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FI 2015

1,530
© Thomson Reuters, Journal Citation Reports, 2015

Indexada en:

Index Current Contents/Clinical Medicine, JCR, SCI-Expanded, Index Medicus/Medline, Excerpta Medica/EMBASE, IBECS, IME, CANCERLIT, SCOPUS

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  • Factor de Impacto: 1,530(2015)
  • 5-años Factor de Impacto: 1,710
  • SCImago Journal Rank (SJR):0,43
  • Source Normalized Impact per Paper (SNIP):0,653
doi: 10.1016/S0213-005X(07)74314-8
Formación médica continuada
Infecciones en los pacientes trasplantados de hígado
Infections in liver transplant recipients
José María Aguado, , Ana García-Reyne, Carlos Lumbreras
Unidad de Enfermedades Infecciosas. Hospital Universitario 12 de Octubre. Madrid. España
Recibido 02 marzo 2007, Aceptado 13 marzo 2007
Resumen

Las infecciones son la causa más importante de morbimortalidad en los pacientes trasplantados. Aparecen en tres momentos diferentes tras el trasplante dependiendo de factores quirúrgicos, el nivel de inmunosupresión, la exposición ambiental y el tipo de profilaxis utilizada. Las infecciones bacterianas surgen sobre todo en los primeros 2 meses y pueden hacerlo como bacteriemia, infección de la herida quirúrgica, infección intraabdominal o neumonía. La tuberculosis en el paciente trasplantado tiene una presentación más agresiva que en el paciente inmunocompetente y además su manejo se ve dificultado por la interacción farmacológica entre los fármacos tuberculostáticos y los inmunosupresores. Los virus producen infección de manera directa en estos pacientes pero además algunos de ellos, el citomegalovirus y el herpesvirus humano 6, son inmunomoduladores y pueden facilitar otras infecciones y el rechazo del injerto. El uso de técnicas de reacción en cadena de la polimerasa y antigenemia ha hecho posible un diagnóstico más precoz de la infección por citomegalovirus y la implantación de medidas profilácticas. Las infecciones fúngicas siguen presentando una alta mortalidad a pesar de las nuevas técnicas diagnósticas y los nuevos fármacos antifúngicos.

Resumen

Infection is the main cause of morbidity and mortality in liver transplant patients. Infections appear in three different periods following transplantation and are related to surgical factors, the degree of immunosuppression, environmental exposure and the type of prophylaxis used. Bacterial infections occur in the first two months after transplantation as bacteremia, surgical wound and intra-abdominal infection, or pneumonia. Tuberculosis in the liver transplant recipient is more aggressive than in immunocompetent persons. Viruses produce direct infection in these patients; moreover, some viruses (e.g., cytomegalovirus and human herpes virus 6) are immunomodulators and can facilitate other infections and graft rejection. Polymerase chain reaction and antigenemia techniques have made possible prompt diagnosis of cytomegalovirus infection and the implementation of prophylactic strategies. Fungal infections still have a high associated mortality rate, despite new diagnostic techniques and new antifungal drugs.

Palabras clave
Trasplante hepático, Infección fúngica profunda, Citomegalovirus
Key words
Liver transplant, Deep fungal infection, Cytomegalovirus
El Texto completo solo esta disponible en PDF
Bibliografía
1.
J.E. Blair,S. Kusne
Bacterial, mycobacterial, and protozoal infections after liver transplantation – part I
Liver Transpl, 11 (2005), pp. 1452-1459
2.
D.L. George,P.M. Arnow,A.S. Fox,A.L. Baker,J.R. Thistlethwaite,J.C. Emond
Bacterial infection as a complication of liver transplantation: epidemiology and risk factors
Rev Infect Dis, 13 (1991), pp. 387-396
3.
K. Itoh,T. Hashimoto,Y. Shimizu,Y. Otobe,M. Tanaka,Y. Nakamura
Bacterial and fungal infections after living related donor liver transplantation
Transplant Proc, 28 (1996), pp. 2404-2405
4.
