Başkent Üniversitesi Yayınları

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Subject: search.filters.subject.Fungal infection

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    Determining the Incidence of Aspergillosis After Liver Transplant
    (Başkent Üniversitesi, 2010-09) Badiee, Parisa; Shakiba, Elaheh; Nikeghbalian, Saman; Malekhosseini, Seyed Ali; Alborzi, Abdolvahab
    Objectives: Aspergillus has become an increasingly frequent cause of life-threatening opportunistic infections in liver transplant recipients. This study seeks to determine the incidence of invasive aspergillosis in liver transplant recipients using routine and molecular methods in a teaching hospital in Shiraz, the unique center for liver transplant in Iran. Materials and Methods: Four hundred eight recipients who underwent liver transplant were followed for Aspergillus infections by microscopic examination, culture, and nested polymerase chain reaction. Blood samples were cultured by bedside inoculation to BACTEC medium. Results: The female-to-male ratio was 151:257 (mean age, 29.6 years; mean hospitalization, 26 days). Sensitivity and specificity of the nested polymerase chain reaction was 92.8% and 94%. Aspergillosis was detected in 19 recipients (4.6%) by routine and molecular method (4 proven, 10 probable, and 5 possible) of whom 12 recipients died (63.2%). Conclusions: This study found the incidence rate of invasive aspergillosis as an uncommon complication of liver transplant recipient cases but associated with poor outcomes. The rate is consistent with those reported in previous studies, but molecular assay that is more-sensitive and specific was used in the present study.
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    Outcome of Mucormycosis in Liver Transplantation: Four Cases and a Review of Literature
    (Başkent Üniversitesi, 2003-12) Davari, Hamid Reza; Malekhossini, Seyed Ali; Salahi, Heshmato-allah; Bahador, Ali; Saberifirozi, Mehdi; Geramizadeh, Bita; Lahsaee, Seyed Masoud; Khosravi, Mohammad Bagher; Imanieh, Mohammad Hadi; Bagheri, Mohammad Hadi
    Mucormycosis is a rare but highly invasive fungal infection that occurs in transplant recipients. The literature contains descriptions of 12 cases of mucormycosis after orthotopic liver transplantation (OLT). This report describes the fatal courses in four patients at our center who developed mucormycosis after liver transplantation. Of 51 liver transplant recipients who received grafts between December 1993 and April 2003, 4 (7.8%; 3 males and 1 female) developed mucormycosis. The primary liver diseases in the four cases were Wilson’s disease, autoimmune hepatitis, primary biliary cirrhosis, and cryptogenic cirrhosis. Three of the transplants were harvested by another team and shipped to our center. We concluded that selection of poor transplant candidates, prolonged antibiotic therapy and/or hospitalization prior to OLT, and breaks in aseptic technique during harvesting, shipping, and during operation are the main reasons for the high incidence of mucormycosis in our OLT patients.