The study of the risk factors of fungal infection after liver transplantation

Objective: To explore the risk factors of fungal infection so as to provide rationales for the prevention of fungal infection after liver transplantation. Methods: The clinical data of 94 cases of fungal infections after liver transplantation from January 1, 2003 to November 30, 2010 at our hospital were collected as the infective group. A total of 603 liver transplant patients without fungal infections during the same period were selected as the control group, x test and t test were utilized for the analysis of possible risk factors for fungal infection. Results: Fungal infection rate was 13.5% (94/697) after liver transplantation and mortality rate of fungal infection 86.2% (81/94). Candida albicans was the majority infective fungi. And the main site of infection was the lungs. The postoperative acute physiology and chronic health evaluation M (APACHE IH) score of the infective group was significantly higher than that of the control group (26.0±5.4 vs 21.5±4.7, P<0.01). The number of patients with primary liver cancer was lower than that of the control group (26.6% vs 45.8%, P<0.01). The number of decompensated HBV cirrhosis and diabetics in the infective group was higher than that of the control group at pre-operation (23.4% vs 11.6%, 9.6% vs 2.8%, both P<0.01). The number of patients with postoperative mechanical ventilation over 10 days, postoperative antibiotics over 14 days, postoperative cardiopulmonary dysfunction and liver function recovery time over 7 days, parenteral nutrition over 12 days and hyperglycemia over 7 days in the infective group were significantly higher than that in the control group (all P<0.01). Conclusion: Preoperative primary disease, postoperative disease severity, postoperative organ dysfunction, long-term mechanical ventilation, antibiotics and hyperglycemia, etc. may be the important risk factors of fungal infection after liver transplantation.