N. Singh,D.L. Paterson,T. Gayowski,M.M. Wagener,I.R. Marino
Predicting bacteremia and bacteremic mortality in liver transplant recipients
Liver Transpl, 6 (2000), pp. 54-61
5.
C.S. Hollenbeak,E.J. Alfrey,W.W. Souba
The effect of surgical site infections on outcomes and resource utilization after liver transplantation
Surgery, 130 (2001), pp. 388-395
6.
O.A. Tachopoulou,D.P. Vogt,J.M. Henderson,M. Baker,T.F. Keys
Hepatic abscess after liver transplantation: 1990-2000
Transplantation, 75 (2003), pp. 79-83
7.
F.G. Durán,B. Piqueras,M. Romero,J.A. Carneros,A. De Diego,M. Salcedo
Pulmonary complications following orthotopic liver transplant
Transpl Int, 11 (1998), pp. 255-259
8.
N. Singh,D.L. Paterson,F.Y. Chang,T. Gayowski,C. Squier,M.M. Wagener
Methicillin-resistant Staphylococcus aureus: the other emerging resistant gram-positive coccus among liver transplant recipients
Clin Infect Dis, 30 (2000), pp. 322-327
9.
D.L. Paterson,J.D. Rihs,C. Squier,T. Gayowski,A. Sagnimeni,N. Singh
Lack of efficacy of mupirocin in the prevention of infections with Staphylococcus aureus in liver transplant recipients and candidates
Transplantation, 75 (2003), pp. 194-198
10.
S.A. McNeil,P.N. Malani,C.E. Chenoweth,R.J. Fontana,J.C. Magee,J.D. Punch
Vancomycin-resistant enterococcal colonization and infection in liver transplant candidates and recipients: a prospective surveillance study
Clin Infect Dis, 42 (2006), pp. 195-203
11.
N. Benito,O. Sued,A. Moreno,J.P. Horcajada,J. González,M. Navasa
Diagnosis and treatment of latent tuberculosis infection in liver transplant recipients in an endemic area
Transplantation, 74 (2002), pp. 1381-1386
12.
S. Kusne,J.E. Blair
Viral and fungal infections after liver transplantation – part II
Liver Transpl, 12 (2006), pp. 2-11
13.
D.H. Dockrell,J. Prada,M.F. Jones,R. Patel,A.D. Badley,W.S. Harmsen
Seroconversion to human herpesvirus 6 following liver transplantation is a marker of cytomegalovirus disease
J Infect Dis, 176 (1997), pp. 1135-1140
14.
R. Teixeira,S. Pastacaldi,S. Davies,A.P. Dhillon,V.C. Emery,K. Rolles
The influence of cytomegalovirus viraemia on the outcome of recurrent hepatitis C after liver transplantation
Transplantation, 70 (2000), pp. 1454-1458
15.
A. Gaeta,C. Nazzari,S. Angeletti,M. Lazzarini,E. Mazzei,C. Mancini
Monitoring for cytomegalovirus infection in organ transplant recipients: analysis of pp65 antigen, DNA and late mRNA in peripheral blood leukocytes
J Med Virol, 53 (1997), pp. 189-195
16.
M.A. Moreno
Viral infections in solid organ transplant recipients
Enferm Infecc Microbiol Clin, 15 (1997), pp. 22-33
17.
M.R. Keating
Antiviral agents
Mayo Clin Proc, 67 (1992), pp. 160-178
18.
A.P. Limaye
Ganciclovir-resistant cytomegalovirus in organ transplant recipients
Clin Infect Dis, 35 (2002), pp. 866-872
19.
J.M. Morales,M.A. Muñoz,G. Fernández Zatarain,C. García Cantón,M.A. García Rubiales,A. Andrés
Reversible acute renal failure caused by the combined use of foscarnet and cyclosporin in organ transplanted patients
Nephrol Dial Transplant, 10 (1995), pp. 882-883
20.
J. De Otero,J. Gavalda,E. Murio,V. Vargas,I. Calico,L. Llopart
Cytomegalovirus disease as a risk factor for graft loss and death after orthotopic liver transplantation
Clin Infect Dis, 26 (1998), pp. 865-870
21.
