Successful Liver Retransplantation in a Patient With Disseminated Aspergillosis and Nocardiosis: A Case Report

Thisuri Jayawardena, Chloe Attree, Sarah Cole, Siong Hui, Bryon Jaques, Gerry MacQuillan, Briohny Smith, Michael Wallace, George Garas, Leon Adams, Gary Jeffrey

Research output: Contribution to journalArticlepeer-review


Background: Clinical guidelines list active fungal infection and sepsis as contraindications to liver transplantation due to the risk of worsening infection with immunosuppression postoperatively. Mortality from systemic opportunistic infections in transplant recipients is high, approaching 100% for disseminated aspergillosis. However, the optimal duration of treatment required before transplant is unclear. Additionally, delaying surgery while the infection is treated risks death from hepatic decompensation and physical deconditioning, preventing progression to transplantation. Case report: Here, we present a patient who underwent successful repeat liver transplantation for recurrent autoimmune hepatitis and graft rejection while undergoing treatment for disseminated aspergillosis and nocardiosis. He had pulmonary, hepatic, and central nervous system involvement. He had received 2 months of antimicrobials but had ongoing radiologic evidence of infection when listed for retransplantation. He remains well and infection-free 1 year postoperatively. Conclusion: Few cases of successful liver transplantation in the setting of disseminated aspergillosis have been reported previously. To our knowledge, this is the first successful liver transplant in a patient with disseminated nocardial infection.

Original languageEnglish
Pages (from-to)244-248
Number of pages5
JournalTransplantation Proceedings
Issue number1
Early online dateJan 2024
Publication statusPublished - Feb 2024


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