Estudo retrospectivo das doenças fúngicas em pacientes transplantados hepático

Abstract

Liver transplantation is the only healing method for patients with severe hepatopathies and at end-stage, since the liver no longer performs its function properly. Several situations can cause liver dysfunction triggering cirrhosis, predisposing the patient to the possible need for a transplantation. Due to immunosuppression, the transplanted patient is predisposed to fungal infections, which can be harmful and interfere with his prognosis at any stage of his life, after the transplantation, particularly in the initial period; severe, superficial or invasive infections can be observed. As they are diseases of difficult diagnosis, with slow evolution and many times neglected; they can cause immeasurable damages or even be lethal to the patients; mainly, in the cases in which they are submitted to invasive procedures and prolonged hospitalizations under administration of inadequate drugs. Material and Method: In this research, through the analysis of medical records, the occurrence of fungal infections in patients with liver transplantation was evaluated and observed, analyzing the cause of liver disease, the period in which the infection occurred, the infected sites, which fungi were found and the relationship of the event with the type of fungus, organs affected and treatment adopted. Results: The genus Candida was the most remarkable in the study; being the species C. glabrata and C. albicans the most frequent. However, other species of the genus Candida were observed, causing infections mainly in TGU, TR and TS, in distinct periods, but with greater occurrences in the first year, after TX. Different types of antifungals and antibiotics were associated as treatment. The most used immunosuppression for graft maintenance were tacrolimus, mycophenolate and corticoids. Conclusion: To improve the diagnostic method; the adequate therapy and clinical attention to the care of these patients are of extreme importance to guarantee their longevity, ensuring the non-occurrence of infections.