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Comparing the results of invasive candidiasis prevention with anidulafungin vs. the lipid formulation of amphotericin B in high-risk patients in the early postoperative period after liver transplantation

https://doi.org/10.23873/2074-0506-2020-12-2-104-111

Abstract

Introduction. The development of invasive candidiasis leads to high mortality after liver transplantation. Choosing an effective prophylaxis is an important task.

The study purpose was to compare the results  of invasive candidiasis prevention with anidulafungin vs. the lipid formulation of amphotericin B in high-risk patients in the early postoperative period after liver transplantation.

Material and methods. The study included 80 patients with risk factors for the development of invasive mycosis who underwent liver transplantation. Patients were divided into 2 groups. In the first group (n = 40), anidulafungin was prescribed for prophylaxis; in the 2nd group (n = 40), the lipid complex of amphotericin B was used.

Results. The most common of Candida spp. isolated in the patients of our study, as expected, was Candida albicans accounting for 31.2%, significantly less than a half. Neither fungal infection breakthrough nor invasive mycosis development were reported in any patient. In group 2, renal replacement therapy was significantly more frequently used. In two cases, the amphotericin B lipid complex was canceled and the conversion to echinocandin was undertaken due to the occurrence of adverse events (chills and fever) associated, in our opinion, with the drug used.

Conclusions. 1. Patients after liver transplantation with 2 or more risk factors have absolute indications to invasive mycosis prevention. 2. Anidulafungin and the lipid formulation of amphotericin B are effective for prophylaxis and prevention of fungal infection breakthrough. 3. Anidulafungin has an advantage in safety over the lipid formulation of amphotericin B. 

About the Authors

S. V. Zhuravel
N.V. Sklifosovsky Research Institute for Emergency Medicine
Belarus

Sergey V. Zhuravel, Dr. Med. Sci., Head of the Scientific Department for Anesthesiology, Intensive and Critical Care



N. K. Kuznetsova
N.V. Sklifosovsky Research Institute for Emergency Medicine
Russian Federation

Natalya K. Kuznetsova, Cand. Med. Sci., Leading Research Associate of the Scientific Department for Anesthesiology, Intensive and Critical Care



I. I. Utkina
N.V. Sklifosovsky Research Institute for Emergency Medicine
Russian Federation

Irina I. Utkina, Cand. Med. Sci., Senior Research Associate of the Scientific Department for Anesthesiology, Intensive and Critical Care



M. S. Novruzbekov
N.V. Sklifosovsky Research Institute for Emergency Medicine
Russian Federation

Murad S. Novruzbekov, Dr. Med. Sci., Head of the Scientific Department for Liver Transplantation



P. V. Gavrilov
N.V. Sklifosovsky Research Institute for Emergency Medicine
Russian Federation

Pavel V. Gavrilov, Junior Research Associate of the Scientific Department for Anesthesiology, Intensive and Critical Care



T. V. Chernenkaya
N.V. Sklifosovsky Research Institute for Emergency Medicine
Russian Federation

Tatyana V. Chernenkaya, Cand. Med. Sci., Head of the Research Laboratory for Clinical Microbiology



G. K. Ospanova
National Scientific Medical Center
Russian Federation

Gulbanu K. Ospanova, Cand. Med. Sci., Senior Resident, Anesthesiologist-Intensivist of the Anesthesiology, Critical and Intensive Care Department



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For citations:


Zhuravel S.V., Kuznetsova N.K., Utkina I.I., Novruzbekov M.S., Gavrilov P.V., Chernenkaya T.V., Ospanova G.K. Comparing the results of invasive candidiasis prevention with anidulafungin vs. the lipid formulation of amphotericin B in high-risk patients in the early postoperative period after liver transplantation. Transplantologiya. The Russian Journal of Transplantation. 2020;12(2):104-111. https://doi.org/10.23873/2074-0506-2020-12-2-104-111

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ISSN 2074-0506 (Print)
ISSN 2542-0909 (Online)