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Journal of Antimicrobial Chemotherapy (1999) 43, 597-600
© 1999 The British Society for Antimicrobial Chemotherapy

Brief report

Fungal infection and liposomal amphotericin B (AmBisome) therapy in liver transplantation: a 2 year review

N. C. Fishera, S. Singhala, S. J. Millerb, J. G. M. Hastingsc and D. J. Mutimera

a Liver Unit, Queen Elizabeth Hospital, Birmingham B15 2TH, UK b Department of Pathology, Queen Elizabeth Hospital, Birmingham B15 2TH, UK c Department of Microbiology, Queen Elizabeth Hospital, Birmingham B15 2TH, UK

Abstract

We reviewed the use of liposomal amphotericin B in 30 patients receiving therapy following liver transplantation over a 2 year period. Five of these patients were treated for presumed invasive aspergillosis: four of them died despite therapy, each having combined renal and respiratory failure at the time of diagnosis of presumed aspergillosis. Post-mortem examination of three of these patients confirmed the diagnosis of aspergillosis. Twenty-five patients were treated empirically; 11 died and supportive evidence for invasive fungal infection following commencement of therapy was found in only one case. Following liver transplantation, the use of liposomal amphotericin B following confirmation of aspergillus infection or for empirical therapy is of uncertain value, and strategies based on selective prophylaxis for high-risk cases may be preferable.


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