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

Ye, Ying; Li, Ruidong; Ai, Jingwen; Zhu, Yimin; Zhou, Xian; Qian, Yue; Chen, Xinchang; Wang, Xuyang; Zhang, Haocheng; Li, Yang; Weng, Shanshan; Yu, Yiqi; Tao, Yue; Huang, Yuxian; Wang, Zhengxin; Zhang, Wenhong

doi:10.1016/j.hbpd.2020.06.001

Cited by 4 publications

(4 citation statements)

References 21 publications

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“…The previous study by Ying et al . 20 has also shown that preoperative infection within 2 weeks can cause postoperative infection in liver transplant recipients, which is consistent with the conclusions in Bertuzzo et al .’s study 15 . Similarly, septic shock within 28 days before LT was associated with higher mortality 90 days after LT.…”

Section: Discussionsupporting

confidence: 91%

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Impact of preoperative infection on the outcomes of liver transplant recipients: a national propensity score-matched retrospective cohort study in China

Xiang,

Song,

Liu

et al. 2024

International Journal of Surgery

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Background: Impact of preoperative infection on liver transplantation (LT) needs further investigation. Materials and Methods: From January 1, 2015 to December 31, 2022, 24,122 eligible patients receiving LT were enrolled from the China Liver Transplant Registry database. The outcomes of LT were compared after using the propensity score-matched analysis. Results: Compared to the non-infection group, patients in the infection group were more likely to have postoperative effusion, infection, abdominal bleeding and biliary complications (all P<0.01), and they had shorter 30-day, 90-day survival and overall survival (OS) (all P<0.01). Cox proportional hazards regression analysis revealed that MELD score and cold ischemia time were risk factors for the OS in the infection group (both P<0.05). Besides, compared to the non-pulmonary group, patients in the pulmonary group were more likely to have postoperative effusion and infection (both P<0.0001), and less likely to have postoperative abscess and early allograft dysfunction (both P<0.05). Patients in the non-abdominal group also had a higher proportion of postoperative infection than those in the abdominal group (P<0.05). Furthermore, compared to the number=1 group, patients in the number≥2 group were more prone to postoperative effusion and infection (both P<0.01), and they also had shorter 30-day and 90-day survival (both P<0.05). Conclusion: Preoperative infection can result in a higher incidence of early postoperative complications and shorter survival in liver transplant recipients. The types and number of infection sites will also influence the prognosis of liver transplant recipients.

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Section: Discussionsupporting

confidence: 91%

“…Stringent criteria were employed for precise infection definition. The identified infections were classified into pulmonary, abdominal, biliary tract, bloodstream, and urinary tract infections 19 , 20 .…”

Section: Methodsmentioning

confidence: 99%

Impact of preoperative infection on the outcomes of liver transplant recipients: a national propensity score-matched retrospective cohort study in China

Xiang,

Song,

Liu

et al. 2024

International Journal of Surgery

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“…It provides guidelines for the clinical use of drugs in response. We found that the rates of bacteria responsible for causing post-transplant infections during hospitalization in this period were 51%, similar to those reported previously 19 (the incidence of infection after liver transplantation was 46.7%). In general, a major cause of mortality and morbidity after LT is infection, which occurs in up to 80% of the patients.…”

Section: Discussionsupporting

confidence: 90%

“…This is similar to the results reported by YUE, which demonstrated the respiratory tract was the most common site of infection (43.4%), followed by the biliary tract (21.9%) and the abdomen (21.4%). 19 It indicates that the pattern of pulmonary infection was changed and nosocomial infection might be the most important epidemiological exposure after transplantation in China. We found that 149 microorganisms were isolated from patients with post-LT infections, 65% gram-negative, 28% gram-positive and 7% fungi.…”

Section: Discussionmentioning

confidence: 99%

Preventing Postoperative Infection In Liver Transplant Patients : Preoperative Assessment, Intraoperative Challenges And Postoperative Management

Huang

Pei

et al. 2023

Preprint

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(1) Background: Infection after liver transplant recipients (LTR) added a great burden to the healthcare system, associated with high morbidity and mortality. Infection prevention and control of LTR were particularly complicated due to application of immunological inhibitor and the surge of multidrug-resistant (MDR) pathogens. (2) Methods: We retrospectively reviewed 131 patients with postoperative infections at our center from 2019 to 2021 and the impact of active screening for infection on epidemiology and outcomes. (3) Results: Postoperative infections occurred in51.1% of LTR , a total of 149 isolates were detected in these infections patients. Time to tracheal intubation,hot ischemia time and tacrolimus concentration after LT were independent risk factors for postoperative infections. More isolated Gram-negative bacteria (65%) than positive bacteria (28%), then fungus (7%), were found. The predominant Gram-negative bacteria were Non-fermentative bacteria (31%), followed by Klebsiella pneumonia (15%). The main Gram-positive bacteria were Coagulase-negative Staphylococcus (CoNS, 14%) and Enterococcus (6%). The main infections included pulmonary infections (38%), abdominal infections (28%) and bloodstream infections (19%). Stenotrophomonas maltophilia (24%) and Klebsiella pneumonia (21%) were the principal pathogens associated with pulmonaryinfections, while Klebsiella pneumoniae (18%) and CoNS (16%) were the main pathogens of abdominal infections. CoNS (27%) and fungi(23%)contribute to half of bloodstream infections. 49%(73/149) of the pathogens were detected as MDR, mainly including Carbapenem-resistant Acinetobacter Baumannii (CRAB) (77%,10/13), CR Klebsiella Pneumoniae (CRKP) (46%,12/26), CR Pseudomonas aeruginosa (CRPAE) (46%,6/13),Meticillin-resistant Staphylococcus aureus (MRSA) (80%,4/5) and MRCoNS (67%,16/24). (4) Conclusions: Our results demonstrated the risk factors and microorganisms' antibiotic resistance characteristics of LT infection, with detailed analysis from different sites of infection. We further provided the empirical regimens base on local antibiotics data to assist the clinician to early initiate appropriate antibiotic therapy and effective infection prevention strategies for common pathogens in different infection sites. More experience, improved surgical techniques, and meticulous donor evaluation will help to minimize infection rates in patients after LT.

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Predictive performance of Metagenomic Next Generation Sequencing in early detection of post-liver transplantation infections

Zhuang,

Zhu,

et al. 2024

Heliyon

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

Cited by 4 publications

References 21 publications

Impact of preoperative infection on the outcomes of liver transplant recipients: a national propensity score-matched retrospective cohort study in China

Impact of preoperative infection on the outcomes of liver transplant recipients: a national propensity score-matched retrospective cohort study in China

Preventing Postoperative Infection In Liver Transplant Patients : Preoperative Assessment, Intraoperative Challenges And Postoperative Management

Predictive performance of Metagenomic Next Generation Sequencing in early detection of post-liver transplantation infections

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