Bloodstream infection after elective liver transplantation is associated with increased mortality in patients with cirrhosis

Karvellas, Constantine J.; McPhail, Mark; Pink, Fred; Asthana, Sonal; Muiesan, Paolo; Heaton, Nigel; Auzinger, G.; Bernal, William; Eltringham, Ian; Wendon, Julia

doi:10.1016/j.jcrc.2010.12.018

Cited by 26 publications

(15 citation statements)

References 21 publications

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“… 4 , 69 – 71 Furthermore, bacteremia, per se, could also be a marker of other factors related to higher mortality, comprising poor graft function, surgical complications and prolonged intensive care unit stay. 72 …”

Section: Methodsmentioning

confidence: 99%

“…Catheter-related bacteremia caused by MRSA was preventable with appropriate prevention strategies. 72 Strict adherence to the principles of intravascular catheter management established by CDC sharply reduced its incidence. 92 – 94 Skin antisepsis with chlorhexidine gluconate or daily skin cleansing with 2% chlorhexidine gluconate can also control this type of bacteremia well.…”

Section: Methodsmentioning

confidence: 99%

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<div>Methicillin-resistant <em>Staphylococcus aureus</em> bacteremia among liver transplant recipients: epidemiology and associated risk factors for morbidity and mortality</div>

Liu¹,

Zhang²,

Wan³

2018

IDR

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Bacteremia due to Staphylococcus aureus, especially methicillin-resistant S. aureus (MRSA), complicates the clinical course of liver transplantation and is associated with high morbidity and mortality. Intravascular catheters had been reported to be the most frequent source of MRSA bacteremia. Among bacteremic liver recipients, 26.3%–100% of S. aureus were MRSA. Previous studies identified pre-transplant and post-transplant acquired S. aureus carriage, greater severity of liver disease, hepatocellular carcinoma and infection with immuno-modulatory viruses as predictors of S. aureus bacteremia in liver recipients. MRSA bacteremia accompanied by pneumonia and abdominal infections was related to mortality. Vancomycin, as well as daptomycin, is a first-line antibiotic for MRSA bacteremia. The purpose of this review is to better understand the characteristics of MRSA bacteremia by summarizing the epidemiology and antimicrobial resistance of S. aureus, the primary source, and related risk factors for morbidity and mortality of MRSA bacteremia. We have also explored the diagnostic, therapeutic and preventive measures for MRSA bacteremia to improve the outcomes of liver recipients.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

<div>Methicillin-resistant <em>Staphylococcus aureus</em> bacteremia among liver transplant recipients: epidemiology and associated risk factors for morbidity and mortality</div>

Liu¹,

Zhang²,

Wan³

2018

IDR

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“…Donation after cardiac death (DCD) is a surgical technique used to expand the donor pool . However, postoperative infection is one of the most significant causes influencing the survival of LTx recipients . Research has been performed to study the incidence, timing, and risk factors for infections after liver transplant .…”

Section: Introductionmentioning

confidence: 99%

DCD liver transplant infection: experience from a single centre in China

Xiang

et al. 2016

Int J Clin Pract

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This is the first study that offers detailed data revealing the timing and incidence of bacterial and fungal infection among adult DCD liver transplant recipients. Bacterial and fungal infection occurs at a high rate during the first week after DCD liver transplant, especially in patients with prolonged respiratory support time and renal failure, and infection is related to increased hospital stay.

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“…Only limited date on the critical care management of and complications in liver transplant recipients are available [ 15 – 18 ]. Therefore, an easy-to-assess test with good accuracy would be valuable for outcome prediction and risk stratification in the postoperative phase of liver transplant patients.…”

Section: Introductionmentioning

confidence: 99%

The combination of MELD score and ICG liver testing predicts length of stay in the ICU and hospital mortality in liver transplant recipients

et al. 2014

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BackgroundEarly prediction of outcome would be useful for an optimal intensive care management of liver transplant recipients. Indocyanine green clearance can be measured non-invasively by pulse spectrophometry and is closely related to liver function.MethodsThis study was undertaken to assess the predictive value of a combination of the model of end stage liver disease (MELD) score and early indocyanine plasma disappearance rates (ICG-PDR) for length of stay in the intensive care unit (ICU), length of stay in the hospital and hospital mortality in liver transplant recipients.ResultsFifty consecutive liver transplant recipients were included in this post Hoc single-center study. ICG-PDR was determined within 6 hours after ICU admission. Endpoints were length of stay in the ICU, length of hospital stay and hospital mortality. The combination of a high MELD score (MELD >25) and a low ICG-PDR clearance (ICG-PDR < 20%/minute) predicts a significant longer stay in the ICU (p = 0.004), a significant longer stay in the hospital (p < 0.001) and a hospital mortality of 40% vs. 0% (p = 0.003).ConclusionThe combination of MELD scores and a singular ICG-PDR measurement in the early postoperative phase is an accurate predictor for outcome in liver transplant recipients. This easy-to-assess tool might be valuable for an optimal intensive care management of those patients.

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Bloodstream infection after elective liver transplantation is associated with increased mortality in patients with cirrhosis

Cited by 26 publications

References 21 publications

<div>Methicillin-resistant <em>Staphylococcus aureus</em> bacteremia among liver transplant recipients: epidemiology and associated risk factors for morbidity and mortality</div>

<div>Methicillin-resistant <em>Staphylococcus aureus</em> bacteremia among liver transplant recipients: epidemiology and associated risk factors for morbidity and mortality</div>

DCD liver transplant infection: experience from a single centre in China

The combination of MELD score and ICG liver testing predicts length of stay in the ICU and hospital mortality in liver transplant recipients

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