Invasive candidiasis in liver transplant patients: Incidence and risk factors in a pediatric cohort.

TitleInvasive candidiasis in liver transplant patients: Incidence and risk factors in a pediatric cohort.
Publication TypeJournal Article
Year of Publication2016
AuthorsDe Luca M, Green M, Symmonds J, Klieger SB, Soltys K, Fisher BT
JournalPediatr Transplant
Volume20
Issue2
Pagination235-40
Date Published2016 Mar
ISSN1399-3046
Abstract

Prolonged OR, re-transplantation, and high-volume intraoperative transfusion have been associated with increased risk for IC in adult LT recipients. Antifungal prophylaxis is recommended for adult patients with these risk factors. There are limited data on the incidence of and risk factors for IC in pediatric LT recipients. A retrospective cohort study of all pediatric LT patients at the CHOP between 2000 and 2012 and the CHP between 2004 and 2012 was performed to define the incidence of IC within 30 days of LT. A 3:1 matched case-control study with incidence density sampling was performed. Conditional logistic regression analyses were used to explore risk factors associated with IC. Among 397 recipients, the incidence of IC was 2.5%. Bivariate analyses showed that ICU admission prior to transplant, OR > 10 h, intraoperative volume infusion of >300 mL/kg, and broad-spectrum antibiotics were significantly associated with IC. In a multivariate model, only ICU admission remained significantly associated with IC. Antifungal prophylaxis was not significantly protective against IC. The low incidence of IC and lack of an identified protective effect from antifungal prophylaxis suggest that prophylaxis in pediatric LT recipients should not be routinely recommended to prevent IC events in the first 30 days post-transplant.

DOI10.1111/petr.12663
Alternate JournalPediatr Transplant
PubMed ID26748472