{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T20:43:25Z","timestamp":1773434605286,"version":"3.50.1"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","license":[{"start":{"date-parts":[[2012,9,1]],"date-time":"2012-09-01T00:00:00Z","timestamp":1346457600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2012,8,27]],"date-time":"2012-08-27T00:00:00Z","timestamp":1346025600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2012,9]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>Invasive fungal infections (IFIs) are associated with a high mortality rate for liver transplantation (LT) recipients. To study the incidence of and risk factors for IFIs in LT recipients and the associated mortality rates, we retrospectively reviewed the records of first-time deceased donor LT recipients (January 2003 to December 2007). The incidence of IFIs was 12%. Non-<jats:italic toggle=\"yes\">albicans<\/jats:italic>\n                                 <jats:italic toggle=\"yes\">Candida<\/jats:italic> species accounted for 55% of IFIs; 50% of these IFIs were <jats:italic toggle=\"yes\">Candida parapsilosis<\/jats:italic>. Only 43% of <jats:italic toggle=\"yes\">Candida<\/jats:italic> isolates were fluconazole-susceptible (minimum inhibitory concentration \u2264 8 \u03bc\/mL). All <jats:italic toggle=\"yes\">C. parapsilosis<\/jats:italic> isolates were fluconazole-resistant, and this coincided with a surge of these isolates during a peak period of LT. Factors associated with IFIs included a creatinine level &gt; 2 mg\/mL [hazard ratio (OR) = 2.4, 95% confidence interval (CI) = 1.2-5.0, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.01], a Model for End-Stage Liver Disease score &gt; 25 (OR = 2.4, 95% CI = 1.2-4.9, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.02), pretransplant fungal colonization (OR = 7.0, 95% CI = 3.2-15.3, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001), and a daily prophylactic fluconazole dosage &lt; 200 mg (OR = 2.8, 95% CI = 1.1-7.4, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.03). According to a multivariate analysis, only pretransplant fungal colonization was associated with IFIs (OR = 7.8, 95% CI = 3.9-16.2, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001). The 1-year patient survival rates with and without IFIs were 41% and 80%, respectively, and the survival rates with <jats:italic toggle=\"yes\">C. parapsilosis<\/jats:italic>, other non-<jats:italic toggle=\"yes\">albicans<\/jats:italic>\n                                 <jats:italic toggle=\"yes\">Candida<\/jats:italic>, and <jats:italic toggle=\"yes\">Candida albicans<\/jats:italic> IFIs were 28%, 50%, and 75%, respectively. In conclusion, IFIs after LT (especially non-<jats:italic toggle=\"yes\">albicans<\/jats:italic>\n                                 <jats:italic toggle=\"yes\">Candida<\/jats:italic> species and fluconazole-resistant <jats:italic toggle=\"yes\">C. parapsilosis<\/jats:italic>) were associated with reduced survival. The risk factors highlight the importance of pretransplant risk assessments. The identification of pretransplant fungal colonization may allow for risk modifications before or at the time of LT. Additionally, the number of LT procedures and prophylactic strategies may affect institutional outbreaks of resistant <jats:italic toggle=\"yes\">Candida<\/jats:italic> strains. Liver Transpl, 2012. \u00a9 2012 AASLD.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/lt.23467","type":"journal-article","created":{"date-parts":[[2012,5,10]],"date-time":"2012-05-10T11:53:46Z","timestamp":1336650826000},"page":"1100-1109","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":72,"title":["Invasive fungal infections following liver transplantation: Incidence, risk factors, survival, and impact of fluconazole-resistant Candida parapsilosis (2003-2007)"],"prefix":"10.1097","volume":"18","author":[{"given":"Anupama","family":"Raghuram","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro","family":"Restrepo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saman","family":"Safadjou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Cooley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Orloff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dwight","family":"Hardy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sam","family":"Butler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine E.","family":"Koval","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-14-20250124","doi-asserted-by":"crossref","first-page":"644652","DOI":"10.1093\/infdis\/170.3.644","article-title":"Risk factors for invasive fungal infections complicating orthotopic liver transplantation.","volume":"170","author":"Collins","year":"1994","journal-title":"J Infect Dis"},{"key":"R2-14-20250124","doi-asserted-by":"crossref","first-page":"375382","DOI":"10.1007\/BF02114892","article-title":"Risk factors for systemic fungal infections in liver transplant recipients.","volume":"14","author":"Briegel","year":"1995","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"R3-14-20250124","doi-asserted-by":"crossref","first-page":"132143","DOI":"10.1097\/00005792-198803000-00006","article-title":"Infections after liver transplantation. 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Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America.","volume":"48","author":"Pappas","year":"2009","journal-title":"Clin Infect Dis"},{"key":"RU10-14-20250124","doi-asserted-by":"crossref","first-page":"386391","DOI":"10.1111\/j.1600-6143.2005.01176.x","article-title":"Invasive fungal infections in lowrisk liver transplant recipients: a multicenter prospective observational study.","volume":"6","author":"Pappas","year":"2006","journal-title":"Am J Transplant"},{"key":"R11-14-20250124","doi-asserted-by":"crossref","first-page":"106113","DOI":"10.1016\/S0002-9343(97)80021-6","article-title":"The independent role of cytomegalovirus as a risk factor for invasive fungal disease in orthotopic liver transplant recipients. Boston Center for Liver Transplantation CMVIGStudy Group. Cytogam, MedImmune, Inc. 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Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: an international consensus.","volume":"34","author":"Ascioglu","year":"2002","journal-title":"Clin Infect Dis"},{"key":"R18-14-20250124","doi-asserted-by":"crossref","first-page":"11011111","DOI":"10.1086\/651262","article-title":"Invasive fungal infections among organ transplant recipients: results of the TransplantAssociated Infection Surveillance Network (TRANSNET).","volume":"50","author":"Pappas","year":"2010","journal-title":"Clin Infect Dis"},{"key":"R19-14-20250124","doi-asserted-by":"crossref","first-page":"4652","DOI":"10.1086\/345441","article-title":"Trends in risk profiles for and mortality associated with invasive aspergillosis among liver transplant recipients.","volume":"36","author":"Singh","year":"2003","journal-title":"Clin Infect Dis"},{"issue":"suppl 1","key":"R20-14-20250124","first-page":"1123","article-title":"; for International Fungal Surveillance Participant Group. 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