Candida albicans arteritis transmitted by preservation fluid after liver transplantation.
BACKGROUND
Fungal infections remain among the main causes of mortality in the chronically immunosuppressed liver transplant (LT) patient. Bacterial and fungal contamination of preservation fluid (PF), in which grafts are stored, represents a potential source of infection for recipients.


METHODS
A 54-year-old patient underwent LT for chronic alcoholic cirrhosis. Mycological culture of the liver PF was positive for Candida albicans. The patient received antimycotic prophylaxis for 4 weeks in absence of clinical and serological signs of infection. He was urgently readmitted 4 months later with hemobilia caused by an arterial pseudoaneurysm that was fistulized in the biliary anastomosis. After an unsuccessful embolization, arterial resection and reconstruction and a biliodigestive anastomosis were performed, with an uneventful postoperative course. Pathology found a mycotic arteritis of the graft artery. Mycotic culture of the arterial segment confirmed the presence of the same Candida albicans genotype previously isolated in the PF.


CONCLUSIONS
Mycotic arteritis is one of the possible complications of yeast contamination of PF. Surgeons and physicians involved in the care of LT patients should be aware of this potentially lethal complication and adopt all the available means for early detection.
University of Strasbourg, Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Strasbourg, France.
Pietro
P
Addeo
University of Strasbourg, Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Strasbourg, France.
Anne-Catherine
AC
Saouli
University of Strasbourg, Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Strasbourg, France.
Marie Lorraine
ML
Woehl-Jaegle
University of Strasbourg, Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Strasbourg, France.
Bernard
B
Ellero
University of Strasbourg, Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Strasbourg, France.
Elie
E
Oussoultzoglou
University of Strasbourg, Department of Pathology, Strasbourg, France.
Luc
L
Marcellin
University of Strasbourg, Department of Pathology, Strasbourg, France.
Philippe
P
Bachellier
D000785:Aneurysm, Infected / Q000188:drug therapy / Q000382:microbiology / Q000635:transmission*; D000935:Antifungal Agents / Q000627:therapeutic use; D001167:Arteritis / Q000188:drug therapy / Q000382:microbiology*; D002176:Candida albicans; D002177:Candidiasis / Q000150:complications / Q000188:drug therapy / Q000635:transmission*; D006431:Hemobilia / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D019188:Organ Preservation Solutions / Q000009:adverse effects*
D000935:Antifungal Agents; D019188:Organ Preservation Solutions