Abstract
The net state of immunosuppression, the occurrence of infections, drug-drug interactions, and toxicity can compromise the outcome of liver transplant recipients with multiple comorbidities. We present a 67-year-old man who developed early posttransplant severe chronic obstructive pulmonary disease exacerbation, pulmonary aspergillosis, and cytomegalovirus reactivation. Drug-drug interactions between azoles and cyclosporine, along with renal and liver toxicity, required adjustments in dosage. Interferon-gamma production from antigen-stimulated T cells was recorded. Early diagnosis and treatment, along with therapeutic drug monitoring and recovery of T-cell immunity, were key factors for a positive outcome.
MeSH terms
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Age Factors
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Aged
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Antifungal Agents / adverse effects
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Antiviral Agents / adverse effects
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Comorbidity
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Cytomegalovirus Infections / diagnosis
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Cytomegalovirus Infections / immunology
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Cytomegalovirus Infections / virology
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Drug Interactions
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Drug Monitoring
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Drug Therapy, Combination
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Graft Rejection / immunology
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Graft Rejection / prevention & control*
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Graft Survival / drug effects
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Humans
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Immunocompromised Host*
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Immunosuppressive Agents / adverse effects*
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Liver Transplantation / adverse effects*
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Male
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Opportunistic Infections / diagnosis
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Opportunistic Infections / immunology
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Opportunistic Infections / microbiology*
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Pulmonary Aspergillosis / diagnosis
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Pulmonary Aspergillosis / immunology
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Pulmonary Aspergillosis / microbiology*
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Risk Factors
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Th1 Cells / drug effects
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Th1 Cells / immunology
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Th1 Cells / microbiology
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Th1 Cells / virology
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Time Factors
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Treatment Outcome
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Virus Activation
Substances
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Antifungal Agents
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Antiviral Agents
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Immunosuppressive Agents