Journal List > J Korean Soc Transplant > v.25(4) > 1034350

Kim, Roh, Moon, Kim, Lee, Song, Shin, Kim, Kwon, Kim, Joh, and Lee: Paranasal Aspergillosis in Patients Prior to Liver Transplantation

Abstract

Background

Aspergillosis infection is associated with high morbidity and mortality in liver transplant recipients. This study investigated the prognosis of liver transplant recipients with a pre-operative treatment for paranasal aspergillosis.

Methods

We collected data from 979 cases of patients who underwent liver transplants at the Samsung Medical Center from May 1996 to Feburary 2010.

Results

Eight patients were diagnosed with paranasal aspergillosis after functional endoscopic sinus surgery (FESS), before liver transplantation. In these 8 patients, 7 (87.5%) were male, with a mean age of 55 years. All patients had a hepatitis B virus infection, and 6 patients had hepatocellular carcinoma. The mean days from FESS to liver transplantation was 31 (range, 12∼47 days) and anti-fungal agents were not used during these periods. All 8 patients were free from a recurrence of aspergillosis after liver transplantation.

Conclusions

Surgical treatment for paranasal aspergillosis in patients prior to liver transplantation does not induce aspergillosis infection after transplantation.

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Fig. 1.
OMU-CT shows the calcification of left maxillary sinus.
jkstn-25-245f1.tif
Fig. 2.
Microscopic finding of paranasal aspergilloma shows fungal hyphae (Periodic Acid-Schiff Stain).
jkstn-25-245f2.tif
Table 1.
Clinical characteristics of recipient with aspergillosis after liver transplantation
ID Sex/age Dx CTP OP Prophylaxis Postop ICU Months PostLTx Outcome
1 M/64 HBV, HCC C LDLT Fuconazole 8 74 Alive
2 M/45 HBV, HCC A LDLT Itraconazole 7 64 Alive
3 M/54 HBV, HCC B LDLT Itraconazole 11 53 Alive
4 F/58 HBV C LDLT Itraconazole 8 42 Alive
5 M/53 HBV, HCC C LDLT Itraconazole 9 22 Alive
6 M/55 HBV, HCC B LDLT Itraconazole 3 18 Alive
7 M/61 HBV, HCC B LDLT Itraconazole 4 13 Alive
8 M/52 HBV C LDLT Itraconazole 5 9 Alive

Abbreviations: Dx, diagnosis; CTP, Child-Turchotte-Pugh score; OP, operation; LDLT, living donor liver transplantation; post LTx, post liver transplantation; HCC, hepatocellular carcinoma.

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