EARLY DETECTION OF INVASIVE PULMONARY FUNGAL INFECTIONS AFTER LIVER TRANSPLANTATION

Abstract

Background The incidence of invasive fungal infections (IFIs), particularly candidiasis and aspergillosis, following solid organ transplantation vary from 1.4% to 42%. Mortality related to IFIs depends on the type of transplant and vary from 3% to 100% of cases. The results largely depend on early initiation of specific treatment for IFIs. Therefore, the diagnosis has to be prompt and based on known risk factors – time of surgical procedure,blood loss, rate of rejection and retransplantation. Aim of work To describe the epidemiology and clinical features of the most common fungal infections after liver transplantation Within this context, we review recent advances in diagnostic modalities and antifungal chemotherapy, and their impact on evolving prophylaxis and treatment paradigms. Material/Methods: This study was performed at the Liver Transplantation Unit, Wadi El Nile Hospital. All liver transplant recipients from March 2012 to January 2014 were included. Fifty consecutive patients undergoing liver transplantation were prospectively observed for fungal infections. The risk factors that were analyzed included age, sex, underlying liver diagnosis, clinical status and laboratory values before transplantation, antibiotic use before and after surgery, total surgical time ,immunosuppression, and the amount of blood products used The detection of fungal antigen in blood by ELISA. Results: Sixteen patients (32% of the total group) had 19 episodes of fungal infection .Infections by Aspergillus (31%), Candida (87.7%). Conclusions: Early diagnosis and prompt treatment is fundament