論文

2021年

Invasive pulmonary aspergillosis after liver transplantation: lessons from successfully treated cases and review of the literature

Surgery Today
  • Abe K
  • ,
  • Shinoda M
  • ,
  • Uno S
  • ,
  • Obara H
  • ,
  • Kitago M
  • ,
  • Abe Y
  • ,
  • Hishida T
  • ,
  • Yagi H
  • ,
  • Hasegawa Y
  • ,
  • Kitagawa Y

51
8
開始ページ
1361
終了ページ
1370
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s00595-021-02263-z
出版者・発行元
Surgery Today

Purpose: Invasive pulmonary aspergillosis (IPA) after liver transplantation (LT) is most often fatal. We analyzed the outcomes of IPA in a single center. Methods: We reviewed, retrospectively, the medical records of recipients of living donor LT (LDLT) or deceased donor LT (DDLT) performed between 1995 and 2019 at our institute. We analyzed the incidence of IPA and assessed the treatment courses of patients treated successfully and those not treatment successfully. Results: Among 326 recipients, IPA was diagnosed in 6 (1.8%). The incidence of IPA was significantly higher in patients with acute liver failure (ALF, 9.8%) than in those without ALF (0.4%), after DDLT (8.8%) than after LDLT (1.0%), and in recipients who received preoperative steroid pulse therapy (16.0%) than in those who did not (0.7%). Complete cure of IPA was achieved in the most recent three patients, by administering voriconazole immediately after the diagnosis of IPA and performing lung resection, while the IPA lesion was single and localized. Conclusions: Patients with risk factors for IPA must be monitored closely. Our three successfully treated cases demonstrate that initiating immediate voriconazole treatment and making a calculated decision about lung resection can contribute to a favorable outcome.

リンク情報
DOI
https://doi.org/10.1007/s00595-021-02263-z
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/33738584
URL
https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85102653929&origin=inward
ID情報
  • DOI : 10.1007/s00595-021-02263-z
  • ISSN : 0941-1291
  • PubMed ID : 33738584

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