TY - JOUR
T1 - Risk factors and impact of β-D glucan on invasive fungal infection for the living donor liver transplant recipients
AU - Kawagishi, Naoki
AU - Satoh, Kazushige
AU - Enomoto, Yoshitaka
AU - Akamatsu, Yorihiro
AU - Sekiguchi, Satoshi
AU - Fujimori, Keisei
AU - Satomi, Susumu
PY - 2006/6/16
Y1 - 2006/6/16
N2 - Invasive fungal infection is a fatal complication in liver transplantation and it is very difficult to diagnose at the early stage. The aim of this study was to review our experience with invasive fungal infections in living donor liver transplantation (LDLT) and to analyze the risk factors and the impact of β-D glucan. From 1991 to 2005, 96 LDLTs were performed in our institution and we measured the serum level of β-D glucan in order to clarify the diagnosis. Invasive fungal infection was diagnosed based on clinical symptoms, culture, radiological evidence and β-D glucan. Active fungal infection was treated with fluconazole, amphotericin B, flucytosine and micafungin. Risk factors both pre- and post- LDLT were analyzed. Candida albicans was the most frequently isolated species (70%). The risk factors identified by univariate analysis include the following four conditions: acute blood purification (plasma exchange with or without continuous hemodiafiltration), hepatic vein complications, renal failure and respiratory failure. By logistic regression analysis, hepatic vein complications and respiratory failure were identified as independent risk factors. The risk factors for invasive fungal infection of LDLT in Japan have not been well analyzed and this report will provide valuable information for the prevention of the fungal infection.
AB - Invasive fungal infection is a fatal complication in liver transplantation and it is very difficult to diagnose at the early stage. The aim of this study was to review our experience with invasive fungal infections in living donor liver transplantation (LDLT) and to analyze the risk factors and the impact of β-D glucan. From 1991 to 2005, 96 LDLTs were performed in our institution and we measured the serum level of β-D glucan in order to clarify the diagnosis. Invasive fungal infection was diagnosed based on clinical symptoms, culture, radiological evidence and β-D glucan. Active fungal infection was treated with fluconazole, amphotericin B, flucytosine and micafungin. Risk factors both pre- and post- LDLT were analyzed. Candida albicans was the most frequently isolated species (70%). The risk factors identified by univariate analysis include the following four conditions: acute blood purification (plasma exchange with or without continuous hemodiafiltration), hepatic vein complications, renal failure and respiratory failure. By logistic regression analysis, hepatic vein complications and respiratory failure were identified as independent risk factors. The risk factors for invasive fungal infection of LDLT in Japan have not been well analyzed and this report will provide valuable information for the prevention of the fungal infection.
KW - Complication
KW - Invasive fungal infection
KW - Living donor liver transplantation
KW - Risk factor
KW - β-D glucan
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U2 - 10.1620/tjem.209.207
DO - 10.1620/tjem.209.207
M3 - Review article
C2 - 16778367
AN - SCOPUS:33745188678
VL - 209
SP - 207
EP - 215
JO - Tohoku Journal of Experimental Medicine
JF - Tohoku Journal of Experimental Medicine
SN - 0040-8727
IS - 3
ER -