title: Successful living-donor liver transplantation after treatment of sinus aspergillosis by endoscopic mycetoma removal and sinus drainage.
abstract: A 47-year-old female was admitted to our hospital for treatment of end-stage liver disease due to primary biliary cirrhosis. Preoperative routine nasal sinus magnetic resonance imaging revealed diffuse inflammatory mucosal hyperplasia of the right maxillary sinus and mycetoma without invasive fungal sinusitis. Aspergillus antigen was positive. With a diagnosis of sinus aspergillosis, endoscopic sinus drainage and removal of mycetoma were performed. After endoscopic treatment, the right maxillary sinus was irrigated using amphotericin B for 2 weeks and then treated by iodine with gentamicin and ketoconazole for 6 weeks. At 1 month after endoscopic treatment, the mycetoma had disappeared. At 3 months after the endoscopic treatment, the patient underwent living-donor liver transplantation using the left and caudate lobe of her daughter. The patient made a satisfactory recovery and was discharged on 19 days after transplant. As of 44 months after transplant, she remains well without recurrence of aspergillosis.
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, 105-8461, Tokyo, Japan. n-okui@jikei.ac.jp.
authors.forename: Norimitsu
authors.initials: N
authors.lastname: Okui
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, 105-8461, Tokyo, Japan. hs0817@jikei.ac.jp.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shiba
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, 105-8461, Tokyo, Japan. swakiyama@jikei.ac.jp.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Wakiyama
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, 105-8461, Tokyo, Japan. tiger@jikei.ac.jp.
authors.forename: Yasuro
authors.initials: Y
authors.lastname: Futagawa
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, 105-8461, Tokyo, Japan. y.ishida@jikei.ac.jp.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ishida
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, 105-8461, Tokyo, Japan. kyanaga@jikei.ac.jp.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
keywords: Aspergillosis; Aspergillus; Liver transplantation; PBC