Fungal complications afterCandidapreservation fluid contamination in liver transplant recipients

Autor: Liliana Mihaila, J.-C. Merle, Laurent Stecken, Eric Levesque, Linda Khoy-Ear, Catherine Paugam-Burtz, Martine Ferrandière, Boris Jung, Faouzi Saliba, Françoise Botterel
Přispěvatelé: Centre hépato-biliaire - CHB [Paul Brousse, Paris], Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse, département d'anesthésiologie, Foie ICU, AP-HP GH Henri Mondor, Créteil, France, Hôpital Beaujon, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7), Centre hépato-biliaire (CHB), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Département d'anesthésiologie, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CHU Bordeaux [Bordeaux], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Unité de Microbiologie, G.H. Kremlin-Bicetre, Kremlin-Bicetre, France, Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université Paris-Sud - Paris 11 (UP11)-AP-HP Hôpital Paul Brousse, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Paul Brousse-Université Paris-Sud - Paris 11 (UP11), Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Rok vydání: 2015
Předmět:
Male
Antifungal Agents
[SDV]Life Sciences [q-bio]
medicine.medical_treatment
preservation fluid
030230 surgery
Liver transplantation
Gastroenterology
Hepatic Artery
0302 clinical medicine
Risk Factors
Postoperative Period
Candida albicans
Candida
Aged
80 and over
liver transplantation
biology
Mortality rate
Incidence (epidemiology)
Candidiasis
Middle Aged
3. Good health
Research Design
Female
030211 gastroenterology & hepatology
France
Immunosuppressive Agents
Adult
medicine.medical_specialty
Organ Preservation Solutions
Peritonitis
Context (language use)
Young Adult
03 medical and health sciences
Internal medicine
medicine
Humans
Clinical significance
Aged
Retrospective Studies
Transplantation
business.industry
fungal infection
medicine.disease
biology.organism_classification
Transplant Recipients
Surgery
aneurysm
Equipment Contamination
business
Complication
Liver Failure
Zdroj: Transplant International
Transplant International, Wiley, 2015, 28 (11), pp.1308-1316. ⟨10.1111/tri.12633⟩
ISSN: 0934-0874
1432-2277
DOI: 10.1111/tri.12633
Popis: International audience; Donor-derived fungal infections can be associated with severe complications in transplant recipients. Donor-derived candidiasis has been described in kidney transplant recipients where contamination of the preservation fluid (PF) was a commonly proposed source. In liver transplantation, these fungal infections have been less explored. The aim of this study was therefore to determine the incidence and clinical relevance of Candida contamination of preservation fluid in the context of liver transplantation. A 5-year (2008-2012) retrospective multicentre study involving six French liver transplantation centers was performed to determine the incidence of Candida PF contamination. Postoperative clinical features, outcomes in recipients, and risk factors for Candida-related complications of liver transplantation were studied. Candida sp. was isolated from 28 of 2107 preservation fluid samples (1.33%). Candida albicans was the most common yeast (n = 18, 64%). Twenty-two recipients (78.5%) received antifungal therapy (echinocandins in 68%) for 7-37 days. Eight patients developed yeast-related complications (28.6%) including hepatic artery aneurysms (n = 6) and Candida peritonitis (n = 2). The 1-year mortality rate among patients after a yeast-related complication was 62.5%. The incidence of Candida PF contamination was low, but was associated with dramatic postoperative complications and high mortality. Close radiological follow-up may enable early recognition of the arterial complications associated with PF contamination by Candida.
Databáze: OpenAIRE
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