Journal Article

Invasive Aspergillosis in Liver Transplant Recipients: Outcome Comparison of Therapy with Amphotericin B Lipid Complex and a Historical Cohort Treated with Conventional Amphotericin B

Peter K. Linden, Kim Coley, Paolo Fontes, John J. Fung and Shimon Kusne

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 37, issue 1, pages 17-25
Published in print July 2003 | ISSN: 1058-4838
Published online July 2003 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/375219
Invasive Aspergillosis in Liver Transplant Recipients: Outcome Comparison of Therapy with Amphotericin B Lipid Complex and a Historical Cohort Treated with Conventional Amphotericin B

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Invasive aspergillosis (IA) in liver transplant recipients is associated with poor response rates and a very high mortality rate, despite administration of therapy with conventional amphotericin B. We conducted a single-center, retrospective study to compare the outcome of liver transplant recipients with IA who received amphotericin B lipid complex (ABLC) or conventional amphotericin B. IA was present in 12 ABLC-treated patients (definite, 4; probable, 8) and 29 amphotericin B recipients (definite, 11; probable, 18) in the historical cohort. The 60-day mortality rate was lower in the ABLC cohort: 4 (33%) of 12 patients versus 24 (83%) of 29 patients (P =.006). Only 1 of 4 ABLC recipients with definite IA died, compared with all 11 in the amphotericin B group. Sixty-day survival probability curves was significantly lower in the amphotericin B cohort (P =.008). ABLC therapy was the only independent mortality-protective variable (odds ratio, 0.31; 95% confidence interval, 0.07–0.44; P =.02). First-line or early salvage therapy for IA with ABLC was associated with significantly improved survival relative to a comparable historical group treated with amphotericin B.

Journal Article.  4733 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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