tacrolimus and Multiple-Pulmonary-Nodules

Topics: Aged; Animals; Anti-Bacterial Agents; Duodenal Diseases; Endoscopy, Digestive System; Fishes; Graft Rejection; Humans; Immunosuppressive Agents; Kidney Transplantation; Male; Multiple Pulmonary Nodules; Mycobacterium Infections, Nontuberculous; Mycophenolic Acid; Pets; Prednisone; Severity of Illness Index; Skin Ulcer; Tacrolimus; Tomography, X-Ray Computed; Zoonoses

The purpose of this study was to evaluate the radiological and clinical findings of invasive pulmonary aspergillosis (IPA) after liver transplantation.. This study included 25 consecutive liver transplant recipients with histologically confirmed IPA after liver transplantation. Radiological examinations performed for diagnosis were available in all patients. Clinical findings and changes in clinical response and radiological findings after treatment were also evaluated.. 3 main radiological findings were identified: nodules, 64% (16/25); masses, 36% (9/25); and consolidations in a patchy pattern, 20% (5/25). A tree-in-bud pattern was found in 12% (3/25) of patients. In 8 (32%) of 25 patients, we found a combination of 2 or more of these signs: 5 (20%) patients presented with concurrent nodules accompanied by patchy consolidations and/or tree-in-bud, and 3 (12%) patients showed masses accompanied by large consolidations. A halo sign was observed in 20 (80%) of 25 patients. Hypodense sign and cavitary lesions were encountered in 17 (68%) of 25 patients. Follow-up radiological findings after treatment showed improvement in 18 patients, no change in 4 patients and progression in 3 patients. There were three aspergillosis-associated deaths during the follow-up period. The onset time of IPA was a median of 31 days after transplantation. The most common symptom at diagnosis was fever (n=15). None of the 25 patients had leukopaenia at the time of the diagnosis of IPA.. The most common radiological findings of IPA after liver transplantation are multiple nodules with or without halo sign, masses and consolidations, which usually appear about 1 month after transplantation.

Topics: Adult; Aged; Consensus; End Stage Liver Disease; Female; Humans; Immunocompromised Host; Immunosuppressive Agents; Invasive Pulmonary Aspergillosis; Liver Transplantation; Male; Middle Aged; Multidetector Computed Tomography; Multiple Pulmonary Nodules; Opportunistic Infections; Prognosis; Retrospective Studies; Tacrolimus