Role of liposomal amphotericin B prophylaxis after liver transplantation compared with fluconazole for high-risk patients. Impact on infections and mortality within one year.
Perrella A, Esposito C, et al.Transplantation Proceedings 2012; 44(7):1977-1981.
Aims
To evaluate the safety and efficacy of liposomal amphotericin B versus fluconazole for chemoprophylaxis among cohorts of high-risk liver transplant patients. The impact on immunosuppressant trough levels and nonfungal infectious episodes during the first year after transplantation was also assessed.
Interventions
Amphotericin B (3 mg/kg/d) or fluconazole (800 mg loading dose and thereafter 400 mg/d according to renal parameters and immunosuppressant trough levels) for at least 7 to 14 days. All patients received a calcineurin inhibitor, everolimus and steroids (0-3 months).
Participants
44 orthotopic liver transplant recipients.
Outcomes
Incidence of bacterial infections, ICU stay, creatinine clearance and acute rejection.
Follow-up
12 months
CET Conclusions
In this small underpowered study there was no incidence of a fungal infection with two methods of prophylaxis but there was perhaps a lower incidence of a bacterial infections in the patients randomised to receive amphotericin B. for chemoprophylaxis.
Data analysis
Per protocol analysis
Trial registration
Not reported