{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T04:46:45Z","timestamp":1791866805733,"version":"4.3.4"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Invasive fungal infection (IFI) remains a cause of morbidity and mortality after liver transplantation; guidelines recommend targeted antifungal prophylaxis in recipients with specific risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively studied adult liver transplant recipients (LTR) at a single center, 2017\u20132023. High\u2010risk recipients received a planned 14\u2010day course of echinocandin prophylaxis, caspofungin in 97.6%. The primary endpoint was IFI within 30 days of transplantation, a window spanning the planned prophylaxis and the 2 weeks after it. Secondary endpoints were fungal etiology and factors associated with IFI. We also examined the temporal distribution of early aspergillosis across the whole institutional registry to 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 286 recipients, 85 (29.72%) were high risk. IFI was more frequent in high\u2010risk than non\u2010high\u2010risk LTR (8\/85, 9.41% vs. 4\/201, 1.99%;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.0077); most were breakthrough (7\/8) mold infections. In exploratory analyses, IFI was associated with high\u2010risk status (unadjusted odds ratio: 5.12, 95% CI: 1.50\u201317.49), MELD &gt; 30 (4.67, 1.25\u201317.41) and diabetes (4.64, 1.37\u201315.79); with 12 events, these estimates are imprecise, and no multivariable model was fitted. Among 452 transplants performed in 2017\u20132025, seven developed early aspergillosis across four calendar years, with no significant variation in annual incidence (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.146), never more than two cases in any 90\u2010day window (Monte Carlo\n                      <jats:italic>p<\/jats:italic>\n                      = 0.82) and none among the 117 transplants of the following 28 months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early IFI under risk\u2010stratified echinocandin prophylaxis concentrated in the sickest recipients and was dominated by mold disease. No clear temporal pattern suggestive of a sustained common\u2010source outbreak was identified, although environmental transmission cannot be excluded.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tid.70338","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T04:11:39Z","timestamp":1791864699000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Invasive Fungal Infections in Liver Transplant Recipients Receiving Risk\u2010Stratified Echinocandin Prophylaxis: A Descriptive Single\u2010Center Cohort Study"],"prefix":"10.1111","author":[{"given":"Giulia","family":"Viero","sequence":"first","affiliation":[{"name":"SC Malattie Infettive Fondazione IRCCS Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8435-1294","authenticated-orcid":false,"given":"Barbara","family":"Antonelli","sequence":"additional","affiliation":[{"name":"SC Chirurgia Generale \u2010 Trapianti di Fegato Fondazione IRCCS Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3707-8886","authenticated-orcid":false,"given":"Clara","family":"Dibenedetto","sequence":"additional","affiliation":[{"name":"SC Gastroenterologia ed Epatologia Fondazione IRCCS Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittorio","family":"Scaravilli","sequence":"additional","affiliation":[{"name":"Dipartimento di Fisiopatologia Medico\u2010Chirurgica e dei Trapianti Universit\u00e0 degli Studi di Milano  Milan Italy"},{"name":"SC Anestesia e Terapia Intensiva Adulti Fondazione IRCCS Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca Del","family":"Prete","sequence":"additional","affiliation":[{"name":"SC Chirurgia Generale \u2010 Trapianti di Fegato Fondazione IRCCS Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7058-6316","authenticated-orcid":false,"given":"Giulia","family":"Renisi","sequence":"additional","affiliation":[{"name":"SC Malattie Infettive Fondazione IRCCS Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Alagna","sequence":"additional","affiliation":[{"name":"SC Malattie Infettive Fondazione IRCCS Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2216-1262","authenticated-orcid":false,"given":"Anna","family":"Celotti","sequence":"additional","affiliation":[{"name":"SC Malattie Infettive Fondazione IRCCS Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Sagasta","sequence":"additional","affiliation":[{"name":"SC Gastroenterologia ed Epatologia Fondazione IRCCS Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1217-6893","authenticated-orcid":false,"given":"Chiara","family":"Abbruzzese","sequence":"additional","affiliation":[{"name":"SC Anestesia e Terapia Intensiva Adulti Fondazione IRCCS Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1735-1400","authenticated-orcid":false,"given":"Giacomo","family":"Grasselli","sequence":"additional","affiliation":[{"name":"Dipartimento di Fisiopatologia Medico\u2010Chirurgica e dei Trapianti Universit\u00e0 degli Studi di Milano  Milan Italy"},{"name":"SC Anestesia e Terapia Intensiva Adulti Fondazione IRCCS Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Lampertico","sequence":"additional","affiliation":[{"name":"SC Gastroenterologia ed Epatologia