ORCID: https://orcid.org/0000-0001-7536-5715; Zeuzem, Nicholas ORCID: https://orcid.org/0009-0006-1523-1313; Jamme, Paul ORCID: https://orcid.org/0000-0003-3330-0088; Stangl, Manfred ORCID: https://orcid.org/0000-0002-9531-0356; Kur, Felix; Guba, Markus ORCID: https://orcid.org/0000-0002-7778-8401; Melichar, Jan; Irlbeck, Michael ORCID: https://orcid.org/0000-0002-7868-265X; Draenert, Rika ORCID: https://orcid.org/0000-0001-6049-3626 und Lange, Christian M. ORCID: https://orcid.org/0000-0001-9983-5136
(11. April 2025):
Liver transplantation in Candida endocarditis–induced acute-on-chronic liver failure.
In: American Journal of Transplantation [Forthcoming]
Abstract
This case report details the clinical course of a 35-year-old patient with decompensated liver cirrhosis due to primary sclerosing cholangitis awaiting liver transplantation. The patient developed recurrent candidemia due to biliary candidiasis complicated by endotipsitis, leading to repeated hospitalizations and an eventual diagnosis of tricuspid valve Candida endocarditis. In the setting of active Candida infection and severe acute-on-chronic liver failure and lacking other suitable alternatives for infection control, an interdisciplinary team of hepatologists, transplant surgeons, and cardiologists decided to proceed with liver transplantation during a window of opportunity with repeat negative blood cultures. The patient experienced an unremarkable posttransplant recovery despite having repeated positive-result blood cultures for Candida albicans and underwent successful tricuspid valve replacement 5 months later. Our goal is to underscore the critical role of multidisciplinary collaboration in managing high-risk transplant candidates, highlighting in particular the potential benefits of liver transplantation in infection-induced acute-on-chronic liver failure, where full recovery from complex infections might not be possible before transplantation in a setting of severe cirrhosis–associated immune deficiency.
| Item Type: | Journal article |
|---|---|
| Faculties: | Medicine > Medical Center of the University of Munich > Clinic for Anaesthesiology Medicine > Medical Center of the University of Munich > Clinic for General, Visceral, Vascular and Transplant Surgery Medicine > Medical Center of the University of Munich > Cardiac Surgery Clinic and Polyclinic Medicine > Medical Center of the University of Munich > Medical Clinic and Outpatient Clinic II (Gastroenterology, Hepatology) |
| Subjects: | 600 Technology > 610 Medicine and health |
| ISSN: | 16006135 |
| Annotation: | Online first |
| Language: | English |
| Item ID: | 126789 |
| Date Deposited: | 12. Jun 2025 06:16 |
| Last Modified: | 12. Jun 2025 06:16 |
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