title: Pneumocystis jirovecii pneumonia in liver transplant recipients: a systematic review.
abstract: BACKGROUND
  Pneumocystis jirovecii is a fungus that causes pneumonia in immunocompromised patients, such as liver transplant recipients.
  
  
  METHODS
  We searched the Medline database in September 2013 for articles referring to infections from P. jirovecii in liver transplant recipients, using the terms "liver transplantation" and "pneumocystis." Our search yielded 60 articles, 35 of which were used for our review.
  
  
  RESULTS
  P. jirovecii pneumonia (PJP) has an incidence of 1%-11% in liver transplant recipients without prophylaxis and mortality rates of 7%-88%. Most cases occur within the first 7 months after transplantation. When prophylactic treatment with oral trimethoprim-sulfamethoxazole is used, its incidence is only 0%-3%. The duration of its use varies from 3 months to 1 year after the liver transplantation.
  
  
  CONCLUSIONS
  PJP has relatively high incidence and high mortality rates in liver transplant recipients without prophylactic treatment, which diminishes or even eliminates its occurrence. Therefore, oral trimethoprim-sulfamethoxazole should be used as prophylaxis for 1 year after the liver transplantation in this population.
authors.affiliation: Second Department of Propedeutic Surgery, "Laiko" General Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece. Electronic address: ioannis.kostakis@gmail.com.
authors.forename: I D
authors.initials: ID
authors.lastname: Kostakis
authors.affiliation: Second Department of Propedeutic Surgery, "Laiko" General Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
authors.forename: G C
authors.initials: GC
authors.lastname: Sotiropoulos
authors.affiliation: Second Department of Propedeutic Surgery, "Laiko" General Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Kouraklis
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D014943:Global Health; D006801:Humans; D016867:Immunocompromised Host; D015994:Incidence; D016031:Liver Transplantation; D045363:Pneumocystis carinii / Q000302:isolation & purification*; D011020:Pneumonia, Pneumocystis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D066027:Transplant Recipients
chemical_list: D000900:Anti-Bacterial Agents