Amphotericin B as antifungal prophylaxis in liver transplantation

Talento A., McDermott S., Gilleece A., McCormick A., Fenelon L., Schaffer K.

Author address: 

NULL

Abstract: 

Objective: The rate of fungal infections in orthotopic liver transplant (OLT) patients ranges from 5 42%. Antifungal prophylaxis has been shown to decrease the incidence of fungal infections. In this study, we wanted to analyse the efficacy of liposomal/lipid complex amphotericin B as universal antifungal prophylaxis in OLT patients Methods: We conducted a retrospective chart review of OLT patients who were treated for fungal infections over a 15year time period from January 1993 to December 2007. Two separate time periods were analyzed: 1. From 1993 to 1999, 71% of patients received fluconazole, 10% liposomal amphotericin B, 15% oral amphotericin B and 3% received both fluconazole and amphotericin B as antifungal prophylaxis; 2. From 2000 to 2007, liposomal or lipid complex amphotericin B was given for universal antifungal prophylaxis due to building works that commenced in the hospital early in 2000. Only patients who did not tolerate liposomal amphotericin B were given lipid complex amphotericin B as prophylaxis(10%). Results: There were a total of 506 OLTs performed on 463 patients during the 15year period. One hundred thirty six OLTs were performed in 117 patients during the first period while there were 370 liver transplants in 346 patients in the second period. During the first period, 21 patients out of 117(18%) were treated for fungal infections compared to 21 patients out of 346 (6.1%) during the second period. This is a significant decrease in fungal infections between the two time periods (chi square 15.03, p value
2009

abstract No: 

P 1776

Full conference title: 

19th European Congress of Clinical Microbiology and Infectious Diseases
    • ECCMID 19th (2009)