[The study of the risk factors of fungal infection after liver transplantation].
OBJECTIVE
To explore the risk factors of fungal infection so as to provide rationales for the prevention of fungal infection after liver transplantation.


METHODS
The clinical data of 94 cases of fungal infections after liver transplantation from January 1, 2003 to November 30, 2010 at our hospital were collected as the infective group. A total of 603 liver transplant patients without fungal infections during the same period were selected as the control group. χ(2) test and t test were utilized for the analysis of possible risk factors for fungal infection.


RESULTS
Fungal infection rate was 13.5% (94/697) after liver transplantation and mortality rate of fungal infection 86.2% (81/94). Candida albicans was the majority infective fungi. And the main site of infection was the lungs. The postoperative acute physiology and chronic health evaluation III (APACHE III) score of the infective group was significantly higher than that of the control group (26.0 ± 5.4 vs 21.5 ± 4.7, P < 0.01). The number of patients with primary liver cancer was lower than that of the control group (26.6% vs 45.8%, P < 0.01). The number of decompensated HBV cirrhosis and diabetics in the infective group was higher than that of the control group at pre-operation (23.4% vs 11.6%, 9.6% vs 2.8%, both P < 0.01). The number of patients with postoperative mechanical ventilation over 10 days, postoperative antibiotics over 14 days, postoperative cardiopulmonary dysfunction and liver function recovery time over 7 days, parenteral nutrition over 12 days and hyperglycemia over 7 days in the infective group were significantly higher than that in the control group (all P < 0.01).


CONCLUSIONS
Preoperative primary disease, postoperative disease severity, postoperative organ dysfunction, long-term mechanical ventilation, antibiotics and hyperglycemia, etc. may be the important risk factors of fungal infection after liver transplantation.
Department of Critical Care Medicine of First Affiliated Hospital of Sun Yat-sen, Guangzhou 510080, China.
Chun-hua
CH
Yang
Xiao-shun
XS
He
Juan
J
Chen
Bin
B
Ouyang
Xiao-feng
XF
Zhu
Min-ying
MY
Chen
Wen-feng
WF
Xie
Li
L
Chen
Dong-hua
DH
Zheng
Yun
Y
Zhong
Xue-xia
XX
Chen
Xiang-dong
XD
Guan
D000328:Adult; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008172:Lung Diseases, Fungal / Q000209:etiology; D009181:Mycoses / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome