CLINICAL SPECTRUM OF FUNGAL-INFECTIONS AFTER ORTHOTOPIC LIVER-TRANSPLANTATION
CLINICAL SPECTRUM OF FUNGAL-INFECTIONS AFTER ORTHOTOPIC LIVER-TRANSPLANTATION
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DOI：
10.1001/archsurg.1991.01410260033005
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发表时间：
1991-02-01
影响因子：
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通讯作者：
SHAW, BW
中科院分区：
文献类型：
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作者：
CASTALDO, P;STRATTA, RJ;SHAW, BW
在50个月的时间里，我们在72例肝移植受者中发现了91例真菌感染（23.8%）。念珠菌占病例总数的83.5%。真菌感染的临床类型包括播散性感染（19例）、腹膜炎（17例）、肺炎（15例）、多部位定植（13例）、真菌血症（11例）和其他部位（16例）。真菌感染的诊断通常在移植后的前2个月（84.7%），平均时间为移植后16天。真菌感染的危险因素包括再移植。风险评分，术中输血需求，紧急情况，Roux肢体胆道重建（成人），类固醇剂量，细菌感染和抗生素治疗，血管并发症。两性霉素B成功治疗真菌感染63例（74.1%），但与患者生存率降低相关（50%对83.5%）。真菌感染是早期发病的常见来源，可能与明确的危险因素有关，这表明需要有效的预防。
During a 50-month period, we identified 91 episodes of fungal infection in 72 liver transplant recipients (23.8%). Candida species accounted for 83.5% of cases. Clinical patterns of fungal infections included disseminated infection (19), peritonitis (17), pneumonitis (15), multiple sites of colonization (13), fungemia (11), and other sites (16). The diagnosis of fungal infection was usually made in the first 2 months (84.7% of cases), at a mean time of 16 days after transplantation. Risk factors for fungal infections included retransplantation. Risk score, intraoperative transfusion requirement, urgent status, Roux limb billary reconstruction (in adults), steroid dose, bacterial infections and antibiotic therapy, and vascular complications. Fungal infections were successfully treated with amphotericin B in 63 cases (74.1%) but were associated with diminished patient survival (50% vs 83.5%). Fungal infection is a frequent source of early morbidity and can be related to well-defined risk factors, suggesting the need for effective prophylaxis.