+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Prevention of invasive fungal infections in liver transplant recipients: the role of prophylaxis with lipid formulations of amphotericin B in high-risk patients



Prevention of invasive fungal infections in liver transplant recipients: the role of prophylaxis with lipid formulations of amphotericin B in high-risk patients



Journal of Antimicrobial ChemoTherapy 52(5): 813-819



Invasive fungal infections (IFI) are associated with high mortality in liver transplant recipients. Prevention remains an elusive goal, especially for IFI caused by moulds. From January 1998, patients who fulfilled four or more variables identified as risk factors for IFI received a cumulative dose of 1-1.5 g of lipid formulations of amphotericin B (L-AmpB; AmBisome or Abelcet). The development of IFI in these patients was compared with historical patients. Two hundred and eighty liver transplant recipients were analysed over a period of 8 years. In the historical group, IFI were observed in 22 of 131 patients (17%) and invasive aspergillosis in 13 of them (10%). After January 1998, IFI were observed in nine of 149 (6%) (P < 0.01) and invasive aspergillosis in six patients (4%) (P = 0.08). In patients with four or more risk factors (high risk) for IFI, the administration of L-AmpB reduced the risk from 36% to 14% (P = 0.07), and the risk of aspergillosis from 23% to 5% (P = 0.08). Notably, prophylaxis reduced the risk of aspergillosis from 32% to 0% in dialysed patients (P = 0.03). Variables independently associated with IFI in high-risk patients were dialysis [odds ratio (OR) 3.9; 95% confidence interval (CI) 1-16.7] and surgical reintervention (OR 5.4; 95% CI 1.2-24.6), while L-AmpB was a protective factor in this multivariate analysis (OR 0.1; 95% CI 0.02-0.8). The analysis in these high-risk patients was not able to demonstrate an association between the administration of L-AmpB and higher survival. Selected risk factors are good predictors of IFI in liver transplant recipients. The administration of L-AmpB in high-risk patients is independently associated with a reduction of IFI.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 012448399

Download citation: RISBibTeXText

PMID: 14563893

DOI: 10.1093/jac/dkg450


Related references

Micafungin versus amphotericin B lipid complex for the prevention of invasive fungal infections in high-risk liver transplant recipients. Transplantation 96(6): 573-578, 2013

Preemptive prophylaxis with a lipid preparation of amphotericin B for invasive fungal infections in liver transplant recipients. Abstracts of the Interscience Conference on Antimicrobial Agents & Chemotherapy 42: 315, 2002

Preemptive prophylaxis with lipid preparation of amphotericin B for invasive fungal infections in liver transplant recipients requiring dialysis. Abstracts of the Interscience Conference on Antimicrobial Agents & Chemotherapy 40: 381, 2000

Preemptive prophylaxis with a lipid preparation of amphotericin B for invasive fungal infections in liver transplant recipients requiring renal replacement therapy. Transplantation 71(7): 910-913, 2001

Preemptive Prophylaxis With A Lipid Preparation Of Amphotericin B For Invasive Fungal Infections In Liver Transplant Recipients Requiring Renal Replacement Therapy1. Transplantation 71(7): 910-913, 2001

Prophylaxis with caspofungin for invasive fungal infections in high-risk liver transplant recipients. Transplantation 87(3): 424-435, 2009

Prospective interventional study to evaluate the efficacy and safety of liposomal amphotericin B as prophylaxis of fungal infections in high-risk liver transplant recipients. Transplantation Proceedings 37(9): 3965-3967, 2006

Randomized, double-blind trial of anidulafungin versus fluconazole for prophylaxis of invasive fungal infections in high-risk liver transplant recipients. American Journal of Transplantation 14(12): 2758-2764, 2015

Invasive fungal infections in lung transplant recipients receiving prophylactic aerosolized amphotericin B formulations. Abstracts of the Interscience Conference on Antimicrobial Agents & Chemotherapy 42: 401, 2002

Amphotericin B lipid complex in the treatment of invasive fungal infections in liver transplant patients. Transplantation Proceedings 29(6): 2670-2674, 1997

Universal prophylaxis with fluconazole for the prevention of early invasive fungal infection in low-risk liver transplant recipients. Transplantation 92(3): 346-350, 2011

Comparison of adverse events and hospital length of stay associated with various amphotericin B formulations: sequential conventional amphotericin b/lipid versus lipid-only therapy for the treatment of invasive fungal infections in hospitalized patients. P and T 38(5): 278-287, 2013

Liposomal Amphotericin B Prevents Invasive Fungal Infections In Liver Transplant Recipients. Transplantation 59(1): 45-50, 1995

Randomized double-blind study of liposomal amphotericin B (Ambisome) prophylaxis of invasive fungal infections in bone marrow transplant recipients. Bone Marrow Transplantation 12(6): 577-582, 1993

Fungal Infection Prophylaxis In Liver Transplant Recipients: The Role Of Low-Dose Amphotericin B. Transplantation 82(Suppl 2): 445-446, 2006