathogenic and biopsy examinations can diagnose fungal infections, which can be effectively treated with antifungal agents such as Fluconazole, Voriconazole or Amphotericin B.
authors.affiliation: Department of Hepatobiliary Surgery, People's Liberation Army General Hospital, Beijing 100853, China. shixianjie301@yahoo.com.cn
authors.forename: Xian-Jie
authors.initials: XJ
authors.lastname: Shi
authors.forename: Shao-Cheng
authors.initials: SC
authors.lastname: Lü
authors.forename: Lei
authors.initials: L
authors.lastname: He
authors.forename: Fang
authors.initials: F
authors.lastname: Lu
authors.forename: Yu-Rong
authors.initials: YR
authors.lastname: Liang
authors.forename: Ying
authors.initials: Y
authors.lastname: Luo
authors.forename: Wen-Bin
authors.initials: WB
authors.lastname: Ji
authors.forename: Zhi-Ming
authors.initials: ZM
authors.lastname: Zhao
mesh_terms: D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D009181:Mycoses / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D011743:Pyrimidines / Q000627:therapeutic use; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D000666:Amphotericin B; D015725:Fluconazole; D065819:Voriconazole