Stern Sabrina, Bezinover Dmitri, Rath Peter-M, Paul Andreas, Saner Fuat H
Department of General, Visceral and Transplant Surgery, University Duisburg-Essen, 45147 Essen, Germany.
Anesthesiology and Perioperative Medicine, Penn State University, PA 17033, USA.
J Clin Med. 2021 May 9;10(9):2022. doi: 10.3390/jcm10092022.
Fungal infections remain a major challenge affecting outcomes after kidney (KT) and liver transplantation (LT).
In this retrospective single center study, the incidence of Candida contamination in renal and hepatic graft preservation solution (PS) was evaluated. In addition, Candida associated infections in recipients and related complications were analyzed.
Overall, the PS of 1248 hepatic and 1273 renal grafts were evaluated. The incidence of fungal contamination in the PS of hepatic and renal grafts was 1.2% and 0.86%, respectively. Additionally, the hepatic PS of one patient who underwent a combined liver-kidney transplant had Candida contamination. was the most common organism (70.4%) and 65.4% of the patients received antifungal treatment. -associated complications in the recipients was 19%. Complications in LT patients included peritonitis and sepsis. Two KT recipients with contaminated PS developed a mycotic aneurysm at the anastomotic site resulting in severe bleeding. The 1-year mortality in patients with PS contamination for LT and KT recipients was 33% and 18%, respectively. Although the incidence of fungal contamination of PS was low, contaminated PS was associated with a high mortality.
The results of the study suggest that PS should be evaluated for fungal growth.
真菌感染仍然是影响肾移植（KT）和肝移植（LT）术后结局的一项重大挑战。
在这项回顾性单中心研究中，对肾和肝移植保存液（PS）中念珠菌污染的发生率进行了评估。此外，还分析了受者中与念珠菌相关的感染及相关并发症。
总体而言，对1248例肝移植和1273例肾移植的保存液进行了评估。肝移植和肾移植保存液中真菌污染的发生率分别为1.2%和0.86%。此外，1例接受肝肾联合移植患者的肝保存液存在念珠菌污染。 是最常见的病原体（70.4%），65.4%的患者接受了抗真菌治疗。受者中与 相关的并发症为19%。肝移植患者的并发症包括 腹膜炎和 败血症。2例保存液受污染的肾移植受者在吻合部位出现霉菌性动脉瘤，导致严重出血。肝移植和肾移植受者中保存液受污染患者的1年死亡率分别为33%和18%。尽管保存液真菌污染的发生率较低，但受污染的保存液与高死亡率相关。
该研究结果表明，应对保存液进行真菌生长评估。
