Context: LIVER transplant recipients are highly susceptible to infections, including those affecting the central nervous system (CNS), due to their compromised immune systems and underlying chronic comorbidities. Results: Despite recent advancements in diagnostic and treatment modalities, post-transplant fungal infections continue to affect these patients. CNS fungal infections following LIVER TRANSPLANTATION pose a significant challenge in the diagnostic and therapeutic management of transplant recipients. Timely diagnosis and treatment are crucial because these infections are often identified late, leading to substantial morbidity and mortality in this patient population. Conclusions: This mini-review aims to explore the incidence of CNS fungal infections in LIVER transplant recipients, the key opportunistic pathogens involved, the associated risk factors, various clinical presentations, and the importance of preventive measures.

Background: Although patient and graft survival rates have been increased, biliary complications after LIVER TRANSPLANTATION are associated with significant morbidity and mortality. There is a multidisciplinary approach to solve this problem.Objective: We reviewed our experience in management of biliary complications after deceased donor LIVER TRANSPLANTATION in 105 patients over a 13-year period.Methods: We reviewed records of 105 patients who underwent deceased donor LIVER TRANSPLANTATION at Nemazee Hospital, Shiraz, southern Iran, who presented with clinical or biochemical signs of biliary complications between January 2000 and September 2013. All patients presented with abnormal results on LIVER function tests and a variety of clinical symptoms such as fever, icter, and cholangitis. In addition, if the find ings of a LIVER biopsy were not conclusive for rejection or for recurrent HCV infection, sonography or MRCP was performed to rule out any biliary complications. If we suspected to any biliary problems, ERCP or PTC was performed for the patients. If the complication was not resolved by the above-mentioned procedures, exploration of common bile duct and Roux-en-Y choledochojejunostomy was done for the patients.Results: Our study group comprised 105 patients; 64 (61%) men and 41 (39%) women with a mean±SD age of 33.6±14.8 (range: 3–66) years. The interval between orthotopic LIVER TRANSPLANTATION and the clinical onset of biliary complications ranged from 1 to 122 (mean±SD of 18.8±28.2) months. The most common indications for LIVER TRANSPLANTATION were cryptogenic cirrhosis (n=29), HBV-induced LIVER cirrhosis (n=15), primary sclerosing cholangitis (n=13), autoimmune hepatitis (n=13), and Wilson’s disease (n=11). The biliary tract was reconstructed with choledochocholedochostomy (duct to duct anastomosis) in 87 (87%) and Roux-en-Y choledochojejunostomy in 13 (13%) LIVER TRANSPLANTATIONs. ERCP and PTC were performed in 73 (69.5%), and 25 (23.8%) suspected patients with biliary complications, respectively. Secondary operation and biliary exploration was performed in 39 (37.1%) patients.21 (28%) of patients who underwent ERCP, and 12 (48%0 of those who underwent PTC needed biliary exploration.Conclusion: ERCP and PTC are effective management for biliary complications after LIVER TRANSPLANTATION.