Fondazione IRCCS Ospedale Maggiore Policlinico  Milan Italy"},{"name":"CRC \u201cA. M. and A. Migliavacca\u201d Center for Liver Disease Dipartimento di Fisiopatologia Medico\u2010Chirurgica e dei Trapianti Universit\u00e0 degli Studi di Milano  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiano","family":"Quintini","sequence":"additional","affiliation":[{"name":"SC Chirurgia Generale \u2010 Trapianti di Fegato Fondazione IRCCS Ospedale Maggiore Policlinico  Milan Italy"},{"name":"Dipartimento di Fisiopatologia Medico\u2010Chirurgica e dei Trapianti Universit\u00e0 degli Studi di Milano  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Bandera","sequence":"additional","affiliation":[{"name":"SC Malattie Infettive Fondazione IRCCS Ospedale Maggiore Policlinico  Milan Italy"},{"name":"Dipartimento di Fisiopatologia Medico\u2010Chirurgica e dei Trapianti Universit\u00e0 degli Studi di Milano  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0383-9579","authenticated-orcid":false,"given":"Andrea","family":"Lombardi","sequence":"additional","affiliation":[{"name":"SC Malattie Infettive Fondazione IRCCS Ospedale Maggiore Policlinico  Milan Italy"},{"name":"Dipartimento di Fisiopatologia Medico\u2010Chirurgica e dei Trapianti Universit\u00e0 degli Studi di Milano  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"1420","DOI":"10.1002\/lt.21873","article-title":"In\u2010Hospital Mortality in Adult Recipients of Living Donor Liver Transplantation: Experience of 576 Consecutive Cases at a Single Center","volume":"15","author":"Kaido T.","year":"2009","journal-title":"Liver Transplantation"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1111\/ajt.16935","article-title":"Risk Factors of Invasive Fungal Infections in Liver Transplant Recipients: A Systematic Review and Meta\u2010Analysis","volume":"22","author":"Phoompoung P.","year":"2022","journal-title":"American Journal of Transplantation"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"524","DOI":"10.3390\/jof7070524","article-title":"Fungal Infections in Liver Transplant Recipients","volume":"7","author":"Scolarici M.","year":"2021","journal-title":"Journal of Fungi"},{"key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1002\/lt.24032","article-title":"Invasive Aspergillosis in Liver Transplant Recipients: Epidemiology, Clinical Characteristics, Treatment, and Outcomes in 116 Cases","volume":"21","author":"Barchiesi F.","year":"2015","journal-title":"Liver Transplantation"},{"key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"E454","DOI":"10.1111\/ctr.12129","article-title":"Fungal Infections After Liver Transplantation: Outcomes and Risk Factors Revisited in the MELD Era","volume":"27","author":"Saliba F.","year":"2013","journal-title":"Clinical Transplantation"},{"key":"e_1_2_11_7_1","doi-asserted-by":"crossref","DOI":"10.1111\/ctr.13623","article-title":"Candida Infections in Solid Organ Transplantation: Guidelines From the American Society of Transplantation Infectious Diseases Community of Practice","volume":"33","author":"Aslam S.","year":"2019","journal-title":"Clinical Transplantation"},{"key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/cid\/ciw326","article-title":"Practice Guidelines for the Diagnosis and Management of Aspergillosis: 2016 Update by the Infectious Diseases Society of America","volume":"63","author":"Patterson T. F.","year":"2016","journal-title":"Clinical Infectious Diseases"},{"key":"e_1_2_11_9_1","doi-asserted-by":"crossref","DOI":"10.1111\/ctr.13544","article-title":"Invasive Aspergillosis in Solid\u2010Organ Transplant Recipients: Guidelines From the American Society of Transplantation Infectious Diseases Community of Practice","volume":"33","author":"Husain S.","year":"2019","journal-title":"Clinical Transplantation"},{"key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"2411","DOI":"10.1007\/s15010-025-02575-z","article-title":"Current Trends on Antifungal Prophylaxis in Solid Organ Transplantation: A Study From ESCMID\u2010EFISG, ESCMID\u2010ESGICH, SITA, and SEIMC\u2010GESITRA\u2010IC","volume":"53","author":"Salmanton\u2010Garc\u00eda J.","year":"2025","journal-title":"Infection"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/LVT.0000000000000755"},{"key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1093\/cid\/ciz1008","article-title":"Revision and Update of the Consensus Definitions of Invasive Fungal Disease From the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium","volume":"71","author":"Donnelly J. P.","year":"2020","journal-title":"Clinical Infectious Diseases"},{"key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1111\/myc.12960","article-title":"Defining Breakthrough Invasive Fungal Infection\u2013Position Paper of the Mycoses Study Group Education and Research Consortium and the European Confederation of Medical Mycology","volume":"62","author":"Cornely O. A.","year":"2019","journal-title":"Mycoses"},{"key":"e_1_2_11_14_1","doi-asserted-by":"crossref","DOI":"10.1128\/AAC.00399-19","article-title":"Echinocandins for the Treatment of Invasive Aspergillosis: From Laboratory to Bedside","volume":"63","author":"Aruanno M.","year":"2019","journal-title":"Antimicrobial Agents and