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

Tu, Zhenhua; Xiang, Penghui; Xu, Xiao; Zhou, Lin; Li, Zhuang; Wu, Jian; Wang, W.; Zheng, Shusen

doi:10.1111/ijcp.12810

Cited by 14 publications

(18 citation statements)

References 28 publications

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“…In our hospital, the incidence of infection after liver transplantation reached 46.7%. It was consistent with the previous reports studied in China, in which 15%-69% of patients acquired postoperative infection [13][14][15][16][17] . Most infection occurred in the first month after liver transplantation, which is related to surgical complications as for traditional view 18 .…”

Section: Discussionsupporting

confidence: 93%

“…However, the most common site of infection is not surgical site, but the respiratory tract and Gram-negative pathogens are major pathogens. Our findings were also supported by other studies in China [14][15] . These indicated that the pattern of posttransplant infection was changed and nosocomial infection might be the most important epidemiological exposure in the first month after transplantation in China.…”

Section: Discussionsupporting

confidence: 92%

See 1 more Smart Citation

Infection within 2 weeks before liver transplantation closely related to prognosis of posttransplant infection: A single-center retrospective observational study in China

et al. 2020

Hepatobiliary & Pancreatic Diseases International

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

Infection within 2 weeks before liver transplantation closely related to prognosis of posttransplant infection: A single-center retrospective observational study in China

et al. 2020

Hepatobiliary & Pancreatic Diseases International

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“…It has been reported by Hamandi et al that infectious complications in solid organ transplants require hospitalisation in 603 of 1414 readmissions at a rate of 0.43 episodes per 1000 transplant-days (95% CI: 0.40-0.47), with 85% occurring after 6 months following transplantation [6]. Conversely, Tu et al report most post-DDLT infections (61.9%) occurring within the first week of transplant, and the 1-and 3-year survival rates without infection significantly increased compared with recipients with infection (p = 0.007) [27]. It is important to know the timings, rate and type of infections after LDLT and DDLT since these infections are not just a controllable risk factor for failure but there has also been a recent quest for markers such as neopterin, associating 1-year posttransplant infections with mortality [28].…”

Section: Discussionmentioning

confidence: 98%

Effects of Infection on Post-Transplant Outcomes: Living versus Deceased Donor Liver Transplants

Siddique¹,

Siddique²,

Machan³

et al. 2017

American Journal of Gastroenterology

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Introduction:Post-transplant infections have been studied widely but data on comparisons of deceased donor liver transplants (DDLT) and living donor liver transplants (LDLT), type and timings of infections, and their relations to outcomes are not explored. Material and methods: We analysed data from 612 participants of the Adult-to-Adult Living Donor Liver Transplantation Study (A2ALL), a retrospective data set of LDLT and DDLT. We compared the type and timing of the first post-transplant infection in relation to transplant outcomes between the two groups. Results: Out of 611 patients, 24.5% experienced the first post-transplant infection, the majority of which were bacterial (35.3%), followed by fungal (11%) and viral infections (4.2%). There was no significant difference in the rate, type or timing of infection between LDLT and DDLT. Patients with late (> 1 year) first infection were 1.8 times more likely to die (95% CI: 1.12-2.98, p = 0.015) and 9 times more likely to have graft failures (95% CI: 3.26-24.8, p < 0.001). DDLT recipients who experienced bacterial infection had a significantly lower survival rate compared to LDLT recipients (p < 0.001). Conclusions: Late infection is associated with lower survival in both DDLT and LDLT. Bacterial infection might be more detrimental for DDLT than LDLT. Late infection should be managed aggressively to improve outcomes. a high clinical burden, with 85% occurring 6 months after transplantation [6]. These conflicting reviews on early and late post-transplant infections and their effect on outcomes in transplant recipients need further exploration to decrease post-transplant morbidity and mortality.Moreover, immunologic and technical advances have improved infection control and post-transplant graft and patient survival, but improvements in immune monitoring and rejection management are required to increase the rates of re-transplantation success [7]. Re-transplant outcomes are poorly understood in liver transplants especially amongst patients receiving living donor transplants. It has been reported that re-transplantation outcomes after living donor

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“…Conversely, Tu et al . report most post-DDLT infections (61.9%) occurring within the first week of transplant, and the 1- and 3-year survival rates without infection significantly increased compared with recipients with infection ( p = 0.007) [ 27 ]. It is important to know the timings, rate and type of infections after LDLT and DDLT since these infections are not just a controllable risk factor for failure but there has also been a recent quest for markers such as neopterin, associating 1-year posttransplant infections with mortality [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of infection on post-transplant outcomes: living versus deceased donor liver transplants

Siddique

Machan

et al. 2018

ceh

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IntroductionPost-transplant infections have been studied widely but data on comparisons of deceased donor liver transplants (DDLT) and living donor liver transplants (LDLT), type and timings of infections, and their relations to outcomes are not explored.Material and methodsWe analysed data from 612 participants of the Adult-to-Adult Living Donor Liver Transplantation Study (A2ALL), a retrospective data set of LDLT and DDLT. We compared the type and timing of the first post-transplant infection in relation to transplant outcomes between the two groups.ResultsOut of 611 patients, 24.5% experienced the first post-transplant infection, the majority of which were bacterial (35.3%), followed by fungal (11%) and viral infections (4.2%). There was no significant difference in the rate, type or timing of infection between LDLT and DDLT. Patients with late (> 1 year) first infection were 1.8 times more likely to die (95% CI: 1.12-2.98, p = 0.015) and 9 times more likely to have graft failures (95% CI: 3.26-24.8, p < 0.001). DDLT recipients who experienced bacterial infection had a significantly lower survival rate compared to LDLT recipients (p < 0.001).ConclusionsLate infection is associated with lower survival in both DDLT and LDLT. Bacterial infection might be more detrimental for DDLT than LDLT. Late infection should be managed aggressively to improve outcomes.

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

Cited by 14 publications

References 28 publications

Infection within 2 weeks before liver transplantation closely related to prognosis of posttransplant infection: A single-center retrospective observational study in China

Infection within 2 weeks before liver transplantation closely related to prognosis of posttransplant infection: A single-center retrospective observational study in China

Effects of Infection on Post-Transplant Outcomes: Living versus Deceased Donor Liver Transplants

Effects of infection on post-transplant outcomes: living versus deceased donor liver transplants

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