Biancofiore G, Baldassarri R, Bindi M L, Mosca C, Filipponi F, Mosca F, Vagelli A
I UO Anestesia e Rianimazione, UTI Postchirurgica e Trapianti, Azienda Ospedaliera Pisana, Università degli Studi, Pisa, Italy.
Minerva Anestesiol. 2001 Jun;67(6):475-82.
The aim of the study was to compare and evaluate the efficacy of two chemoprophylactic protocols against mycotic infections in a liver transplant recipients population.
single-blind, randomized.
Liver transplant Center of a National Health System teaching hospital.
Eighty-eight consecutive patients submitted to liver transplantation were enrolled in the study. Immediately before surgery they were randomized to receive sequential treatment with intravenous liposomal amphotericine B + oral itraconazole or intravenous fluconazole + oral itraconazole. Intravenous drugs were administered in the first postoperative week, and oral treatments for the following three weeks. In addition to analyzing the frequency and incidence of colonization, local and disseminated infection of mycotic origin, the causes of death and the possible risk factors for mycotic disease have been examined.
Eighty-five patients completed the study. No significative difference was evident in the two groups as regards to single organ and systemic fungal infection rate. Two out of a total of 5 deaths were related to mycotic disease. Pre-transplant fungal colonization, more severe liver disease indicating the transplant procedure and the rejection of the graft were all risk factors for the development of mycotic infection.
The two protocols used in the study showed and equal efficacy in preventing fungal infections in liver transplant recipients.
本研究的目的是比较和评估两种化学预防方案对肝移植受者群体真菌感染的疗效。
单盲、随机。
一家国家卫生系统教学医院的肝移植中心。
88例连续接受肝移植的患者纳入本研究。术前即刻将他们随机分为接受静脉脂质体两性霉素B + 口服伊曲康唑或静脉氟康唑 + 口服伊曲康唑序贯治疗。静脉用药在术后第一周给予，口服治疗持续接下来的三周。除了分析真菌定植的频率和发生率、真菌源性局部和播散性感染、死亡原因以及真菌病的可能危险因素外，还进行了检查。
85例患者完成了研究。两组在单器官和系统性真菌感染率方面无明显差异。总共5例死亡中有2例与真菌病有关。移植前真菌定植、提示移植手术的更严重肝病以及移植物排斥都是真菌感染发生的危险因素。
本研究中使用的两种方案在预防肝移植受者真菌感染方面显示出同等疗效。