Chemotherapy"},{"key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"2765","DOI":"10.1111\/ajt.12925","article-title":"Antifungal Prophylaxis in Liver Transplantation: A Systematic Review and Network Meta\u2010Analysis","volume":"14","author":"Evans J. D. W.","year":"2014","journal-title":"American Journal of Transplantation"},{"key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"2758","DOI":"10.1111\/ajt.12963","article-title":"Randomized, Double\u2010Blind Trial of Anidulafungin Versus Fluconazole for Prophylaxis of Invasive Fungal Infections in High\u2010Risk Liver Transplant Recipients","volume":"14","author":"Winston D. J.","year":"2014","journal-title":"American Journal of Transplantation"},{"key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1002\/lt.24391","article-title":"Caspofungin Versus Fluconazole as Prophylaxis of Invasive Fungal Infection in High\u2010Risk Liver Transplantation Recipients: A Propensity Score Analysis","volume":"22","author":"Fort\u00fan J.","year":"2016","journal-title":"Liver Transplantation"},{"key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1007\/s11605-019-04241-w","article-title":"A Multicenter, Randomized, Open\u2010Label Study to Compare Micafungin With Fluconazole in the Prophylaxis of Invasive Fungal Infections in Living\u2010Donor Liver Transplant Recipients","volume":"24","author":"Kang W.\u2010H.","year":"2020","journal-title":"Journal of Gastrointestinal Surgery"},{"key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1093\/cid\/ciu1128","article-title":"Randomized Trial of Micafungin for the Prevention of Invasive Fungal Infection in High\u2010Risk Liver Transplant Recipients","volume":"60","author":"Saliba F.","year":"2015","journal-title":"Clinical Infectious Diseases"},{"key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1111\/myc.13362","article-title":"Breakthrough Invasive Fungal Infections in Liver Transplant Recipients Exposed to Prophylaxis With Echinocandins vs Other Antifungal Agents: A Systematic Review and Meta\u2010Analysis","volume":"64","author":"Gatti M.","year":"2021","journal-title":"Mycoses"},{"key":"e_1_2_11_21_1","doi-asserted-by":"crossref","first-page":"1520","DOI":"10.3390\/jcm12041520","article-title":"Incidence of Invasive Fungal Infections in Liver Transplant Recipients Under Targeted Echinocandin Prophylaxis","volume":"12","author":"Breitkopf R.","year":"2023","journal-title":"Journal of Clinical Medicine"},{"key":"e_1_2_11_22_1","doi-asserted-by":"crossref","DOI":"10.1111\/tid.13608","article-title":"Breakthrough Invasive Fungal Infection After Liver Transplantation in Patients on Targeted Antifungal Prophylaxis: A Prospective Multicentre Study","volume":"23","author":"Rinaldi M.","year":"2021","journal-title":"Transplant Infectious Disease"},{"key":"e_1_2_11_23_1","article-title":"IDSA 2026 Clinical Practice Guideline Update on the Prevention of Invasive Aspergillosis in Adult Solid Organ Transplant Recipients","author":"Schuster M. G.","year":"2026","journal-title":"Infectious Diseases Society of America"},{"key":"e_1_2_11_24_1","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1053\/jlts.2002.36239","article-title":"Risk Factors for Invasive Aspergillosis in Liver Transplant Recipients","volume":"8","author":"Fort\u00fan J.","year":"2002","journal-title":"Liver Transplantation"},{"key":"e_1_2_11_25_1","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1111\/jdi.13183","article-title":"Opportunistic Invasive Fungal Disease in Patients With Type\u00a02 Diabetes Mellitus From Southern China: Clinical Features and Associated Factors","volume":"11","author":"Lao M.","year":"2020","journal-title":"Journal of Diabetes Investigation"},{"key":"e_1_2_11_26_1","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.mycmed.2013.07.052","article-title":"Invasive Fungal Infections in Renal Transplant Recipients: About 11 Cases","volume":"23","author":"Trabelsi H.","year":"2013","journal-title":"Journal de Mycologie M\u00e9dicale"},{"key":"e_1_2_11_27_1","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1086\/430602","article-title":"Risk Factors for Invasive Aspergillosis in Solid\u2010Organ Transplant Recipients: A Case\u2010Control Study","volume":"41","author":"Gavalda J.","year":"2005","journal-title":"Clinical Infectious Diseases"},{"key":"e_1_2_11_28_1","doi-asserted-by":"crossref","first-page":"46","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 N.","year":"2003","journal-title":"Clinical Infectious Diseases"}],"container-title":["Transplant Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.70338","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tid.70338","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.70338","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T04:11:48Z","timestamp":1791864708000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tid.70338"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,12]]},"references-count":27,"alternative-id":["10.1111\/tid.70338"],"URL":"https:\/\/doi.org\/10.1111\/tid.70338","archive":["Portico"],"relation":{},"ISSN":["1398-2273","1399-3062"],"issn-type":[{"value":"1398-2273","type":"print"},{"value":"1399-3062","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,12]]},"assertion":[{"value":"2026-09-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70338"}}