Abstract:Objective The goal of the current study was to determine the characteristics of fungal infection in liver transplant recipients, analyze the associated risk factors, and to further examine prophylactic measures taken to prevent such infections. Methods One hundred and ninety five liver transplant recipients were retrospectively studied in the Liver Transplant Center between January 2003 to January 2005. Results Fungal infection occurred in 25 of 195 recipients with the morbidity rate of 12.7%. Forty strains of fungi were isolated including 25 cases of Candida albicans (62.5%), 9 cases of C. glabrata (22.5%), 5 cases of C. tropicalis (12.5%) and 1 case of C. guilliermondii (2.5%). The majority of infections occurred in the respiratory tract (49%). Compared to the control group, the most common risk factors associated with fungal infection in liver transplant recipients were (1) long-term administration of broad-spectrum antibiotics both pre-and post-operation, (2) the total number of days the patient stayed in the hospital, (3) the amount of time a vein catheter had to remain in place, (4) the counts of white blood cells and neutrophil cells 24 hours post-operation, (5) the levels of the total and direct bilirubin and (6) the total volume of blood received during the operation. Three out of 195 recipients (12%) died as a result of fungal infection. Conclusion Multiple risk factors can lead to a fungal infection after liver transplantation. Results from this study indicate that certain preventative measure must be taken in order to eliminate or reduce the severity and/or occurence of fungal infections following liver transplantation including narrowing the course of broad spectrum antibiotics, adopting an strict indication of vein puncture, shortening the number of days a vein catheter stays in place, and post-operation monitoring white blood cell counts and hepatic function.
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