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Is Routine Prophylaxis Against Pneumocystis jirovecii Needed in Liver Transplantation? A Retrospective Single-Centre Experience and Current Prophylaxis Strategies in Spain

Abstract: In liver transplant (LT) recipients, Pneumocystis jirovecii pneumonia (PJP) is most frequently reported before 1992 when immunosuppressive regimens were more intense. It is uncertain whether universal PJP prophylaxis is still applicable in the contemporary LT setting. We aimed to examine the incidence of PJP in LT recipients followed at our institution where routine prophylaxis has never been practiced and to define the prophylaxis strategies currently employed among LT units in Spain. All LT performed from 1990 to October 2019 were retrospectively reviewed and Spanish LT units were queried via email to specify their current prophylaxis strategy. During the study period, 662 LT procedures were carried out on 610 patients. Five cases of PJP were identified, with only one occurring within the first 6 months. The cumulative incidence and incidence rate were 0.82% and 0.99 cases per 1000 person transplant years. All LT units responded, the majority of which provide prophylaxis (80%). Duration of prophylaxis, however, varied significantly. The low incidence of PJP in our unprophylaxed cohort, with most cases occurring beyond the usual recommended period of prophylaxis, questions a one-size-fits-all approach to PJP prophylaxis. A significant heterogeneity in prophylaxis strategies exists among Spanish LT centres.

Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria

 Fuente: J Clin Med . 2020 Nov 6;9(11):3573

Editorial: MDPI

 Año de publicación: 2020

Nº de páginas: 13

Tipo de publicación: Artículo de Revista

 DOI: 10.3390/jcm9113573

ISSN: 2077-0383

Url de la publicación: https://www.doi.org/10.3390/jcm9113573

Autoría

FORTEA, JOSÉ IGNACIO

CUADRADO, ANTONIO

PUENTE, ÁNGELA

ÁLVAREZ FERNÁNDEZ, PALOMA

HUELIN, PATRICIA

ÁLVAREZ TATO, CARMEN

GARCÍA CARRERA, INÉS

COBREROS, MARINA

CAGIGAL COBO, MARÍA LUISA

CALVO MONTES, JORGE

RUIZ DE ALEGRÍA PUIG, CARLOS

CASTILLO SUESCUN, FEDERICO JOSÉ

FERNÁNDEZ SANTIAGO, ROBERTO

ECHEVERRI CIFUENTES, JUAN ANDRÉS

CASAFONT, FERNANDO

CRESPO, JAVIER

FÁBREGA, EMILIO