TABLE 2.
Baseline characteristics of adult patients who underwent a single liver transplant at Duke University Hospital in the period between 1 January 2015 and 31 December 2020 stratified by antifungal prophylaxis regimena
| Micafungin prophylaxis n = 53 | Fluconazole prophylaxis n = 100 | P-value (micafungin prophylaxis vs fluconazole prophylaxis) | No antifungal prophylaxis n = 317 | P-value (micafungin and fluconazole prophylaxis vs no prophylaxis) | |
|---|---|---|---|---|---|
| Male gender, n (%) | 36 (67.9) | 57 (57.0) | 0.23 | 227 (71.6) | 0.02 |
| Race, n (%) | 0.16 | 0.02 | |||
| Caucasian | 41 (77.4) | 72 (72.0) | 275 (86.8) | ||
| African American | 4 (7.5) | 18 (18.0) | 27 (8.5) | ||
| Asian | 3 (5.7) | 3 (3.0) | 5 (1.6) | ||
| American Indian or Alaska Native | 3 (5.7) | 1 (1.0) | 2 (0.6) | ||
| Other | 0 (0.0) | 3 (3.0) | 3 (0.9) | ||
| Declined | 2 (3.8) | 3 (3.0) | 5 (1.6) | ||
| Age (years), mean (standard deviation) | 52.6 (12.8) | 53.7 (10.0) | 0.54 | 57.7 (10.8) | <0.01 |
| BMI, mean (standard deviation) | 29.2 (5.0) | 30.7 (5.7) | 0.11 | 30.2 (5.5) | 0.97 |
| Underlying disease leading to transplant, n (%) | 0.40 | <0.01 | |||
| Drug-induced acute hepatic necrosis | 1 (1.9) | 1 (1.0) | 1 (0.3) | ||
| Acute hepatic necrosis other | 3 (5.7) | 4 (4.0) | 1 (0.3) | ||
| Cirrhosis biliary (primary and secondary) | 3 (5.7) | 5 (5.0) | 7 (2.2) | ||
| Cirrhosis alcoholic | 12 (22.6) | 17 (17.0) | 55 (17.4) | ||
| Cirrhosis autoimmune | 5 (9.4) | 4 (4.0) | 4 (1.3) | ||
| Cirrhosis cryptogenic | 3 (5.7) | 2 (2.0) | 19 (6.0) | ||
| Cirrhosis NASH | 5 (9.4) | 24 (24.0) | 68 (21.5) | ||
| Cirrhosis HBV related | 1 (1.9) | 4 (4.0) | 2 (0.6) | ||
| Cirrhosis HCV related | 6 (11.3) | 11 (11.0) | 43 (13.6) | ||
| Hepatocellular carcinoma | 2 (3.8) | 11 (11.0) | 79 (24.9) | ||
| Cholangiocarcinoma | 0 (0.0) | 1 (1.0) | 3 (0.9) | ||
| Hepatic epithelioid hemangioendothelioma | 1 (1.9) | 0 (0.0) | 3 (0.9) | ||
| Primary sclerosing cholangitis | 6 (11.3) | 11 (11.0) | 23 (7.3) | ||
| Alpha 1 anti-trypsin deficiency | 1 (1.9) | 1 (1.9) | 5 (1.6) | ||
| Hemochromatosis | 0 (0.0) | 0 (0.0) | 1 (0.3) 3 (0.9) | ||
| Other | 4 (7.5) | 3 (3.0) | |||
| Pre-transplant immunosuppressive therapy, n (%) | 10 (18.9) | 11 (11.0) | 0.22 | 15 (4.7) | <0.01 |
| Pre-transplant diabetes, n (%) | 11 (20.8) | 31 (31.0) | 0.19 | 110 (34.7) | 0.14 |
| Pre-transplant end-stage renal disease, n (%) | 7 (13.2) | 6 (6.0) | 0.14 | 7 (2.2) | <0.01 |
| Antibiotic use in the 4 months prior to transplant, n (%) | 38 (71.7) | 82 (82.0) | 0.15 | 229 (72.2) | 0.18 |
| Ascites, n (%) | 41 (77.4) | 70 (70.0) | 0.45 | 182 (57.4) | <0.01 |
| Prior hepatobiliary surgery, n (%) | 20 (37.7) | 36 (36.0) | 0.86 | 80 (25.2) | 0.01 |
| Days admitted before transplant, mean (standard deviation) | 8.2 (7.5) | 4.2 (6.5) | <0.01 | 1.8 (5.9) | <0.01 |
| MELD score at transplant, mean (standard deviation) | 28.3 (9.6) | 25.5 (9.8) | 0.09 | 18.1 (7.4) | <0.01 |
| Donor status, n (%) | 0.56 | <0.01 | |||
| - Brain death | 49 (92.5) | 87 (87.0) | 305 (96.2) | ||
| - Cardiac death | 2 (3.8) | 8 (8.0) | 12 (3.8) | ||
| - Living donor | 2 (3.8) | 5 (5.0) | 0 (0.0) | ||
| Repeat transplantation, n (%) | 6 (11.3) | 4 (4.0) | 0.10 | 2 (0.6) | <0.01 |
| Split liver, n (%) | 4 (7.5) | 12 (12.0) | 0.58 | 2 (0.6) | <0.01 |
| Cold ischemic time (minutes), mean (standard deviation) | 326 (126.2) | 318 (118.8) | 0.72 | 313.9 (113.7) | 0.52 |
| Warm ischemic time (minutes), mean (standard deviation) | 37 (6.6) | 39 (6.4) | 0.12 | 40 (41.0) | 0.53 |
| Primary closure, n (%) | 48 (90.6) | 94 (94.0) | 0.52 | 313 (98.7) | <0.01 |
| Transplant surgery >8 hours, n (%) | 15 (28.3) | 26 (26.0) | 0.85 | 26 (8.2) | <0.01 |
| Roux en Y biliary anastomosis, n (%) | 17 (32.1) | 20 (20.0) | 0.11 | 37 (11.7) | <0.01 |
| Bacterial contamination due to entry into GI tract, n (%) | 4 (7.5) | 1 (1.0) | 0.05 | 0 (0.0) | <0.01 |
| Units PRBC required during surgery, mean (standard deviation) | 7.4 (7.1) | 7.0 (8.7) | 0.79 | 3.1 (3.5) | <0.01 |
| >6 units PRBC required during surgery, n (%) | 18 (34.0) | 36 (36.0) | 0.86 | 43 (13.6) | <0.01 |
| Anastomotic leak, n (%) | 6 (11.3) | 10 (10.0) | 0.79 | 11 (3.5) | <0.01 |
| Post-transplant renal replacement therapy, n (%) | 17 (32.1) | 25 (25.0) | 0.35 | 17 (5.4) | <0.01 |
| Return to the OR for abdominal surgery within 3 months of transplant, n (%) | 22 (41.5) | 36 (36.0) | 0.60 | 48 (15.1) | <0.01 |
| Duration of antifungal prophylaxis, mean (standard deviation) | 4.3 (1.7) | 4.1 (1.8) | 0.56 | − | − |
| Candida IP-SSI, n (%) | 5 (9.4) | 1 (1.0) | 0.02 | 4 (1.3) | 0.09 |
a
BMI, body mass index; NASH, non-alcoholic steatohepatitis; HBV, hepatitis B virus; HCV, hepatitis C virus; MELD, model for end-stage liver disease; GI, gastrointestinal; PRBC, packed red blood cells; OR, operating room.