Analysis of fungal infection and risk factors in patients with liver failure after liver transplantation

WEI Xi-le; LI Lin; FAN Ming; LIU Hai-liang; ZHANG Xiao-jing; LI Min

doi:10.16048/j.issn.2095-5561.2024.03.08

Abstract：Objective To investigate the species,distribution and risk factors of fungal infection after liver transplantation in patients with liver failure.Methods A total of 118 patients with liver failure admitted to the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Air Force Medical University from April 2020 to December 2023 were selected as the study objects.According to whether fungal infection occurred after liver transplantation,they were divided into infected group ( n=31) and uninfected group ( n=87).The types and distribution of fungal infection after liver transplantation were analyzed,and the risk factors of fungal infection after liver transplantation in patients with liver failure were analyzed by multivariate Logistic regression model.Results The incidence of fungal infection after liver transplantation in 118 patients with liver failure was 26.3％ ( 31/118) .A total of 52 strains of 6 species were isolated from 31 patients by fungal culture.Candida albicans accounted for the highest proportion of bacteria species,57.7％ (30/52).Respiratory tract infection accounted for the highest proportion of infection sites,75.0％ (39/52).Multivariate Logistic regression model showed that invasive mechanical ventilation duration≥48 h,intraoperative blood transfusion duration≥2 weeks of antibiotic use were risk factors for fungal infection after liver transplantation (P<0.05).Conclusion Fungal infection after liver transplantation in patients with liver failure is most likely to occur in the respiratory tract,and Candida albicans is the main pathogen.Invasive mechanical ventilation time≥48 h,intraoperative massive blood transfusion,and antibiotic use time≥2 weeks are the risk factors for fungal infection after liver transplantation.