R.H. Rubin
Preemptive therapy in immunocompromised hosts
N Engl J Med, 324 (1991), pp. 1057-1059
22.
E. Gane,F. Saliba,G.J. Valdecasas,J. O’Grady,M.D. Pescovitz,S. Lyman
Randomized trial of efficacy and safety of oral ganciclovir in the prevention of cytomegalovirus disease in liver-transplant recipients. The Oral Ganciclovir International Transplantation Study Group [corrected]
Lancet, 350 (1997), pp. 1729-1733
23.
C. Paya,A. Humar,E. Domínguez,K. Washburn,E. Blumberg,B. Alexander
Efficacy and safety of valganciclovir vs. oral ganciclovir for prevention of cytomegalovirus disease in solid organ transplant recipients
Am J Transplant, 4 (2004), pp. 611-620
24.
C. Díaz-Pedroche,C. Lumbreras,P. Del Valle,R. San Juan,S. Hernando,D. Folgueira
Efficacy and safety of valgancyclovir as preemptive therapy for the prevention of cytomegalovirus disease in solid organ transplant recipients
Transplant Proc, 37 (2005), pp. 3766-3767
25.
J.M. Park,K.D. Lake,J.D. Arenas,R.J. Fontana
Efficacy and safety of low-dose valganciclovir in the prevention of cytomegalovirus disease in adult liver transplant recipients
Liver Transpl, 12 (2006), pp. 112-116
26.
N. Singh,C. Wannstedt,L. Keyes,T. Gayowski,M.M. Wagener,T.V. Cacciarelli
Efficacy of valganciclovir administered as preemptive therapy for cytomegalovirus disease in liver transplant recipients: impact on viral load and late-onset cytomegalovirus disease
Transplantation, 79 (2005), pp. 85-90
27.
D.R. Snydman
Historical overview of the use of cytomegalovirus hyperimmune globulin in organ transplantation
Transpl Infect Dis, 3 (2001), pp. 6-13
28.
D.R. Snydman,M.E. Falagas,R. Avery,C. Perlino,R. Ruthazer,R. Freeman
Use of combination cytomegalovirus immune globulin plus ganciclovir for prophylaxis in CMV-seronegative liver transplant recipients of a CMV-seropositive donor organ: a multicenter, open-label study
Transplant Proc, 33 (2001), pp. 2571-2575
29.
A.D. Pinna,J. Rakela,A.J. Demetris,J.J. Fung
Five cases of fulminant hepatitis due to herpes simplex virus in adults
Dig Dis Sci, 47 (2002), pp. 750-754
30.
J.A. Fishman,R.H. Rubin
Infection in organ-transplant recipients
N Engl J Med, 338 (1998), pp. 1741-1751
31.
R. Cirelli,K. Herne,M. McCrary,P. Lee,S.K. Tyring
Famciclovir: review of clinical efficacy and safety
Antiviral Res, 29 (1996), pp. 141-151
32.
S.K. Tyring,D. Baker,W. Snowden
Valacyclovir for herpes simplex virus infection: long-term safety and sustained efficacy after 20 years’ experience with acyclovir
J Infect Dis, 186 (2002), pp. 40-46
33.
A. Jain,M. Nalesnik,J. Reyes,R. Pokharna,G. Mazariegos,M. Green
Posttransplant lymphoproliferative disorders in liver transplantation: a 20-year experience
Ann Surg, 236 (2002), pp. 429-436
34.
G. Dotti,R. Fiocchi,T. Motta,C. Mammana,E. Gotti,S. Riva
Lymphomas occurring late after solid-organ transplantation: influence of treatment on the clinical outcome
Transplantation, 74 (2002), pp. 1095-1102
35.
T.E. Starzl,M.A. Nalesnik,K.A. Porter,M. Ho,S. Iwatsuki,B.P. Griffith
Reversibility of lymphomas and lymphoproliferative lesions developing under cyclosporin-steroid therapy
Lancet, 1 (1984), pp. 583-587
36.
