Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.17/2170
Título: Prophylactic Use of Liposomal Amphotericin B in Preventing Fungal Infections Early After Liver Transplantation: a Retrospective, Single-Center Study
Autor: Antunes, AM
Teixeira, C
Corvo, ML
Perdigoto, R
Barroso, E
Marcelino, P
Palavras-chave: HCC CHBPT
Retrospective Studies
Amphotericin B/administration & dosage
Antifungal Agents/administration & dosage
Dose-Response Relationship, Drug
Infusions, Intravenous
Incidence
Liver Transplantation
Mycoses/epidemiology
Mycoses/prevention & control
Reoperation
Data: 2014
Editora: Elsevier
Citação: Transplant Proc. 2014 Dec;46(10):3554-9
Resumo: In this study the authors evaluated the efficacy of prophylaxis with liposomal amphotericin B (L-AmB) in the incidence of fungal infections (FI) during the first 3 months after liver transplant (LT). The study was retrospective and accessed a 4-year period from 2008 to 2011. All patients who died in the first 48 hours after LT were excluded. Patients were divided by the risk groups for FI: Group 1, high-risk (at least 1 of the following conditions: urgent LT; serum creatinine >2 mg/dL; early acute kidney injury [AKI] after LT; retransplantation; surgical exploration early post-LT; transfused cellular blood components [>40 U]); and Group 2, low-risk patients. Group 1 patients were further separated into those who received antifungal prophylaxis with L-AmB and those who did not. Prophylaxis with L-AmB consisted of intravenous administration of L-AmB, 100 mg daily for 14 days. Four hundred ninety-two patients underwent LT; 31 died in the first 48 hours after LT. From the remaining 461 patients, 104 presented with high-risk factors for FI (Group 1); of these, 66 patients received antifungal prophylaxis and 38 did not. In this group 8 FI were observed, 5 in patients without antifungal prophylaxis (P = .011). Three more FI were identified in Group 2. By logistic regression analysis, the categorical variable high-risk group was independently related to the occurrence of invasive FI (P = .006). We conclude that prophylaxis with L-AmB after LT was effective in reducing the incidence of FI. No influence on mortality was detected.
Peer review: yes
URI: http://hdl.handle.net/10400.17/2170
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