Introduction: Invasive fungal infections (IFIs) have been reported to have high rates of mortality in transplant recipients. The aim of this study is two folds, first to evaluate the incidence of IFIs among liver transplant recepients; second to find out the possible risk factors of the development of IFIs.

Materials and Methods: A retrospective analysis was made of the recorded data in 408 patients received liver transplantation between January 1990 to December 2012 at Başkent University. Demographic and clinical findings of these patients including age, gender, primary liver disease, immunsupressive treatment, blood drug level and the time between the transplant surgery and the occurence of the fungal infections were examined.

Results: Only 10 of 408 liver transplant patients (2.5%) were developed IFIs. Of the total 10 patients, 8 were male and two of them were women. The mean age of these patients was 45.5±21.9 years. Six of ten patients had the diagnosis of diabetes mellitus before liver transplantation. In addition, three of ten patients had CMV infections before the diagnosis of IFIs. Diagnosis of the fungal infections was made by the positive blood or bronchoalveolar lavage cultures and with the biopsies. The mean time between transplantation and the development of IFIs was 32±19.2 days. Aspergillus was the most common cause of invasive fungal infections (n=8), followed by candida (n=1) and criptococcus neoformans (n=1). Pulmonary involvement was dominant in nearly all patients (n=9), and only one patient had disseminated fungal infection (criptococcosis). The only one of these ten patients response to therapy, while the remaining patients died because of IFIs.

Conclusions: Only ten of our liver transplant patients (2.5%) had fungal infections and we suggested that the most predisposing factor of IFIs in transplant patients were found to be diabetes mellitus and CMV infection, In addition to immunosupressive therapy. As reported in the literature, Aspergillus was found to be the most common pathogen also among our cases. This study pointed out that because of its high mortality rate, it is very important to follow up transplant patients carefully for the development of IFIs.