Fungal complications after Candida preservation fluid contamination in liver transplant recipients.

Abstract

Donor-derived fungal infections can be associated with severe complications in transplant recipients. Donor-derived candidiasis has been described in kidney transplant recipients where contamination of the preservation fluid (PF) was a commonly proposed source. In liver transplantation, these fungal infections have been less explored. The aim of this study was therefore to determine the incidence and clinical relevance of Candida contamination of preservation fluid in the context of liver transplantation. A 5-year (2008-2012) retrospective multicentre study involving six French liver transplantation centers was performed to determine the incidence of Candida PF contamination. Postoperative clinical features, outcomes in recipients, and risk factors for Candida-related complications of liver transplantation were studied. Candida sp. was isolated from 28 of 2107 preservation fluid samples (1.33%). Candida albicans was the most common yeast (n = 18, 64%). Twenty-two recipients (78.5%) received antifungal therapy (echinocandins in 68%) for 7-37 days. Eight patients developed yeast-related complications (28.6%) including hepatic artery aneurysms (n = 6) and Candida peritonitis (n = 2). The 1-year mortality rate among patients after a yeast-related complication was 62.5%. The incidence of Candida PF contamination was low, but was associated with dramatic postoperative complications and high mortality. Close radiological follow-up may enable early recognition of the arterial complications associated with PF contamination by Candida.

• Authors: Eric Levesque, Catherine Paugam-Burtz, Faouzi Saliba, Linda Khoy-Ear, Jean-Claude Merle, Boris Jung, Laurent Stecken, Martine Ferrandiere, Liliana Mihaila, Francoise Botterel
• Journal: Transplant international : official journal of the European Society for Organ Transplantation (Transpl Int) Vol. 28 Issue 11 Pg. 1308-16 (Nov 2015) ISSN: 1432-2277 [Electronic] Switzerland
• PMID: 26147662 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © 2015 Steunstichting ESOT.

Chemical References

• Antifungal Agents
• Immunosuppressive Agents
• Organ Preservation Solutions

Topics

• Adult
• Aged
• Aged, 80 and over
• Aneurysm
• Antifungal Agents (therapeutic use)
• Candida
• Candidiasis (complications)
• Equipment Contamination
• Female
• France
• Hepatic Artery (pathology)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Liver Failure (surgery)
• Liver Transplantation (adverse effects)
• Male
• Middle Aged
• Organ Preservation Solutions (adverse effects)
• Peritonitis (microbiology)
• Postoperative Period
• Research Design
• Retrospective Studies
• Risk Factors
• Transplant Recipients
• Young Adult