E.A. Verschuuren,S.J. Stevens,G.W. Van Imhoff,J.M. Middeldorp,C. De Boer,G. Koeter
Treatment of posttransplant lymphoproliferative disease with rituximab: the remission, the relapse, and the complication
Transplantation, 73 (2002), pp. 100-104
37.
R.R. Razonable,C.V. Paya
The impact of human herpesvirus-6 and -7 infection on the outcome of liver transplantation
Liver Transpl, 8 (2002), pp. 651-658
38.
A. Humar,D. Kumar,J. Raboud,A.M. Caliendo,G. Moussa,G. Levy
Interactions between cytomegalovirus, human herpesvirus-6, and the recurrence of hepatitis C after liver transplantation
Am J Transplant, 2 (2002), pp. 461-466
39.
Z. Kadry,O. Bronsther,J.J. Fung
Kaposi's sarcoma in liver transplant recipients on FK506
Transplantation, 65 (1998), pp. 1140
40.
M.E. Roland,P.G. Stock
Liver transplantation in HIV-infected recipients
Semin Liver Dis, 26 (2006), pp. 273-284
41.
J. Fortún,P. Martín-Dávila,M.E. Álvarez,A. Sánchez-Sousa,C. Quereda,E. Navas
Aspergillus antigenemia sandwich-enzyme immunoassay test as a serodiagnostic method for invasive aspergillosis in liver transplant recipients
Transplantation, 71 (2001), pp. 145-149
42.
J. Fortún,P. Martín-Dávila,S. Moreno,E. De Vicente,J. Nuño,A. Candelas
Risk factors for invasive aspergillosis in liver transplant recipients
Liver Transpl, 8 (2002), pp. 1065-1070
43.
T.J. Walsh,J.W. Hiemenz,N.L. Seibel,J.R. Perfect,G. Horwith,L. Lee
Amphotericin B lipid complex for invasive fungal infections: analysis of safety and efficacy in 556 cases
Clin Infect Dis, 26 (1998), pp. 1383-1396
44.
R. Herbrecht,D.W. Denning,T.F. Patterson,J.E. Bennett,R.E. Greene,J.W. Oestmann
Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis
N Engl J Med, 347 (2002), pp. 408-415
45.
S.A. Pacetti,S.P. Gelone
Caspofungin acetate for treatment of invasive fungal infections
Ann Pharmacother, 37 (2003), pp. 90-98
46.
D.J. Winston,R.W. Busuttil
Randomized controlled trial of oral itraconazole solution versus intravenous/oral fluconazole for prevention of fungal infections in liver transplant recipients
Transplantation, 74 (2002), pp. 688-695
47.
J. Fortún,P. Martín-Dávila,S. Moreno,R. Bárcena,E. De Vicente,A. Honrubia
Prevention of invasive fungal infections in liver transplant recipients: the role of prophylaxis with lipid formulations of amphotericin B in high-risk patients
J Antimicrob Chemother, 52 (2003), pp. 813-819
48.
T. Shah,W.K. Lai,P. Gow,J. Leeming,D. Mutimer
Low-dose amphotericin for prevention of serious fungal infection following liver transplantation
Transpl Infect Dis, 7 (2005), pp. 126-132
49.
J.M. Aguado,J.A. Herrero,J. Gavalda,J. Torre-Cisneros,M. Blanes,G. Rufi
Clinical presentation and outcome of tuberculosis in kidney, liver, and heart transplant recipients in Spain. Spanish Transplantation Infection Study Group, GESITRA
Transplantation, 63 (1997), pp. 1278-1286
50.
N. Singh,D.L. Paterson
Mycobacterium tuberculosis infection in solid-organ transplant recipients: impact and implications for management
Clin Infect Dis, 27 (1998), pp. 1266-1277
51.
J. Hernández-Pérez,M. Yebra-Bango,E. Jiménez-Martínez,C. Sanz-Moreno,V. Cuervas-Mons,L. Alonso Pulpon
Visceral leishmaniasis (kala-azar) in solid organ transplantation: report of five cases and review
Clin Infect Dis, 29 (1999), pp. 918-921
52.
