https://scholars.lib.ntu.edu.tw/handle/123456789/535433
標題: | Cryptococcosis in patients with cirrhosis of the liver and posttransplant outcomes | 作者: | Singh N. Sifri C.D. Silveira F.P. Miller R. Gregg K.S. Huprikar S. Lease E.D. Zimmer A. Stephen Dummer J. Spak C.W. Koval C. Banach D.B. Shroff M. Le J. Ostrander D. Avery R. Eid A. Razonable R.R. Montero J. Blumberg E. Alynbiawi A. Morris M.I. Randall H.B. Alangaden G. Tessier J. Wagener M.M. HSIN-YUN SUN |
公開日期: | 2015 | 出版社: | Lippincott Williams and Wilkins | 卷: | 99 | 期: | 10 | 起(迄)頁: | 2132-2141 | 來源出版物: | Transplantation | 摘要: | Background. The outcomes and optimal management of cirrhotic patients who develop cryptococcosis before transplantation are not fully known. Methods.We conducted a multicenter study involving consecutive patients with cirrhosis and cryptococcosis between January 2000 and March 2014. Data collected were generated as standard of care. Results. In all, 112 patients were followed until death or up to 9 years. Disseminated disease and fungemia were present in 76.8% (86/112) and 90-day mortality was 57.1% (64/112). Of the 39 patients listed for transplant, 20.5% (8) underwent liver transplantation, including 2 with active but unrecognized disease before transplantation. Median duration of pretransplant antifungal therapy and posttransplant therapy was 43 days (interquartile range, 8-130 days) and 272 days (interquartile range, 180-630 days), respectively. Transplantation was associated with lower mortality (P = 0.002). None of the transplant recipients developed disease progression during the median follow-up of 3.5 years with a survival rate of 87.5%. Conclusions. Cryptococcosis in patients with cirrhosis has grave prognosis. Our findings suggest that transplantation after recent cryptococcal disease may not be a categorical exclusion and may be cautiously undertaken in liver transplant candidates who are otherwise deemed clinically stable. Copyright ? 2015 Wolters Kluwer Health, Inc. All rights reserved. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84943139097&doi=10.1097%2fTP.0000000000000690&partnerID=40&md5=12e880dd3ae0d820bb874fd7f0db5d12 https://scholars.lib.ntu.edu.tw/handle/123456789/535433 |
ISSN: | 0041-1337 | DOI: | 10.1097/TP.0000000000000690 | SDG/關鍵字: | antifungal agent; antifungal agent; fluconazole; adult; Article; cryptococcosis; disease association; disease course; female; follow up; fungemia; human; liver cirrhosis; liver transplantation; major clinical study; male; mortality; priority journal; risk factor; survival rate; survival time; treatment outcome; treatment planning; clinical trial; complication; cryptococcosis; graft recipient; liver; liver cirrhosis; liver transplantation; middle aged; multicenter study; pathology; prognosis; Antifungal Agents; Cryptococcosis; Disease Progression; Female; Fluconazole; Humans; Liver; Liver Cirrhosis; Liver Transplantation; Male; Middle Aged; Prognosis; Risk Factors; Transplant Recipients; Treatment Outcome |
顯示於: | 醫學系 |
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