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

Linden, Peter K.; Coley, Kim; Fontes, Paolo; Fung, John J.; Kusne, Shimon
July 2003
Clinical Infectious Diseases;7/1/2003, Vol. 37 Issue 1, p17
Academic Journal
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.


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