DEEP CANDIDA INFECTION IN CHILD LIVER-TRANSPLANT RECIPIENTS - SEROLOGICAL DIAGNOSIS AND INCIDENCE

Nineteen children who received 22 orthotopic liver grafts on 20 occasi ons were studied with regard to Candida infection. Serum samples were analysed to determine Candida, IgA, IgM and IgG antibodies and detect free C. albicans glucoprotein antigen. Five children (25%) had a confi rmed deep C. albicans infection (DCI) during the first 2 weeks after t ransplantation. In all children with DCI, serology was positive, a med ian of 6 days (range 2-9 days) before Candida infection was verified b y fungal culture, direct microscopy and/or autopsy. The positive predi ctive values for Candida IgG, IgM and IgA antibodies in children with DCI were 100%, 78% and 100%, respectively, and for free C. albicans an tigen, 45%. Pathological titres of IgM and IgA antibodies against Cand ida before liver transplantation were present in three of four childre n who later developed a DCI and in no child without infection. In conc lusion, regular screening by Candida serology is recommended both befo re and after liver transplantation.