Naslov
Viral and fungal infections in patients with liver transplantation

Autori
Naumovski-Mihalić, Slavica ; Čolić-Cvrlje, Vesna ; Hofman, Blaženka ; Buhin, Majda ; Mašinović, Denis ; Patrlj, Leonard ; Kocman, Branislav ; Jadrijević, Stipislav ; Vladić, Ivan

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
4th Croatian Congress on Infectious Diseases Conference proceedings / Primorac, Dragan - Opatija : Hrvatski liječnički zbor, 2004

Skup
4th Croatian Congress on Infectious Diseases with International Participation

Mjesto i datum
Opatija, Hrvatska, 02.10.2004. - 06.10.2004

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
liver transplantation; viral infection; fungal infection

Sažetak
Orthotopic liver transplantation (OLT) is successifuly therapy for patients with and stage liver disease and for severe acute liver failure. One of the most common problem after OLT are infections especialy fungal and viral infection, in spite od improved surgery, immunosupression and antimicrobial profilaxis. The risk of infection and types of infections differ based upon the time after transplantation. Most postoperative infections can be grouped into three major periods: transplant to one month, one month to six month, and after six month. Timing of oportunistic infections depends on prfilaxis, enviromental exposure and level of iummunosupresion. In early post-transplantatoon period infections are related to surgical procedure or intensive care treatment. During the first month after transplantation are important bacterial and fungal infections. The incidence of fungal infection in liver transplant recipients is higher than that seen in patients who have had other types of solid organ transplants. Candida species are the leading causative agents of these fungal infections, accaunting for 77 to 83 percent. The incidents of invasive fungal infections following liver transplantation ranges from 14 to 42 percent and these infections are associated with high overall mortality rates – 50 to 70 percent. In the period of one to six months after OLT, transplant infections related to cumulative effect of relatively high dose immunosupression develop in a relatively defined time intervals. In this period, opportunistic organisms such Citomegalo virus (CMV), Epstein Barr virus (EBV) and Aspergillus must be considered. CMV is one the most common pathogens causing disease during this period. In the absence of profilaxis, CMV infection or disease will occur in aproximately 50 to 60 percent of patients ; 20 to 30 percent of these will develop CMV related disease. Of other viruses varicella zoster virus, herpes simplex virus, EBV and other viruses, EBV is the most important, because the most sever complication of EBV is post transplatation lymphoproliferative disease. Aspergillus specise infections also occur during period of one to six month and account for 15 to 20 percent of inavsive fungal infections. After six month opprtunistic infections are uncommon in patients receiving maintenance doses of immunosupression with good graft function. Chronic viral infectiones including EBV, CMV, hepatits B (HBV), hepatits C (HCV) and human herpes viruses can led to complications in the late posttransplant period. Chronic viral infection can produce damage to the liver alograft (HBV and HCV) or cause secondary tumors including lymphoma due to EBV and hepatocellular carcinoma due to HBV or HCV. It is important to focus the evaluation on likely sites and sources of infection. If the patient has received excessive immunosupression, the risk of viral and fungal infection is markedly increased. The key factor in treating infectious complications in liver transplant patients is early detection and diagnosis.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA