BACKGROUND/ PURPOSE: Early identification and treatment of fungal infections is essential for recipients of liver transplants, but the sensitivity of surveillance culture is insufficient. Measurement of the serum level of β-D-glucan is a rapid diagnostic strategy for invasive fungal infection. We aimed to evaluate the significance of serum β-D-glucan levels in transplant recipients after living donor liver transplantation (LDLT). METHODS: We retrospectively analyzed the clinical and laboratory data of 100 consecutive adult transplant recipients after LDLT performed between August 1997 and August 2009. RESULTS: Seventy-one had high serum β-D-glucan levels (>20 pg/ml) after LDLT. Nearly half (47.2%) of the episodes of increase occurred within the first 5 days after surgery. The mortality rate of the recipients with high serum β-D-glucan levels was similar to that of the recipients without high levels. However, in terms of the time line of increase, the recipients with high serum β-D-glucan levels from 15 days onward after surgery showed a significantly higher mortality rate than those with high levels before 15 days after surgery (33.3 and 4.3%, respectively; p < 0.001). CONCLUSIONS: High serum levels of β-D-glucan at late time points after LDLT indicate established fungal infection and higher mortality.
BACKGROUND/ PURPOSE: Early identification and treatment of fungal infections is essential for recipients of liver transplants, but the sensitivity of surveillance culture is insufficient. Measurement of the serum level of β-D-glucan is a rapid diagnostic strategy for invasive fungal infection. We aimed to evaluate the significance of serum β-D-glucan levels in transplant recipients after living donor liver transplantation (LDLT). METHODS: We retrospectively analyzed the clinical and laboratory data of 100 consecutive adult transplant recipients after LDLT performed between August 1997 and August 2009. RESULTS: Seventy-one had high serum β-D-glucan levels (>20 pg/ml) after LDLT. Nearly half (47.2%) of the episodes of increase occurred within the first 5 days after surgery. The mortality rate of the recipients with high serum β-D-glucan levels was similar to that of the recipients without high levels. However, in terms of the time line of increase, the recipients with high serum β-D-glucan levels from 15 days onward after surgery showed a significantly higher mortality rate than those with high levels before 15 days after surgery (33.3 and 4.3%, respectively; p < 0.001). CONCLUSIONS: High serum levels of β-D-glucan at late time points after LDLT indicate established fungal infection and higher mortality.
Authors: Siang Fei Yeoh; Tae Jin Lee; Ka Lip Chew; Stephen Lin; Dennis Yeo; Sajita Setia Journal: Infect Drug Resist Date: 2018-05-30 Impact factor: 4.003
Authors: Alexander Szyszkowitz; Christoph Zurl; Anna Herzeg; Anton Berger; Geza Gemes; Martin Mitteregger; Florian Prüller; Juergen Prattes; Ines Zollner-Schwetz; Thomas Valentin; Martin Hoenigl; Robert Krause Journal: Open Forum Infect Dis Date: 2018-11-08 Impact factor: 3.835