17. Microbiological Prophylaxis in Liver Transplantation

  1. James Neuberger DM, FRCP2,
  2. James Ferguson MD, FRCPE3 and
  3. Philip N. Newsome PhD, FRCPE4
  1. Matthew J. Armstrong and
  2. Philip N. Newsome

Published Online: 19 JUL 2013

DOI: 10.1002/9781118675915.ch17

Liver Transplantation: Clinical Assessment and Management

Liver Transplantation: Clinical Assessment and Management

How to Cite

Armstrong, M. J. and Newsome, P. N. (2013) Microbiological Prophylaxis in Liver Transplantation, in Liver Transplantation: Clinical Assessment and Management (eds J. Neuberger, J. Ferguson and P. N. Newsome), John Wiley & Sons, Ltd, Oxford, UK. doi: 10.1002/9781118675915.ch17

Editor Information

  1. 2

    Associate Medical Director, Organ Donation and Transplantation, NHS Blood and Transplant, Bristol; Honorary Consultant Physician, Queen Elizabeth Hospital, Birmingham, UK

  2. 3

    Consultant Hepatologist, Queen Elizabeth Hospital, Birmingham, UK

  3. 4

    Head of Cell Therapy, Senior Lecturer in Hepatology and Consultant Transplant Hepatologist, Centre for Liver Research and Birmingham NIHR Liver Biomedical Research Unit, Institute of Biomedical Research, The Medical School, University of Birmingham; Queen Elizabeth Hospital, Birmingham, UK

Author Information

  1. University of Birmingham, Birmingham, UK

Publication History

  1. Published Online: 19 JUL 2013

ISBN Information

Print ISBN: 9781118277386

Online ISBN: 9781118675915

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Keywords:

  • antifungal;
  • broad-spectrum antibiotics;
  • cytomegalovirus;
  • hepatitis B virus;
  • infection;
  • nucleos(t)ide analogues;
  • pneumocystis pneumonia;
  • universal prophylaxis

Summary

Advances in immunosuppressive agents over the last 20 years have been paralleled by improvements in our understanding of microbiological prophylaxis in liver transplantation. Universal and targeted prophylactic strategies have decreased the post-transplant incidence and severity of pneumocystis pneumonia and cytomegalovirus, respectively. The combination of hepatitis B immune globulin and oral nucleos(t)ide analogues has dramatically improved the survival of patients transplanted for HBV-related liver disease, with the latter enabling hepatitis B core antibody-positive donor grafts to be utilised. Patients who are in high-risk groups (acute liver failure, retransplantation, renal failure) benefit from targeted antifungal prophylaxis.