{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T13:50:35Z","timestamp":1764251435903},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,8,2]],"date-time":"2016-08-02T00:00:00Z","timestamp":1470096000000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Targeted antifungal prophylaxis against <jats:italic>Candida<\/jats:italic> species or against <jats:italic>Candida<\/jats:italic> species and <jats:italic>Aspergillus<\/jats:italic> species, according to individual patient risk factors (<jats:styled-content style=\"fixed-case\">RF<\/jats:styled-content>s), is recommended by experts. However, recent studies have reported fluconazole is as effective as broader spectrum antifungals for preventing invasive fungal infection (<jats:styled-content style=\"fixed-case\">IFI<\/jats:styled-content>) after liver transplantation (<jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective cohort study of all adult patients who underwent <jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content> at our 1420\u2010bed tertiary teaching hospital, from June 2010 to December 2014, to assess the rate and etiology of <jats:styled-content style=\"fixed-case\">IFI<\/jats:styled-content> within 100\u00a0days after <jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>, to investigate the compliance with targeted prophylaxis, and to analyze risk factors for developing <jats:styled-content style=\"fixed-case\">IFI<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 303 patients underwent <jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>. Patients were classified as having low (no <jats:styled-content style=\"fixed-case\">RF<\/jats:styled-content>s), intermediate (1 <jats:styled-content style=\"fixed-case\">RF<\/jats:styled-content> for invasive candidiasis [<jats:styled-content style=\"fixed-case\">IC<\/jats:styled-content>]), and high risk (1 <jats:styled-content style=\"fixed-case\">RF<\/jats:styled-content> for invasive aspergillosis [<jats:styled-content style=\"fixed-case\">IA<\/jats:styled-content>] or \u22652 <jats:styled-content style=\"fixed-case\">RF<\/jats:styled-content>s for <jats:styled-content style=\"fixed-case\">IC<\/jats:styled-content>) for <jats:styled-content style=\"fixed-case\">IFI<\/jats:styled-content> in 20%, 30%, and 50% of cases, respectively. A total of 139 patients received antifungal prophylaxis: 98 with a mold\u2010active drug and 41 with fluconazole. Overall adherence to targeted prophylaxis was 53%. Nineteen patients (6.3%) developed <jats:styled-content style=\"fixed-case\">IFI<\/jats:styled-content>: 7 <jats:styled-content style=\"fixed-case\">IC<\/jats:styled-content> and 12 <jats:styled-content style=\"fixed-case\">IA<\/jats:styled-content>. Multivariate Cox regression analysis, adjusted for median model for end\u2010stage liver disease score at <jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>, stratification risk group, and adherence to targeted prophylaxis, showed that graft dysfunction, renal replacement therapy, and prophylaxis with fluconazole were independent risk factors for <jats:styled-content style=\"fixed-case\">IFI<\/jats:styled-content>. Seven of the 9 patients who received fluconazole prophylaxis and developed <jats:styled-content style=\"fixed-case\">IFI<\/jats:styled-content> were classified as having high risk for <jats:styled-content style=\"fixed-case\">IFI<\/jats:styled-content>, and 6 developed <jats:styled-content style=\"fixed-case\">IA<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Recommended stratification is accurate for predicting patients at very high risk for <jats:styled-content style=\"fixed-case\">IFI<\/jats:styled-content>, who should receive prophylaxis with a mold\u2010active drug.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.12560","type":"journal-article","created":{"date-parts":[[2016,5,30]],"date-time":"2016-05-30T07:32:43Z","timestamp":1464593563000},"page":"538-544","source":"Crossref","is-referenced-by-count":36,"title":["Antifungal prophylaxis in liver transplant recipients: one size does not fit 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