Invasive Fungal Infections in Low-Risk Liver Transplant Recipients: A Multi-Center Prospective Observational Study

Prevention of invasive fungal infections (IFIs) in ortho-topic liver transplant (OLT) recipients utilizing post-operative systemic antifungal prophylaxis, typically with fluconazole, is justified among those at high risk for IFI. Use of postoperative antifungal prophy-laxis for low-risk OLT recipients is widely practiced but not universally accepted nor supported by data. We conducted a prospective observational study among 200 OLT recipients who were at low risk for IFI and did not receive postoperative antifungal prophylaxis. Pa-tients were considered low risk if they had ≤1 of the following conditions: choledochojejunostomy anasto-mosis; retransplantation; intra-operative administra-tion of ≥units of 40 blood products or return to the operating room for intra-abdominal bleeding; retur