{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T15:58:02Z","timestamp":1791907082509,"version":"4.3.4"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2016,3,28]],"date-time":"2016-03-28T00:00:00Z","timestamp":1459123200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2016,3,28]],"date-time":"2016-03-28T00:00:00Z","timestamp":1459123200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:p>Targeted prophylaxis has proven to be an efficient strategy in liver transplantation recipients (LTRs). The aim of this study was to compare the effectiveness and safety of caspofungin with that of fluconazole in high\u2010risk (HR) LTRs. Caspofungin and fluconazole were compared in a multicenter, retrospective, cohort study in HR\u2010LTRs in Spain. Outcomes were assessed at 180 days after transplantation. A propensity score approach was applied. During the study period (2005\u20102012), we analyzed 195\u2009HR\u2010LTRs from 9 hospitals. By type of prophylaxis, 97 patients received caspofungin and 98 received fluconazole. Of a total of 17 (8.7%) global invasive fungal infections (IFIs), breakthrough IFIs accounted for 11 (5.6%) and invasive aspergillosis (IA) accounted for 6 (3.1%). By univariate analysis, no differences were observed in the prevention of global IFIs. However, caspofungin was associated with a significant reduction in the rate of breakthrough IFIs (2.1% versus 9.2%, <jats:italic toggle=\"yes\">P\u2009=\u2009<\/jats:italic>0.04). In patients requiring dialysis (n\u2009=\u200962), caspofungin significantly reduced the frequency of breakthrough IFIs (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.03). The propensity score analysis confirmed a significant reduction in the frequency of IA in patients receiving caspofungin (absolute risk reduction, 0.06; 95% confidence interval [CI], 0.001\u20100.11; <jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.044). Linear regression analysis revealed a significant decrease in blood alanine aminotransferase levels and a significant increase in bilirubin levels after administration of caspofungin. Caspofungin and fluconazole have similar efficacy for the prevention of global IFIs in HR\u2010LTRs in this observational, multicenter cohort study. However, caspofungin was associated with a significant reduction of breakthrough IFIs and, after adjusting for confounders, caspofungin was associated with a lower rate of IA. This benefit is probably more favorable in patients on dialysis. Caspofungin is safe in HR\u2010LTRs, although bilirubin levels may be increased.<\/jats:p>","DOI":"10.1002\/lt.24391","type":"journal-article","created":{"date-parts":[[2015,12,28]],"date-time":"2015-12-28T03:46:45Z","timestamp":1451274405000},"page":"427-435","source":"Crossref","is-referenced-by-count":47,"title":["Caspofungin versus fluconazole as prophylaxis of invasive fungal infection in high\u2010risk liver transplantation recipients: A propensity score analysis"],"prefix":"10.1097","volume":"22","author":[{"given":"Jes\u00fas","family":"Fort\u00fan","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Instituto de Investigaci\u00f3n Ram\u00f3n y Cajal,Universidad de Alcal\u00e1,Madrid,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfonso","family":"Muriel","sequence":"additional","affiliation":[{"name":"Unit of Biostatistics, Ram\u00f3n y Cajal Hospital, Centro de Investigaci\u00f3n Biom\u00e9dica en Red Epidemiolog\u00eda y Salud P\u00f9blica,Madrid,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Mart\u00edn\u2010D\u00e1vila","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Instituto de Investigaci\u00f3n Ram\u00f3n y Cajal,Universidad de Alcal\u00e1,Madrid,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Montejo","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario Cruces,Barakaldo\u2010Bilbao,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"Len","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases,Hospital Universitari Vall d\u00b4Hebron"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Torre\u2010Cisneros","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases,Hospital Universitario Reina Sof\u00eda\u2010IMIBIC (Instituto Maim\u00f3nides de Investigaci\u00f3n Biom\u00e9dica de C\u00f3rdoba)\u2010Universidad de C\u00f3rdoba,C\u00f3rdoba,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi","family":"Carratal\u00e1","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hospital Universitari de Bellvitge\u2010IDIBELL,University of Barcelona,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology and Infectious Diseases,Hospital General Universitario Gregorio Mara\u00f1\u00f3n,Madrid,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Carmen","family":"Fari\u00f1as","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario Marqu\u00e9s de Valdecilla, Universidad de Cantabria,Santander,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asunci\u00f3n","family":"Moreno","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hospital Universitari Clinic, Barcelona,Universidad Aut\u00f3noma,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gema","family":"Fresco","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Instituto de Investigaci\u00f3n Ram\u00f3n y Cajal,Universidad de Alcal\u00e1,Madrid,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josune","family":"Goikoetxea","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario Cruces,Barakaldo\u2010Bilbao,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Gavald\u00e1","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases,Hospital Universitari Vall d\u00b4Hebron"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Pozo","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases,Hospital Universitario Reina Sof\u00eda\u2010IMIBIC (Instituto Maim\u00f3nides de Investigaci\u00f3n Biom\u00e9dica de C\u00f3rdoba)\u2010Universidad de C\u00f3rdoba,C\u00f3rdoba,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Bodro","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hospital Universitari de Bellvitge\u2010IDIBELL,University of Barcelona,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Vena","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology and Infectious Diseases,Hospital General Universitario Gregorio Mara\u00f1\u00f3n,Madrid,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Casafont","sequence":"additional","affiliation":[{"name":"Department of Digestive Diseases,Hospital Universitario Marqu\u00e9s de Valdecilla,Santander,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Cervera","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hospital Universitari Clinic, Barcelona,Universidad Aut\u00f3noma,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Tiago","family":"Silva","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario \u201c12 de Octubre,\u201d Instituto de Investigaci\u00f3n Hospital \u201c12 de Octubre,\u201d,Madrid,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 M.","family":"Aguado","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Hospital Universitario \u201c12 de Octubre,\u201d Instituto de Investigaci\u00f3n Hospital \u201c12 de Octubre,\u201d,Madrid,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"and for the Grupo de Estudio de Infecci\u00f3n en Pacientes Trasplantados\u2014Grupo de Estudio de Micolog\u00eda M\u00e9dica (Sociedad Espa\u00f1ola de Enfermedades Infecciosas y Microbiolog\u00eda Cl\u00ednica), and Red Espa\u00f1ola de Investigaci\u00f3n en Patolog\u00eda Infecciosa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2016,3,28]]},"reference":[{"issue":"suppl 7","key":"lt24391-bib-0001-20240115","first-page":"27","article-title":"Invasive fungal infections in solid organ transplant recipients","volume":"20","year":"2014","journal-title":"Clin Microbiol 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