Candida albicans arteritis transmitted by preservation fluid after liver transplantation.

TitleCandida albicans arteritis transmitted by preservation fluid after liver transplantation.
Publication TypeJournal Article
Year of Publication2014
AuthorsAddeo P, Saouli A-, Woehl-Jaegle ML, Ellero B, Oussoultzoglou E, Marcellin L, Bachellier P
JournalAnnals of transplantation : quarterly of the Polish Transplantation Society// Ann Transplant
Pagination64 - 7
Date Published2014//
ISBN Number2329-0358
Other Numbersc78, 9802544
Keywords*Aneurysm, Infected/tm [Transmission], *Arteritis/mi [Microbiology], *Candida albicans, *Candidiasis/tm [Transmission], *Liver Transplantation/ae [Adverse Effects], *Organ Preservation Solutions/ae [Adverse Effects], Aneurysm, Infected/dt [Drug Therapy], Aneurysm, Infected/mi [Microbiology], Antifungal Agents/tu [Therapeutic Use], Arteritis/dt [Drug Therapy], Candidiasis/co [Complications], Candidiasis/dt [Drug Therapy], Hemobilia/dt [Drug Therapy], Hemobilia/mi [Microbiology], Humans, Male, Middle Aged

BACKGROUND: Fungal infections remain among the main causes of mortality in the chronically immunosuppressed liver transplant (LT) patient. Bacterial and fungal contamination of preservation fluid (PF), in which grafts are stored, represents a potential source of infection for recipients., CASE REPORT: A 54-year-old patient underwent LT for chronic alcoholic cirrhosis. Mycological culture of the liver PF was positive for Candida albicans. The patient received antimycotic prophylaxis for 4 weeks in absence of clinical and serological signs of infection. He was urgently readmitted 4 months later with hemobilia caused by an arterial pseudoaneurysm that was fistulized in the biliary anastomosis. After an unsuccessful embolization, arterial resection and reconstruction and a biliodigestive anastomosis were performed, with an uneventful postoperative course. Pathology found a mycotic arteritis of the graft artery. Mycotic culture of the arterial segment confirmed the presence of the same Candida albicans genotype previously isolated in the PF., CONCLUSIONS: Mycotic arteritis is one of the possible complications of yeast contamination of PF. Surgeons and physicians involved in the care of LT patients should be aware of this potentially lethal complication and adopt all the available means for early detection.

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