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Risk factors of invasive fungal infections in liver transplant recipients: A systematic review and meta-analysis

2021; Elsevier BV; Volume: 22; Issue: 4 Linguagem: Inglês

10.1111/ajt.16935

1600-6143

Pakpoom Phoompoung, Sabina Herrera, Armelle Pérez Cortés Villalobos, Farid Foroutan, Ani Orchanian‐Cheff, Shahid Husain,

Pneumocystis jirovecii pneumonia detection and treatment

American Journal of TransplantationVolume 22, Issue 4 p. 1213-1229 ORIGINAL ARTICLE Risk factors of invasive fungal infections in liver transplant recipients: A systematic review and meta-analysis Pakpoom Phoompoung, Pakpoom Phoompoung orcid.org/0000-0002-9503-4830 Ajmera Transplant Centre, University Health Network, Toronto, Ontario, Canada Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandSearch for more papers by this authorSabina Herrera, Sabina Herrera orcid.org/0000-0002-5057-354X Ajmera Transplant Centre, University Health Network, Toronto, Ontario, CanadaSearch for more papers by this authorArmelle Pérez Cortés Villalobos, Armelle Pérez Cortés Villalobos orcid.org/0000-0002-2140-910X Ajmera Transplant Centre, University Health Network, Toronto, Ontario, CanadaSearch for more papers by this authorFarid Foroutan, Farid Foroutan orcid.org/0000-0002-1029-1812 Ajmera Transplant Centre, University Health Network, Toronto, Ontario, CanadaSearch for more papers by this authorAni Orchanian-Cheff, Ani Orchanian-Cheff Library and Information Services, University Health Network, Toronto, Ontario, CanadaSearch for more papers by this authorShahid Husain, Corresponding Author Shahid Husain shahid.husain@uhn.ca orcid.org/0000-0002-9216-5229 Ajmera Transplant Centre, University Health Network, Toronto, Ontario, Canada Correspondence Shahid Husain, Toronto General Hospital, 585 University Avenue, 9-MaRS-9080, Toronto, Ontario M5G 2N2, Canada. Email: shahid.husain@uhn.caSearch for more papers by this author Pakpoom Phoompoung, Pakpoom Phoompoung orcid.org/0000-0002-9503-4830 Ajmera Transplant Centre, University Health Network, Toronto, Ontario, Canada Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandSearch for more papers by this authorSabina Herrera, Sabina Herrera orcid.org/0000-0002-5057-354X Ajmera Transplant Centre, University Health Network, Toronto, Ontario, CanadaSearch for more papers by this authorArmelle Pérez Cortés Villalobos, Armelle Pérez Cortés Villalobos orcid.org/0000-0002-2140-910X Ajmera Transplant Centre, University Health Network, Toronto, Ontario, CanadaSearch for more papers by this authorFarid Foroutan, Farid Foroutan orcid.org/0000-0002-1029-1812 Ajmera Transplant Centre, University Health Network, Toronto, Ontario, CanadaSearch for more papers by this authorAni Orchanian-Cheff, Ani Orchanian-Cheff Library and Information Services, University Health Network, Toronto, Ontario, CanadaSearch for more papers by this authorShahid Husain, Corresponding Author Shahid Husain shahid.husain@uhn.ca orcid.org/0000-0002-9216-5229 Ajmera Transplant Centre, University Health Network, Toronto, Ontario, Canada Correspondence Shahid Husain, Toronto General Hospital, 585 University Avenue, 9-MaRS-9080, Toronto, Ontario M5G 2N2, Canada. Email: shahid.husain@uhn.caSearch for more papers by this author First published: 25 December 2021 https://doi.org/10.1111/ajt.16935Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract Invasive fungal infections (IFIs) remain one of the most common infectious complications after organ transplantation, and liver transplant recipients (LTRs) have the highest mortality rate. However, risk factors associated with IFIs have only been evaluated in small single-center studies. We performed a meta-analysis by conducting a comprehensive search using Ovid MEDLINE, Ovid Embase, Cochrane database of systematic reviews, and Cochrane central register of controlled trials. All case-control and cohort studies evaluating risk factors for IFIs in adult LTRs were screened. Utilizing a random-effects model, a multivariate analysis was completed, and 28 studies were eligible for meta-analysis. Rates of IFIs ranged from 1.4% to 32.7%. Previous antibiotic use (OR 9.3; 95% CI 3.2–27.0) and bacterial infection (OR 4.3; 95% CI 2.1–8.6) were risk factors of invasive candidiasis. Yet for invasive aspergillosis, posttransplant renal replacement therapy (OR 9.2; 95% CI 4.2–20.4), reoperation (OR 8.0; 95% CI 2.9–21.7), and cytomegalovirus infection (OR 6.2; 95% CI 2.0–19.3) were risk factors. The top independent risk factors for IFIs during studies from 2010 to 2019 were previous fungal colonization (OR 9.19; 95% CI 4.92–17.16), reoperation (OR 5.45; 95% CI 2.93–10.15), and previous bacterial infections (OR 3.81; 95% CI 2.13–6.83). These risk factors may be targeted by antifungal prophylaxis in LTRs. Open Research DATA AVAILABILITY STATEMENT The data used to support the findings of this study are included within the article. Supporting Information Filename Description ajt16935-sup-0001-AppendixS1.docxWord 2007 document , 45.2 KB Appendix S1 ajt16935-sup-0002-AppendixS2-S3.docxWord 2007 document , 23.5 KB Appendix S2-S3 Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article. Volume22, Issue4April 2022Pages 1213-1229 AST and ASTS members - please log in via your Society website for full journal access.AST Members >> ASTS Members >> RelatedInformation