Evidence map›Paper›PMID 39966110›Full record

ArticleVirchows Archiv : an international journal of pathology2025

High relevance of invasive fungal disease in chronic liver transplant failure: a comprehensive cross-sectional study.

Aleksandra V Puzalkova, Katharina Hofmann, Tilman Pfeffer, Isabel M Klein, Arianeb Mehrabi, Uta Merle, Albrecht Stenzinger, Roland Penzel, Christa Flechtenmacher, Peter Schirmacher

Abstract read
In one paragraph

Article in Virchows Archiv : an international journal of pathology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Aleksandra V Puzalkova *Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.
Katharina Hofmann *Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.
Tilman PfefferInstitute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.
Isabel M KleinInstitute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.
Arianeb MehrabiDepartment of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Uta MerleDepartment of Gastroenterology, Infectious Diseases and Intoxication, Internal Medicine IV, Heidelberg University Hospital, Heidelberg, Germany.
Albrecht StenzingerInstitute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.
Roland PenzelInstitute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.
Christa FlechtenmacherInstitute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.
Peter SchirmacherInstitute of Pathology, Heidelberg University Hospital, Heidelberg, Germany. Peter.Schirmacher@med.uni-heidelberg.de.ORCID http://orcid.org/0000-0002-0950-3339

Funding

Gilead Sciences 13797
6 · The paper itself

Abstract

Invasive fungal infection (IFI) is a severe complication in organ transplant patients and a major diagnostic and therapeutic challenge. The aim of this comprehensive retrospective study was the characterization of IFI in context of chronic liver transplant failure regarding prevalence, morphological changes, and inducing fungal species. All explanted liver transplants due to chronic transplant failure from Heidelberg University Hospital were extensively reexamined for the presence of mycotic infection. Special stains were performed to uncover severity and associated conditions of IFI and fungal species were identified on the molecular level. Light-microscopic examination revealed fungal infection in 41 (27.5%) of 149 explanted livers with chronic transplant failure, with 68% representing newly specified cases compared to primary reports. We could show an increase of the proportion of mycotic infections during the investigated time period (1991-2021) as well as a shorter transplant survival when compared to the non-affected organs. Typically, large bile ducts were affected, accompanied by acute inflammation with frequent abscess and bile concrement formation. In 35 of 41 cases, the identification of the fungal species was achieved, revealing Candida albicans as prominent species (74.3%). In three autopsy livers of patients that died after liver transplantation of septic multiorgan failure, Candida spp. could be identified. Our data show the underestimated prevalence and high diagnostic and clinical relevance of mycotic infection in chronic liver transplant failure. Adapting diagnostic procedures, molecular pathological analyses, and therapeutic strategies is relevant to identify and prevent chronic transplant organ failure caused by IFIs.

Indexed as

Invasive Fungal InfectionsLiver TransplantationAdultAgedCross-Sectional StudiesFemaleGermanyHumansMaleMiddle AgedPrevalenceRetrospective StudiesYoung AdultChronic transplant failureInvasive fungal infectionLiver transplantationMycosis

Identifiers

PMID39966110
PMCPMC12391138

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.