Antifungal management practices in liver transplant recipients

N. Singh*, M. M. Wagener, T. V. Cacciarelli, J. Levitsky

*Corresponding author for this work

Research output: Contribution to journalArticle

75 Scopus citations

Abstract

We sought to determine the approach to antifungal prophylaxis, and diagnostic and therapeutic practices for the management of invasive aspergillosis in liver transplant recipients. Data were collected by an electronic survey questionnaire sent to all active liver transplant programs in North America; 63% (67/106) of the sites completed the survey. Overall, 91% of the sites employed antifungal prophylaxis; 28% used universal prophylaxis and 72% targeted it toward high-risk patients. Fluconazole was the most commonly used agent for universal and targeted prophylaxis. The leading choice for mold-active agents for antifungal prophylaxis was the echinocandins. Combination therapy was used as primary therapy for invasive aspergillosis in 47%, and as salvage in 80%. Thus, a vast majority of the surveyed programs employ antifungal prophylaxis and most use targeted prophylaxis. Consideration of these practices could guide clinical trial design to optimize antifungal prophylaxis in these patients. Our findings also merit investigations to better define the role of diagnostic assays and combination therapeutic strategies for invasive aspergillosis in liver transplant recipients.

Original languageEnglish (US)
Pages (from-to)426-431
Number of pages6
JournalAmerican Journal of Transplantation
Volume8
Issue number2
DOIs
StatePublished - Feb 1 2008

Keywords

  • Aspergillosis
  • Fungal infections
  • Prophylaxis
  • Transplants

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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