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Bassetti M, Peghin M, Carnelutti A, et al. Invasive Candida Infections in Liver Transplant Recipients: Clinical Features and Risk Factors for Mortality. Transplant Direct. 2017;3(5):e156doi: 10.1097/TXD.0000000000000673.
Bassetti, M., Peghin, M., Carnelutti, A., Righi, E., Merelli, M., Ansaldi, F., Trucchi, C., Alicino, C., Sartor, A., Wauters, J., Lagrou, K., Tascini, C., Menichetti, F., Mesini, A., De Rosa, F. G., Lagunes, L., Rello, J., Colombo, A. L., Vena, A., Munoz, P., Tumbarello, M., Sganga, G., Martin-Loeches, I., & Viscoli, C. (2017). Invasive Candida Infections in Liver Transplant Recipients: Clinical Features and Risk Factors for Mortality. Transplantation direct, 3(5), e156. https://doi.org/10.1097/TXD.0000000000000673
Bassetti, Matteo, et al. "Invasive Candida Infections in Liver Transplant Recipients: Clinical Features and Risk Factors for Mortality." Transplantation direct vol. 3,5 (2017): e156. doi: https://doi.org/10.1097/TXD.0000000000000673
Bassetti M, Peghin M, Carnelutti A, Righi E, Merelli M, Ansaldi F, Trucchi C, Alicino C, Sartor A, Wauters J, Lagrou K, Tascini C, Menichetti F, Mesini A, De Rosa FG, Lagunes L, Rello J, Colombo AL, Vena A, Munoz P, Tumbarello M, Sganga G, Martin-Loeches I, Viscoli C. Invasive Candida Infections in Liver Transplant Recipients: Clinical Features and Risk Factors for Mortality. Transplant Direct. 2017 Apr 18;3(5):e156. doi: 10.1097/TXD.0000000000000673. eCollection 2017 May. PMID: 28573191; PMCID: PMC5441987.
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Transplant Direct. 2017 Apr 18;3(5):e156. doi: 10.1097/TXD.0000000000000673. eCollection 2017 May.

Invasive Candida Infections in Liver Transplant Recipients: Clinical Features and Risk Factors for Mortality.

Transplantation direct

Matteo Bassetti, Maddalena Peghin, Alessia Carnelutti, Elda Righi, Maria Merelli, Filippo Ansaldi, Cecilia Trucchi, Cristiano Alicino, Assunta Sartor, Joost Wauters, Katrien Lagrou, Carlo Tascini, Francesco Menichetti, Alessio Mesini, Francesco G De Rosa, Leonel Lagunes, Jordi Rello, Arnaldo L Colombo, Antonio Vena, Patricia Munoz, Mario Tumbarello, Gabriele Sganga, Ignacio Martin-Loeches, Claudio Viscoli

Affiliations

  1. Infectious Diseases Clinic, Department of Medicine University of Udine and Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy.
  2. Department of Health Sciences, University of Genoa, Genoa, Italy.
  3. Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium.
  4. Department of Laboratory Medicine and National Reference Center for Mycosis, University Hospitals of Leuven, Leuven, Belgium.
  5. Department of Microbiology & Immunology Leuven, KU Leuven, Belgium.
  6. First Infecious Diseases Unit, Ospedale Cotugno, Azienda Ospedaliera dei Colli, Naples, Italy.
  7. Infectious Disease Department, Cisanello Hospital, Pisa, Italy.
  8. Infectious Diseases Unit, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy.
  9. Department of Medical Sciences, University of Torino, Torino, Italy.
  10. Critical Care, Hospital Vall d'Hebron, Institut de Recerca Vall d'Hebron-UAB, CIBERES, Barcelona, Spain.
  11. University Hospital, Universidade Federal de São Paulo, São Paulo, Brazil.
  12. Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
  13. Infectious Diseases Institute, Policlinico Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy.

PMID: 28573191 PMCID: PMC5441987 DOI: 10.1097/TXD.0000000000000673

Abstract

BACKGROUND: Invasive fungal infections remain a leading cause of morbidity and mortality among liver transplant recipients (LTRs). In this patient population, invasive Candida infections (ICIs) account for the large majority of cases. To date, only small studies and case-series analysing clinical presentation and risk factors for mortality in LTRs with ICIs are available.

METHODS: We performed a retrospective multicenter multinational study in 10 centers in Europe and Brazil. All consecutive LTRs developing ICIs during the period January 2011 to December 2013 were included in the study.

RESULTS: A total of 42 LTRs were included. Median age was 52.5 years, and 78.6% of patients were men. Viral hepatitis was the most common cause for liver transplantation (42.9%). Candidemia represented the majority of cases (24, 57.1%), followed by intra-abdominal candidiasis (18, 42.9%). Overall 30-day mortality was 23.8%, with higher mortality in patients with candidemia compared with intra-abdominal candidiasis (37.5% vs 5.6%,

CONCLUSIONS: Our study confirms the occurrence of high mortality rates in LTRs developing ICIs. Mortality rates varied according to the type of infection, with candidemia representing a risk factor for mortality. The high rates of antifungal resistance should be considered in the choice of the empiric antifungal regimen.

Conflict of interest statement

The authors declare no conflicts of interest.

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