Risk factors for invasive aspergillosis in living donor liver transplant recipients
Risk factors for invasive aspergillosis in living donor liver transplant recipients
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DOI：
10.1002/lt.21099
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发表时间：
2007-04-01
影响因子：
4.6
通讯作者：
Mishima, Michiaki
中科院分区：
文献类型：
--
作者：
Osawa, Makoto;Ito, Yutaka;Mishima, Michiaki
侵袭性曲霉病是肝移植术后的严重并发症。死亡供体肝移植（DDLT）后IA的危险因素已在几份报告中提出，但对于活体供体肝移植受者还没有很好的确定。在此，进行了回顾性病例对照研究。1999年1月至2002年12月在京都大学医院对5例IA患者进行了活体肝移植（LDLT）后的研究。作为比较，无IA的活体肝移植受者被作为对照。这些患者在每例IA病例之前或之后1个月接受LDLT，并且具有与后者相同的生存时间。我们评估了两组的临床和实验室结果，直到他们死亡。LDLT后IA患者预后极差。通过单因素分析，IA的危险因素是术前重症监护室停留时间（P = 0.02）和术前类固醇给药（P = 0.02）。重型肝炎术前激素治疗可能易导致LDLT后IA的发生。
Invasive aspergillosis (IA) is a severe complication of liver transplantation. Risk factors for IA after deceased donor liver transplantation (DDLT) have been presented in several reports, but are not well established for living donor liver transplant recipients. Here, a retrospective case-control study was performed. Five cases with IA were investigated after living donor liver transplantation (LDLT) between January 1999 and December 2002 at Kyoto University Hospital. For comparison, living donor liver transplant recipients without IA were taken as controls. These patients had undergone LDLT 1 month before or after each IA case and had the same survival times as the latter. We evaluated the clinical and laboratory findings for both groups up until their demise. Patients with IA after LDLT had a very poor prognosis. By univariate analysis, risk factors for IA were preoperative intensive care unit stay (P = 0.02) and preoperative steroid administration (P = 0.02). Preoperative steroid administration for fulminant hepatitis possibly predisposed to the development of IA after LDLT.