Retrospective study evaluating the performance of risk factors for invasive mold infections in liver transplantation
| Autor: | Kyle D. Brizendine, Karyna M Neyra |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Antifungal Agents medicine.medical_treatment 030230 surgery Liver transplantation Single Center Cohort Studies 03 medical and health sciences 0302 clinical medicine Fulminant hepatic failure Risk Factors Internal medicine medicine Humans Renal replacement therapy Aged Retrospective Studies Transplantation Aspergillus biology business.industry Incidence (epidemiology) Incidence Retrospective cohort study Middle Aged biology.organism_classification Liver Transplantation Infectious Diseases Number needed to treat 030211 gastroenterology & hepatology Female business Invasive Fungal Infections |
| Zdroj: | Transplant infectious disease : an official journal of the Transplantation SocietyREFERENCES. 22(1) |
| ISSN: | 1399-3062 |
| Popis: | Background Mold infections in liver transplant are associated with high mortality. Guidelines recommend prophylaxis targeted against mold based upon risk factors of fulminant hepatic failure, retransplantation, reoperation, and renal replacement therapy post-transplant. It is not known if these factors identify risk of mold infection at every center. Methods A retrospective study was conducted of adult liver transplant recipients at a single center from 2010 to 2014. The association between risk factors and invasive mold infection and effect of antifungal prophylaxis were determined. Results Five hundred thirty-four liver transplant recipients were identified. The overall incidence of invasive mold infection was 0.9% (N = 5). The incidence in patients with (N = 128) and without (N = 406) risk factors was 0.78% and 0.98%, respectively. Antifungal prophylaxis with mold activity was administered to 23/128 (18%) with risk factors, and none developed infection. No mold-active prophylaxis was given to 105/128 (82%) with risk factors, and incidence of mold infection was 0.95% (N = 1). Number needed to treat was 105. Conclusions Traditional risk factors for mold infection in liver transplant performed poorly. These results underscore the importance of transplant center-specific data to inform adoption of an antifungal prophylactic strategy. Studies are needed to determine alternative risk factors to facilitate appropriate targeting of antifungals. |
| Databáze: | OpenAIRE |
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