Scientific article
English

Invasive aspergillosis in liver transplant recipients in the current era

Published inAmerican journal of transplantation, vol. 24, no. 11, p. 2092-2107
Publication date2024-11
First online date2024-05-25
Abstract

Invasive aspergillosis (IA) is a rare but fatal disease among liver transplant recipients (LiTRs). We performed a multi-center 1:2 case-control study comparing LiTRs diagnosed with proven/probable IA and controls with no invasive fungal infection. We included 62 IA cases and 124 matched controls. Disseminated infection occurred only in eight cases (13%). 12-week all-cause mortality of IA was 37%. In multivariate analyses, systemic antibiotics usage (adjusted odds ratio [aOR], 4.74; p=0.03) and history of pneumonia (aOR, 48.7; p=0.01) were identified as independent risk factors associated with the occurrence of IA. Moreover, reoperation (aOR, 5.99; p=0.01), systemic antibiotics usage (aOR, 5.03; p=0.04), and anti-mold prophylaxis (aOR, 11.9; p=0.02) were identified as independent risk factors associated with the occurrence of early IA. Among IA cases, Aspergillus colonization (adjusted hazard ration [aHR], 86.9; p<0.001), ICU stay (aHR, 3.67; p=0.02), disseminated IA (aHR, 8.98; p<0.001), and dialysis (aHR, 2.93; p=0.001) were identified as independent risk factors associated with 12-week all-cause mortality; while recent receipt of tacrolimus (aHR, 0.11; p=0.001) was protective. Mortality among LiTRs with IA remains high in the current era. The identified risk factors and protective factors may be useful for establishing robust targeted anti-mold prophylactic and appropriate treatment strategies against IA.

Keywords
  • Invasive aspergillosis
  • Liver transplantation
  • Targeted antifungal prophylaxis
Citation (ISO format)
KIMURA, Muneyoshi et al. Invasive aspergillosis in liver transplant recipients in the current era. In: American journal of transplantation, 2024, vol. 24, n° 11, p. 2092–2107. doi: 10.1016/j.ajt.2024.05.016
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Journal ISSN1600-6135
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