Invasive fungal infections following liver transplantation. 2017

Rachel Hogen, and Kiran K Dhanireddy
Division of Surgical Education, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.

OBJECTIVE The review outlines the microbiology, presentation, prophylactic strategies, resistance patterns, and consequences of invasive fungal infections (IFIs) in orthotopic liver transplantation (OLT) recipients. RESULTS There has been an increase in the proportion of non-albicans Candida causing IFIs. The biomarkers galactomannan and β-D-glucan should not be routinely used in the diagnosis of IFIs in OLT recipients due to their limited accuracy. Echinocandins have emerged as noninferior to fluconazole and other prophylactic regimens. Their broad spectrum of activity and side-effect profile are appealing; however, the development of echinocandin resistance, especially in Candida glabrata has been highlighted as one of their limitations. CONCLUSIONS A significant decline in IFIs but an increase in IFIs caused by non-albicans Candida species has been observed in the model for end-stage liver disease era. Diagnostic tools remain limited. Studies continue to support antifungal prophylaxis individualized to recipient risk with echinocandins now established as an additional option for antifungal prophylaxis. The appropriate duration of antifungal prophylaxis remains ill-defined with some studies advocating targeted therapy based on clinical status and others more prolonged therapy beyond the historically common 4 weeks. However, prolonged therapy with echinocandins can result in resistance.

UI MeSH Term Description Entries
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000072742 Invasive Fungal Infections Mycoses which manifest as infections of deep tissue or blood. Disseminated Fungal Infection,Invasive Mycoses,Disseminated Fungal Infections,Fungal Infection, Disseminated,Fungal Infection, Invasive,Infection, Disseminated Fungal,Infection, Invasive Fungal,Invasive Fungal Infection,Mycoses, Invasive
D016019 Survival Analysis A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function. Analysis, Survival,Analyses, Survival,Survival Analyses
D016031 Liver Transplantation The transference of a part of or an entire liver from one human or animal to another. Grafting, Liver,Hepatic Transplantation,Liver Transplant,Transplantation, Hepatic,Transplantation, Liver,Hepatic Transplantations,Liver Grafting,Liver Transplantations,Liver Transplants,Transplant, Liver

Related Publications

Rachel Hogen, and Kiran K Dhanireddy
January 2012, International journal of organ transplantation medicine,
Rachel Hogen, and Kiran K Dhanireddy
April 2023, Journal of clinical medicine,
Rachel Hogen, and Kiran K Dhanireddy
May 2011, International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases,
Rachel Hogen, and Kiran K Dhanireddy
November 2021, World journal of hepatology,
Rachel Hogen, and Kiran K Dhanireddy
January 2011, Annals of transplantation,
Rachel Hogen, and Kiran K Dhanireddy
January 2005, Mycoses,
Rachel Hogen, and Kiran K Dhanireddy
June 2023, Journal of fungi (Basel, Switzerland),
Rachel Hogen, and Kiran K Dhanireddy
January 2003, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America,
Rachel Hogen, and Kiran K Dhanireddy
September 1994, The Journal of infectious diseases,
Rachel Hogen, and Kiran K Dhanireddy
November 2020, Biomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals,
Copied contents to your clipboard!