Title:Manifestations, Prevalence, Management and Outcome of Invasive Aspergillosis
in Post-Liver Transplant Patients
Volume: 19
Issue: 1
Author(s): Mohsen Aliakbarian, Rozita Khodashahi*, Kambiz Akhavan Rezayat, Hamid Reza Naderi, Mandana Khodashahi, Maziar Mortazavi Pasand, Ebrahim Khaleghi and Maliheh Dadgar Moghaddam
Affiliation:
- Fellowship in IC Host and Transplant, Clinical Research Development Unit, Imam Reza Hospital, Faculty of Medicine,
Mashhad University of Medical Sciences, Mashhad, Iran
- Transplant Research Center, Clinical Research Institute,
Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Infectious Diseases and Tropical Medicine,
Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Keywords:
Aspergillosis, fungal infections, transplant patients, voriconazole, invasive, transplantation., 61
Abstract:
Background: Aspergillosis is a severe and fatal complication that causes infection in
transplant recipients and patients with immunodeficiency syndrome, neutropenia, chronic granulomatosis,
and hematologic malignancies. Invasive Aspergillosis has been reported as one of the
fungal infections with high mortality in transplant recipients. This study aimed to describe the
manifestations, prevalence, management and outcome of invasive Aspergillosis fungal infections in
liver transplant patients.
Methods: This descriptive cross-sectional study was conducted on patients with liver transplantation
who were infected with invasive Aspergillosis fungal infections. The data were extracted from
the medical records of the archive of Montasryieh Hospital, Mashhad, Iran, between August 2019
and August 2020.
Results: In general, 86 patients who had liver transplantation were hospitalized at Montasryieh
Hospital from August 2019 to August 2020. Among them, 10 patients were infected with invasive
Aspergillosis. Only 6.7% of the patients were categorized under late-onset (> 90 days after liver
transplantation), and 93.3% of them were early-onset (< 90 days after liver transplantation). Invasive
Aspergillosis fungal infections were suspected based on clinical or radiological signs (possible
in 30% of cases; n = 3). The probable diagnosis was reported in 60% (n = 6), and the proven diagnosis
was observed only in one patient. In addition, 80% of the patients were diagnosed with Pulmonary
Aspergillosis, and two patients had pulmonary Aspergillosis in combination with the central
nervous system and cutaneous Aspergillosis. A correlation was found between a comorbid disease
and the type of Aspergillosis (r = 0.69; P = 0.02). Voriconazole was effective to treat invasive
Aspergillosis in all patients.
Conclusion: The prevalence rate of Aspergillosis is relatively high among liver transplant recipient
populations (11%). All recipients infected with Aspergillosis had at least one risk factor, including
an underlying disease. It seems that Voriconazole therapy is effective among transplant patients
with pulmonary Aspergillosis.
