1. Fungal complications afterCandidapreservation fluid contamination in liver transplant recipients
- Author
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Liliana Mihaila, J.-C. Merle, Laurent Stecken, Eric Levesque, Linda Khoy-Ear, Catherine Paugam-Burtz, Martine Ferrandière, Boris Jung, Faouzi Saliba, Françoise Botterel, Centre hépato-biliaire - CHB [Paul Brousse, Paris], Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse, département d'anesthésiologie, Foie ICU, AP-HP GH Henri Mondor, Créteil, France, Hôpital Beaujon, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7), Centre hépato-biliaire (CHB), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Département d'anesthésiologie, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CHU Bordeaux [Bordeaux], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Unité de Microbiologie, G.H. Kremlin-Bicetre, Kremlin-Bicetre, France, Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université Paris-Sud - Paris 11 (UP11)-AP-HP Hôpital Paul Brousse, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Paul Brousse-Université Paris-Sud - Paris 11 (UP11), Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), and Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
- Subjects
Male ,Antifungal Agents ,[SDV]Life Sciences [q-bio] ,medicine.medical_treatment ,preservation fluid ,030230 surgery ,Liver transplantation ,Gastroenterology ,Hepatic Artery ,0302 clinical medicine ,Risk Factors ,Postoperative Period ,Candida albicans ,Candida ,Aged, 80 and over ,liver transplantation ,biology ,Mortality rate ,Incidence (epidemiology) ,Candidiasis ,Middle Aged ,3. Good health ,Research Design ,Female ,030211 gastroenterology & hepatology ,France ,Immunosuppressive Agents ,Adult ,medicine.medical_specialty ,Organ Preservation Solutions ,Peritonitis ,Context (language use) ,Young Adult ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,Clinical significance ,Aged ,Retrospective Studies ,Transplantation ,business.industry ,fungal infection ,medicine.disease ,biology.organism_classification ,Transplant Recipients ,Surgery ,aneurysm ,Equipment Contamination ,business ,Complication ,Liver Failure - Abstract
International audience; Donor-derived fungal infections can be associated with severe complications in transplant recipients. Donor-derived candidiasis has been described in kidney transplant recipients where contamination of the preservation fluid (PF) was a commonly proposed source. In liver transplantation, these fungal infections have been less explored. The aim of this study was therefore to determine the incidence and clinical relevance of Candida contamination of preservation fluid in the context of liver transplantation. A 5-year (2008-2012) retrospective multicentre study involving six French liver transplantation centers was performed to determine the incidence of Candida PF contamination. Postoperative clinical features, outcomes in recipients, and risk factors for Candida-related complications of liver transplantation were studied. Candida sp. was isolated from 28 of 2107 preservation fluid samples (1.33%). Candida albicans was the most common yeast (n = 18, 64%). Twenty-two recipients (78.5%) received antifungal therapy (echinocandins in 68%) for 7-37 days. Eight patients developed yeast-related complications (28.6%) including hepatic artery aneurysms (n = 6) and Candida peritonitis (n = 2). The 1-year mortality rate among patients after a yeast-related complication was 62.5%. The incidence of Candida PF contamination was low, but was associated with dramatic postoperative complications and high mortality. Close radiological follow-up may enable early recognition of the arterial complications associated with PF contamination by Candida.
- Published
- 2015
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