Impact of pretransplant infections on clinical outcomes of liver transplant recipients

Sun, Hsin‐Yun; Cacciarelli, Thomas V.; Singh, Nina

doi:10.1002/lt.21982

Cited by 51 publications

(59 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…14 Similarly, patients with liver failure awaiting transplantation are at increased risk of infections, and although infections before transplantation may not affect mortality, in the posttransplant period early bacterial infections are a major cause of mortality. 15,16 Major Risk Factors of Infection in Liver Disease…”

Section: Significance Of Infectious Insult In Liver Diseasementioning

confidence: 99%

Infections in Liver Disease

Nanchal

Ahmad

2016

Critical Care Clinics

View full text Add to dashboard Cite

Section: Significance Of Infectious Insult In Liver Diseasementioning

confidence: 99%

Infections in Liver Disease

Nanchal

Ahmad

2016

Critical Care Clinics

View full text Add to dashboard Cite

“…Sun et al divided their 100 DDLT cases into two groups; a pre-transplant infection group (32/100) and a non-infection group (68/100). They concluded that pre-transplant infections were not a significant risk factor for poor outcomes if the post-transplant infections were adequately treated [1]. Our study evaluated the influence of preoperative infections in LDLT cases for the first time.…”

Section: Discussionmentioning

confidence: 97%

“…Since deceased donor liver transplantation (DDLT) is usually performed as an emergent surgery, a preceding preoperative evaluation for occult infection cannot always be extensively performed. Despite this drawback of emergency surgery, some studies have revealed that histories of pre-transplant infections do not affect the outcomes of DDLT [1,2]. However, the outcomes of patients with pre-transplant infections have not been clarified in living donor liver transplantation (LDLT).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Impact of Treated Bacterial Infections within One Month before Living Donor Liver Transplantation in Adults

et al. 2014

View full text Add to dashboard Cite

Background:The impact of treated preoperative bacterial infections on the outcome of living-donor liver transplantation (LDLT) is not well defined. The aim of this study was to determine the frequency of pre-transplant bacterial infections within one month before LDLT and their impact on the post-transplant morbidity and mortality. Material/Methods:We retrospectively reviewed the records of 50 adult LDLT recipients between January 2009 and October 2011. Patients were divided into two groups based on whether they had episodes of bacterial infections within one month before LDLT. Results:There were 20 patients who required antimicrobial therapy for pre-transplant infections. The pre-transplant infections comprised urinary tract infections (35%), cholangitis (10%), pneumonia (10%), bacteremia (5%), spontaneous bacterial peritonitis (5%), acute sinusitis (5%), subcutaneous abscess (5%), and empirical treatment (25%). Patients with pre-transplant infections had higher Child-Pugh scores [median, 11 vs. 9.5, P<0.05] and model for end-stage liver disease scores [median, 17.5 vs. 14, P<0.05] compared with the other patients. There were no correlations between the pathogens involved in the pre-transplant infections and those involved in post-transplant infections. The incidence of post-transplant infections was higher in the pre-transplant infection group within one week after LDLT, but was almost the same within one month after LDLT. The one-year survival rates were not significantly different between the groups. Conclusions:Although pre-transplant infections are associated with a high risk of postoperative bacterial infection shortly after LDLT, they did not affect the short-term outcome when they had been appropriately treated before transplantation.

show abstract

“…To decrease infections caused by these factors, we follow a fast-track surgery pathway. 9 Factors related to surgical procedures are also important. Disruption 6 Retransplant, prolonged ventilator support, renal failure, extended renal replacement therapy, prolonged use of antimicrobial agents, colonization with resistant hospital flora, and immunosuppression play critical roles in postoperative development of infections.…”

Section: Discussionmentioning

confidence: 99%

Untitled

Soy

Akdur²,

Yıldırım³

et al. 2018

Exp Clin Transplant

View full text Add to dashboard Cite

Objectives: Despite surgical advances and effective prophylactic strategies in liver transplant, infection is still a major cause of morbidity and mortality. Up to 80% of liver recipients will develop at least 1 infection during the first year after liver transplant. The spectrum and manifestations of these infections are broad and variable. Their diagnosis and treatment are often delayed because immunosuppressive therapy diminishes inflammatory responses. However, if an infection is not identified early enough and treated properly, it can have devastating consequences. In addition, prophylactic approaches remain controversial. Our aim was to review our early postoperative infection management after liver transplant. Materials and Methods: We retrospectively evaluated infections that occurred during the first hospital stay of transplant patients. Infections were grouped as surgical site and nonsurgical site infections. Consequences and treatment protocols of infections were stratified according to the Clavien scale. Results: Between December 1988 and January 2017, we performed 561 liver transplants at our center (patient age range, 6 months to 64 years), which included 401 living-donor (72%) and 160 deceaseddonor (28%) liver transplants. Early postoperative infections were detected in 131 patients (23.3%), comprising 67 surgical site (51%), 56 nonsurgical site (43%), and 8 combined surgical and nonsurgical site infections (6%). Although no mortalities occurred in patients with single nonsurgical or surgical site infections, there were 4 mortalities in patients with combined surgical and nonsurgical site infections. In the 4 other patients with combined infections, 3 patients required endoscopic or radiologic intervention and 1 recovered from single-organ dysfunction. Conclusions: Initiation of appropriate prophylactic and therapeutic protocols at the right time decreases morbidity and mortality due to infection in liver transplant recipients. Increased understanding and effective approaches to prevent infection are essential to improving both graft and recipient survival. Key words: Cytomegalovirus, End-stage liver disease; Pneumocystis jiroveci, Surgical site infection IntroductionLiver transplantation is the standard therapeutic procedure for patients with end-stage liver disease. Liver transplant survival rates are reported as 85% in the first year. Despite surgical advances and effective prophylactic strategies, infection is still a major cause of morbidity and mortality after liver transplant. The incidence of infectious complications in liver transplant recipients remains higher than in any other solid-organ transplant procedure, with up to 80% of liver recipients developing at least 1 infection during the first year after transplant. 1 The incidence of infection-related mortality has decreased from more than 50% before 1980, to 25% to 35% in the 1980s, and to less than 10% in the 1990s. 2 The spectrum and manifestations of these infections are broad and variable. Liver transplant patients are in i...

show abstract

Impact of pretransplant infections on clinical outcomes of liver transplant recipients

Cited by 51 publications

References 17 publications

Infections in Liver Disease

Infections in Liver Disease

The Impact of Treated Bacterial Infections within One Month before Living Donor Liver Transplantation in Adults

Untitled

Contact Info

Product

Resources

About