Significance of serum β-d-glucan levels in recipients of living donor liver transplantation

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BACKGROUND/PURPOSE: Early identification and treatment of fungal infections is essential for recipients of liver transplants, but the sensitivity of surveillance culture is insufficient. Measurement of the serum level of β-D: -glucan is a rapid diagnostic strategy for invasive fungal infection. We aimed to evaluate the significance of serum β-D: -glucan levels in transplant recipients after living donor liver transplantation (LDLT). METHODS: We retrospectively analyzed the clinical and laboratory data of 100 consecutive adult transplant recipients after LDLT performed between August 1997 and August 2009. RESULTS: Seventy-one had high serum β-D: -glucan levels (>20pg/ml) after LDLT. Nearly half (47.2%) of the episodes of increase occurred within the first 5days after surgery. The mortality rate of the recipients with high serum β-D: -glucan levels was similar to that of the recipients without high levels. However, in terms of the time line of increase, the recipients with high serum β-D: -glucan levels from 15days onward after surgery showed a significantly higher mortality rate than those with high levels before 15days after surgery (33.3 and 4.3%, respectively; p<0.001). CONCLUSIONS: High serum levels of β-D: -glucan at late time points after LDLT indicate established fungal infection and higher mortality.

Journal of hepato-biliary-pancreatic sciences, 18(3), pp.432-435; 2011

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