{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T03:16:30Z","timestamp":1768878990564,"version":"3.49.0"},"reference-count":10,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T00:00:00Z","timestamp":1635206400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Preventive strategies for invasive aspergillosis (IA) have still not been determined in heart transplant recipients whereas IA leads to a high mortality rate at 12 months posttransplantation. The use of voriconazole or echinocandins was proposed but can favor emergence of <jats:italic>Aspergillus<\/jats:italic> or <jats:italic>Candida sp<\/jats:italic>. resistant strains or promote neurological and liver disorders in some patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess whether universal prophylaxis with weekly high\u2010dose of liposomal amphotericin\u2010B (L\u2010AmB) can safely prevent IA in heart transplant recipients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients\/methods<\/jats:title><jats:p>Retrospective before\/after study that included 142 patients who received heart transplantation between 2010 and 2019 at the University Hospital of Toulouse (France). Weekly high dose of L\u2010AmB (7.5 mg\/kg\/week) was used as universal prophylaxis from 2016 because of high environmental exposure to <jats:italic>Aspergillus sp<\/jats:italic>. and high incidence of IA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Cumulative 1\u2010year incidence of IA decreased from 23% to 5% after introduction of L\u2010Amb prophylaxis. Multivariate analysis (Cox model) identified L\u2010AmB prophylaxis as a protective factor against IA (hazard ratio [HR] 0.21 [95% confidence interval 0; 0.92], <jats:italic>p<\/jats:italic> = .04), whereas postoperative renal replacement therapy was associated with IA (HR 3.6 [95% confidence interval 1.38; 9.3], <jats:italic>p<\/jats:italic> = .001), after correction for confounding effects (induction regimen, methylprednisolone pulses and history of hematological malignancy). The incidence of acute kidney injury requiring renal replacement therapy was similar in the two groups, suggesting a low risk of kidney toxicity when L\u2010AmB is used weekly. No patient developed severe kidney electrolyte loss nor L\u2010AmB\u2010related anaphylaxis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Once\u2010weekly high\u2010dose L\u2010AmB is safe and may prevent the development of IA after heart transplantation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.13745","type":"journal-article","created":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T03:57:13Z","timestamp":1634615833000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Weekly high\u2010dose liposomal amphotericin B prevents invasive aspergillosis after heart transplantation"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5819-9508","authenticated-orcid":false,"given":"Olivier","family":"Cointault","sequence":"first","affiliation":[{"name":"D\u00e9partement de N\u00e9phrologie et Transplantation d'organes Centre Hospitalier Universitaire de Toulouse  Toulouse France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0191-2584","authenticated-orcid":false,"given":"Marine","family":"Joly","sequence":"additional","affiliation":[{"name":"D\u00e9partement de N\u00e9phrologie et Transplantation d'organes Centre Hospitalier Universitaire de Toulouse  Toulouse France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0055-0136","authenticated-orcid":false,"given":"Sophie","family":"Cassaing","sequence":"additional","affiliation":[{"name":"Laboratoire de Mycologie\u2014Parasitologie Centre Hospitalier Universitaire de Toulouse  Toulouse France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7950-4313","authenticated-orcid":false,"given":"Fran\u00e7ois","family":"Labaste","sequence":"additional","affiliation":[{"name":"D\u00e9partement d'Anesth\u00e9sie et R\u00e9animation Centre Hospitalier Universitaire de Toulouse  Toulouse France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6739-162X","authenticated-orcid":false,"given":"Chlo\u00e9","family":"Danet","sequence":"additional","affiliation":[{"name":"Service de Pharmacologie Clinique Centre Hospitalier Universitaire de Toulouse  Toulouse France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6984-8849","authenticated-orcid":false,"given":"Lydie","family":"Porte","sequence":"additional","affiliation":[{"name":"Service des Maladie Infectieuses et Tropicales Centre Hospitalier Universitaire de Toulouse  Toulouse France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joelle","family":"Guitard","sequence":"additional","affiliation":[{"name":"D\u00e9partement de N\u00e9phrologie et Transplantation d'organes Centre Hospitalier Universitaire de Toulouse  Toulouse France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nassim","family":"Kamar","sequence":"additional","affiliation":[{"name":"D\u00e9partement de N\u00e9phrologie et Transplantation d'organes Centre Hospitalier Universitaire de Toulouse  Toulouse France"},{"name":"Universit\u00e9 Paul Sabatier\u2014Toulouse 3  Toulouse France"},{"name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale U1043, IFR\u2010BMT, H\u00f4pital Purpan  Toulouse France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stanislas","family":"Faguer","sequence":"additional","affiliation":[{"name":"D\u00e9partement de N\u00e9phrologie et Transplantation d'organes Centre Hospitalier Universitaire de Toulouse  Toulouse France"},{"name":"D\u00e9partement d'Anesth\u00e9sie et R\u00e9animation Centre Hospitalier Universitaire de Toulouse  Toulouse France"},{"name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale UMR 1297, Institut des Maladies M\u00e9taboliques et Cardiovasculaires, H\u00f4pital Rangueil  Toulouse France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the Toulouse Acquired Immune Deficiency and Infection study 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