Fungal complications after Candida preservation fluid contamination in liver transplant recipients

Eric Levesque 1, 2 Catherine Paugam-Burtz 3, 4 Faouzi Saliba 5 Linda Khoy-Ear 3 Jean-Claude Merle 6 Boris Jung 7, 8 Laurent Stecken 9 Martine Ferrandiere 10 Liliana Mihaila 11 Françoise Botterel 12
1 Centre hépato-biliaire - CHB [Paul Brousse, Paris]
2 département d'anesthésiologie, Foie ICU, AP-HP GH Henri Mondor, Créteil, France
3 Hôpital Beaujon
4 UPD7 - Université Paris Diderot - Paris 7
5 CHB - Centre hépato-biliaire
6 Département d'anesthésiologie,
7 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
8 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
9 CHU Bordeaux [Bordeaux]
10 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
11 Unité de Microbiologie, G.H. Kremlin-Bicetre, Kremlin-Bicetre, France
12 UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12
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.
Keywords : Candida aneurysm fungal infection liver transplantation preservation fluid
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https://hal.umontpellier.fr/hal-01761272
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Soumis le : lundi 3 février 2020 - 15:59:33
Dernière modification le : vendredi 7 février 2020 - 01:24:11

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CNRS | UNIV-PARIS7 | BS | UPEC-UPEM | UPEC | UNIV-MONTPELLIER | USPC | UNIV-PARIS-SACLAY

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Eric Levesque, Catherine Paugam-Burtz, Faouzi Saliba, Linda Khoy-Ear, Jean-Claude Merle, et al.. Fungal complications after Candida preservation fluid contamination in liver transplant recipients. Transplant International, Wiley, 2015, 28 (11), pp.1308 - 1316. ⟨10.1111/tri.12633⟩. ⟨hal-01761272⟩

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