Early invasive aspergillosis after liver transplantation: a matched case–control analysis of clinical features and risk factors in a Chinese cohort
- 1Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Liver Transplant Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- 2Department of Clinical Pharmacy, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
Abstract
Background: Early invasive aspergillosis (IA) is a severe complication of liver transplantation, but data from Chinese recipients remain limited. We evaluated its clinical characteristics, outcomes, and independent predictors. Methods: We retrospectively studied adult liver transplant recipients at the First Affiliated Hospital of Zhejiang University from August 2018 to March 2023. Patients meeting 2020 EORTC/MSGERC criteria for proven or probable IA within 1 month post-transplant were matched 1:2 to non-IA controls by age, sex, and etiology. Postoperative intensive care unit and intubation durations were excluded from multivariable regression to eliminate temporal bias. Results: Among 1051 recipients, 78 developed early IA (7.4% incidence; 3 proven, 75 probable), matched to 156 controls. Aspergillus fumigatus predominated (64.1%), with a median onset of 5 days. IA was associated with reduced 12-month survival (65.4% vs 80.1%, P = 0.014). Higher acute-on-chronic liver failure (ACLF) grade, preoperative corticosteroid exposure, and postoperative 12-hour lactate >5 mmol/L were independent risk factors. Conclusion: ACLF severity, pretransplant corticosteroids, and early postoperative hyperlactatemia independently correlate with early IA. These hypothesis-generating findings help identify high-risk recipients requiring targeted surveillance.
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BibTeX
@article{zhang2026early,
title = {{Early invasive aspergillosis after liver transplantation: a matched case–control analysis of clinical features and risk factors in a Chinese cohort}},
author = {Yuntao Zhang and Zongyan Luo and Pingbo Jin and Shichao Shen and Ying Chen and Junfang Liu and Yue Wu and Rongrong Wang and Tingbo Liang and Wei Zhang},
journal = {International Journal of Infectious Diseases},
year = {2026},
month = nov,
doi = {10.1016/j.ijid.2026.109206},
url = {https://doi.org/10.1016/j.ijid.2026.109206},
note = {CC BY},
}
RIS
TY - JOUR
TI - Early invasive aspergillosis after liver transplantation: a matched case–control analysis of clinical features and risk factors in a Chinese cohort
AU - Yuntao Zhang
AU - Zongyan Luo
AU - Pingbo Jin
AU - Shichao Shen
AU - Ying Chen
AU - Junfang Liu
AU - Yue Wu
AU - Rongrong Wang
AU - Tingbo Liang
AU - Wei Zhang
PY - 2026
DA - 2026/11/04
JO - International Journal of Infectious Diseases
DO - 10.1016/j.ijid.2026.109206
UR - https://doi.org/10.1016/j.ijid.2026.109206
AB - Background: Early invasive aspergillosis (IA) is a severe complication of liver transplantation, but data from Chinese recipients remain limited. We evaluated its clinical characteristics, outcomes, and independent predictors. Methods: We retrospectively studied adult liver transplant recipients at the First Affiliated Hospital of Zhejiang University from August 2018 to March 2023. Patients meeting 2020 EORTC/MSGERC criteria for proven or probable IA within 1 month post-transplant were matched 1:2 to non-IA controls by age, sex, and etiology. Postoperative intensive care unit and intubation durations were excluded from multivariable regression to eliminate temporal bias. Results: Among 1051 recipients, 78 developed early IA (7.4% incidence; 3 proven, 75 probable), matched to 156 controls. Aspergillus fumigatus predominated (64.1%), with a median onset of 5 days. IA was associated with reduced 12-month survival (65.4% vs 80.1%, P = 0.014). Higher acute-on-chronic liver failure (ACLF) grade, preoperative corticosteroid exposure, and postoperative 12-hour lactate >5 mmol/L were independent risk factors. Conclusion: ACLF severity, pretransplant corticosteroids, and early postoperative hyperlactatemia independently correlate with early IA. These hypothesis-generating findings help identify high-risk recipients requiring targeted surveillance.
SN - 1201-9712
SN - 1878-3511
ER -