Effect of Prophylactic Antifungal Protocols on the Prognosis of Liver Transplantation: A Propensity Score Matching and Multistate Model Approach
Joint Authors
Lee, Wei-Chen
Wang, Yu-Chao
Lee, Chen-Fang
Chen, Yi-Chan
Huang, Ting-Shuo
Chan, Kun-Ming
Soong, Ruey-Shyang
Wu, Ting-Jung
Chou, Hong-Shiue
Cheng, Chih-Hsien
Source
Issue
Vol. 2016, Issue 2016 (31 Dec. 2016), pp.1-7, 7 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2016-09-26
Country of Publication
Egypt
No. of Pages
7
Main Subjects
Abstract EN
Background.
Whether routine antifungal prophylaxis decreases posttransplantation fungal infections in patients receiving orthotopic liver transplantation (OLT) remains unclear.
This study aimed to determine the effectiveness of antifungal prophylaxis for patients receiving OLT.
Patients and Methods.
This is a retrospective analysis of a database at Chang Gung Memorial Hospital.
We have been administering routine antibiotic and prophylactic antifungal regimens to recipients with high model for end-stage liver disease scores (>20) since 2009.
After propensity score matching, 402 patients were enrolled.
We conducted a multistate model to analyze the cumulative hazards, probability of fungal infections, and risk factors.
Results.
The cumulative hazards and transition probability of “transplantation to fungal infection” were lower in the prophylaxis group.
The incidence rate of fungal infection after OLT decreased from 18.9% to 11.4% ( p = 0.052 ); overall mortality improved from 40.8% to 23.4% ( p < 0.001 ).
In the “transplantation to fungal infection” transition, prophylaxis was significantly associated with reduced hazards for fungal infection (hazard ratio: 0.57, 95% confidence interval: 0.34–0.96, p = 0.033 ).
Massive ascites, cadaver transplantation, and older age were significantly associated with higher risks for mortality.
Conclusion.
Prophylactic antifungal regimens in high-risk recipients might decrease the incidence of posttransplant fungal infections.
American Psychological Association (APA)
Chen, Yi-Chan& Huang, Ting-Shuo& Wang, Yu-Chao& Cheng, Chih-Hsien& Lee, Chen-Fang& Wu, Ting-Jung…[et al.]. 2016. Effect of Prophylactic Antifungal Protocols on the Prognosis of Liver Transplantation: A Propensity Score Matching and Multistate Model Approach. BioMed Research International،Vol. 2016, no. 2016, pp.1-7.
https://search.emarefa.net/detail/BIM-1098411
Modern Language Association (MLA)
Chen, Yi-Chan…[et al.]. Effect of Prophylactic Antifungal Protocols on the Prognosis of Liver Transplantation: A Propensity Score Matching and Multistate Model Approach. BioMed Research International No. 2016 (2016), pp.1-7.
https://search.emarefa.net/detail/BIM-1098411
American Medical Association (AMA)
Chen, Yi-Chan& Huang, Ting-Shuo& Wang, Yu-Chao& Cheng, Chih-Hsien& Lee, Chen-Fang& Wu, Ting-Jung…[et al.]. Effect of Prophylactic Antifungal Protocols on the Prognosis of Liver Transplantation: A Propensity Score Matching and Multistate Model Approach. BioMed Research International. 2016. Vol. 2016, no. 2016, pp.1-7.
https://search.emarefa.net/detail/BIM-1098411
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1098411