L. Chiche,A. Lesage,C. Duhamel,E. Salame,M. Malet,D. Samba
Posttransplant malaria: first case of transmission of Plasmodium falciparum from a white multiorgan donor to four recipients
Transplantation, 75 (2003), pp. 166-168
53.
C.P. Wajszczuk,J.S. Dummer,M. Ho,D.H. Van Thiel,T.E. Starzl,S. Iwatsuki
Fungal infections in liver transplant recipients
Transplantation, 40 (1985), pp. 347-353
54.
S. Kusne,J.S. Dummer,N. Singh,S. Iwatsuki,L. Makowka,C. Esquivel
Infections after liver transplantation: an analysis of 101 consecutive cases
Medicine (Baltimore), 67 (1988), pp. 132-143
55.
J.J. Wade,N. Rolando,K. Hayllar,J. Philipott-Howard,M.W. Casewell,R. Williams
Bacterial and fungal infections after liver transplantation. An analysis of 284 patients
Hepatology, 21 (1995), pp. 1328-1336
56.
J. Briegel,H. Forst,B. Spill,A. Haas,B. Grabein,M. Haller
Risk factors for systemic fungal infections in liver transplant recipients
Eur J Clin Microbiol Infect Dis, 14 (1995), pp. 375-382
57.
R. Patel,D. Portela,A.D. Badley,W.S. Harmsen,J.J. Larson-Keller,D.M. Ilstrup
Risk factors of invasive Candida and non-Candida fungal infections after liver transplantation
Transplantation, 62 (1996), pp. 926-934
58.
M. Miguélez,C. Lumbreras,J.A. Herrero,J.M. Aguado,A. Del Palacio,F. Colina
Infección fúngica profunda en receptores de un trasplante de hígado: análisis de 21 casos
Med Clin (Barc), 110 (1998), pp. 406-410
59.
N. Singh,M.M. Wagener,I.R. Marino,T. Gayowski
Trands in invasive fungal infections in liver transplant recipients: correlation with evolution in transplantation practices
Transplantation, 73 (2002), pp. 63-67
60.
N. Singh,L. Mieles,V.L. Yu,T. Gayowski
Invasive aspergillosis in liver transplant recipients: association with candidemia and consumption coagulopathy and failure with low-dose amphotericin B
Clin Infect Dis, 17 (1993), pp. 906-908
61.
J. Tollemar,K. Hockerstedt,B.G. Ericzon,H. Jalanko,O. Ringden
Liposomal amphotericin B prevents invasive fungal infections in liver transplant recipients
Transplantation, 59 (1995), pp. 45-50
62.
C. Lumbreras,V. Cuervas-Mons,P. Jara,A. Del Palacio,V.S. Turrión,C. Barrios
Randomized trail of fluconazole versus nystatin for the prophylaxis of Candida infection following liver transplantation
J Infect Dis, 174 (1996), pp. 583-588
63.
D.J. Winston,A. Pakrasi,R.W. busuttil
Prophylactic fluconazole in liver trasplant recipients. A randomized, double-blind, placebo-controlled trial
Ann Intern Med, 131 (1999), pp. 729-737
64.
D.J. Winston,R.W. Busuttil
Randomized controlled trial of oral itraconazole solution versus intravenous/oral fluconazole for prevention of fungal infections in liver transplant recipients
Transplantation, 74 (2002), pp. 688-695
65.
J. Fortún,A. López-San Román,J.J. Velasco,A. Sánchez-Sousa,E. De Vicente,J. Nuño
Selection of Candida glabrata strains with reduced susceptibility to azoles in four liver transplant patients with invasive cadidiasis
Eur J Clin Microbiol Infect Dis, 16 (1997), pp. 314-318
Correspondencia: Dr. J.M. Aguado. Unidad de Enfermedades Infecciosas. Hospital Universitario 12 de Octubre. Edificio Materno-Infantil. Planta 6.ª Avda. de Córdoba, km 5,400. 28041 Madrid. España.
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