Is Routine Prophylaxis Against Pneumocystis jirovecii Needed in Liver Transplantation? A Retrospective Single-Centre Experience and Current Prophylaxis Strategies in Spain
| Autor: | Javier Crespo, María Luisa Cagigal Cobo, Carmen Álvarez Tato, Paloma Álvarez Fernández, Roberto Fernández Santiago, Angela Puente, Jorge Calvo Montes, Emilio Fábrega, Inés García Carrera, Patricia Huelin, Juan Andrés Echeverri Cifuentes, Fernando Casafont, Antonio Cuadrado, Marina Cobreros, José Ignacio Fortea, Carlos Ruiz de Alegría Puig, Federico José Castillo Suescun, Juan Carlos Rodríguez Sanjuán |
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| Přispěvatelé: | Universidad de Cantabria |
| Rok vydání: | 2020 |
| Předmět: |
Pediatrics
medicine.medical_specialty medicine.medical_treatment lcsh:Medicine 030230 surgery Liver transplantation Pneumocystis Jirovecii Article Pneumocystis jirovecii 03 medical and health sciences 0302 clinical medicine Medicine Cumulative incidence liver transplantation biology Prophylaxis business.industry Incidence (epidemiology) lcsh:R Pneumocystis jirovecii Pneumonia General Medicine biology.organism_classification Liver Transplantation Single centre Cohort 030211 gastroenterology & hepatology business |
| Zdroj: | Journal of Clinical Medicine, Vol 9, Iss 3573, p 3573 (2020) J Clin Med . 2020 Nov 6;9(11):3573 UCrea Repositorio Abierto de la Universidad de Cantabria Universidad de Cantabria (UC) Journal of Clinical Medicine Volume 9 Issue 11 |
| ISSN: | 2077-0383 |
| DOI: | 10.3390/jcm9113573 |
| Popis: | In liver transplant (LT) recipients, Pneumocystis jirovecii pneumonia (PJP) is most frequently reported before 1992 when immunosuppressive regimens were more intense. It is uncertain whether universal PJP prophylaxis is still applicable in the contemporary LT setting. We aimed to examine the incidence of PJP in LT recipients followed at our institution where routine prophylaxis has never been practiced and to define the prophylaxis strategies currently employed among LT units in Spain. All LT performed from 1990 to October 2019 were retrospectively reviewed and Spanish LT units were queried via email to specify their current prophylaxis strategy. During the study period, 662 LT procedures were carried out on 610 patients. Five cases of PJP were identified, with only one occurring within the first 6 months. The cumulative incidence and incidence rate were 0.82% and 0.99 cases per 1000 person transplant years. All LT units responded, the majority of which provide prophylaxis (80%). Duration of prophylaxis, however, varied significantly. The low incidence of PJP in our unprophylaxed cohort, with most cases occurring beyond the usual recommended period of prophylaxis, questions a one-size-fits-all approach to PJP prophylaxis. A significant heterogeneity in prophylaxis strategies exists among Spanish LT centres. Funding: This study was supported by the Health Research Institute Marqués de Valdecilla. IDIVAL. Santander. NEXT VAL17/07 grant to José Ignacio Fortea Ormaechea. |
| Databáze: | OpenAIRE |
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