Prophylactic use of liposomal amphotericin B in preventing fungal infections early after liver transplantation: a retrospective, single-center study
| Autor: | C. Teixeira, M.L. Corvo, A.M. Antunes, Rui Perdigoto, Eduardo Barroso, Paulo Marcelino |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Mycoses/prevention & control Antifungal Agents medicine.medical_treatment Liver transplantation Amphotericin B/administration & dosage Single Center chemistry.chemical_compound Internal medicine Amphotericin B medicine Humans Infusions Intravenous Retrospective Studies Transplantation Creatinine Dose-Response Relationship Drug business.industry Incidence (epidemiology) Incidence Acute kidney injury Retrospective cohort study Middle Aged medicine.disease Surgery HCC CHBPT Liver Transplantation chemistry Mycoses Liposomal amphotericin Antifungal Agents/administration & dosage Female Mycoses/epidemiology business medicine.drug |
| Zdroj: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) Agência para a Sociedade do Conhecimento (UMIC)-FCT-Sociedade da Informação instacron:RCAAP |
| ISSN: | 1873-2623 |
| Popis: | In this study the authors evaluated the efficacy of prophylaxis with liposomal amphotericin B (L-AmB) in the incidence of fungal infections (FI) during the first 3 months after liver transplant (LT). The study was retrospective and accessed a 4-year period from 2008 to 2011. All patients who died in the first 48 hours after LT were excluded. Patients were divided by the risk groups for FI: Group 1, high-risk (at least 1 of the following conditions: urgent LT; serum creatinine >2 mg/dL; early acute kidney injury [AKI] after LT; retransplantation; surgical exploration early post-LT; transfused cellular blood components [>40 U]); and Group 2, low-risk patients. Group 1 patients were further separated into those who received antifungal prophylaxis with L-AmB and those who did not. Prophylaxis with L-AmB consisted of intravenous administration of L-AmB, 100 mg daily for 14 days. Four hundred ninety-two patients underwent LT; 31 died in the first 48 hours after LT. From the remaining 461 patients, 104 presented with high-risk factors for FI (Group 1); of these, 66 patients received antifungal prophylaxis and 38 did not. In this group 8 FI were observed, 5 in patients without antifungal prophylaxis (P = .011). Three more FI were identified in Group 2. By logistic regression analysis, the categorical variable high-risk group was independently related to the occurrence of invasive FI (P = .006). We conclude that prophylaxis with L-AmB after LT was effective in reducing the incidence of FI. No influence on mortality was detected. |
| Databáze: | OpenAIRE |
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