Invasive aspergillosis in liver transplant recipients: Epidemiology, clinical characteristics, treatment, and outcomes in 116 cases

Invasive aspergillosis in liver transplant recipients: Epidemiology, clinical characteristics, treatment, and outcomes in 116 cases

Invasive aspergillosis (IA) in liver transplant recipients is associated with grave outcomes. We reviewed 116 individual cases reported in the literature from 1985 to 2013. IA was diagnosed after a median of 25 days after transplantation and involved a single organ in 51% of the cases, whereas in th...

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Bibliographic Details
Published in:Liver transplantation 2015-02, Vol.21 (2), p.204-212
Main Authors: Barchiesi, Francesco, Mazzocato, Susanna, Mazzanti, Sara, Gesuita, Rosaria, Skrami, Edlira, Fiorentini, Alessandro, Singh, Nina
Format: Article
Language:eng
Subjects:
Adult
Amphotericin B - therapeutic use
Aspergillosis - therapy
Aspergillus flavus
Aspergillus fumigatus
Cohort Studies
Female
Humans
Kaplan-Meier Estimate
Liver Failure - complications
Liver Failure - surgery
Liver Transplantation
Male
Middle Aged
Probability
Proportional Hazards Models
Renal Insufficiency - complications
Transplant Recipients
Treatment Outcome
Voriconazole - therapeutic use
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Summary:Invasive aspergillosis (IA) in liver transplant recipients is associated with grave outcomes. We reviewed 116 individual cases reported in the literature from 1985 to 2013. IA was diagnosed after a median of 25 days after transplantation and involved a single organ in 51% of the cases, whereas in the remaining cases, multiple sites were involved. The most common infecting Aspergillus species were Aspergillus fumigatus (73%), Aspergillus flavus (14%), and Aspergillus terreus (8%). Amphotericin B was the drug most frequently used, and it was followed by voriconazole and itraconazole. Combination regimens were used in 51% of the cases. The overall 1‐year cumulative survival probability was 35% [95% confidence interval (CI) = 24.6%‐49.6%]. Survival was significantly higher for patients reported from the year 2000 and thereafter (P 
ISSN:1527-6465
1527-6473