Surgical Site Infection After Liver Transplantation: Risk Factors and Association With Graft Loss or Death

Hellinger, Walter C.; Crook, Julia E.; Heckman, Michael G.; Diehl, Nancy N.; Shalev, Jefree A.; Zubair, Abba C.; Willingham, Darrin L.; Hewitt, Winston R.; Grewal, Hani P.; Nguyen, Justin H.; Hughes, Christopher

doi:10.1097/tp.0b013e3181a25133

Cited by 75 publications

(92 citation statements)

References 29 publications

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“…17 In the current study, the overall incidence of NI was 28.7%. The most common types of infection were catheter-related and/or bloodstream infections and surgical site infections, with respiratory infections being the next most common infection type.We report a lower incidence of infectious events during the first 30 days (28.7%) as compared with other studies, which report an incidence of 50% 18 and 60%.…”

Section: Discussionmentioning

confidence: 93%

Effects of Blood Products on Nosocomial Infections in Liver Transplant Recipients

Özkardeşler

Avkan-Oğuz²,

Akan³

et al. 2013

Exp Clin Transplant

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Objectives: Infection is the most severe complication after an organ transplant. Blood cell transfusion is an independent risk factor for adverse events, including infection in the recipient. This study sought to evaluate the effect of blood product transfusions on nosocomial infections in liver transplant patients. Materials and Methods: Patients who underwent a liver transplant at our hospital between 2003 and 2010 were recruited for this study. Exclusion criteria were incomplete records, patients who were hospitalized for more than 48 hours during the 4 weeks before transplant, and pediatric transplants. Incidence of nosocomial infections, which were defined as infections occurring within 30 days after transplant was the primary endpoint. Results: The incidence of nosocomial infections was 28.7%. The number of transfusions of packed red blood cells and fresh frozen plasma was significantly higher in patients with nosocomial infection compared with patients without nosocomial infection (P = .018 and P = .039). Blood products dose-dependently contributed to nosocomial infections. Transfusions of ≥ 7.5 units of red blood cells (odds ratio: 2.8) or ≥ 12.5 units of fresh frozen plasma (odds ratio: 3.27) were associated with nosocomial infections (P = .042 and P = .015). The infection-related mortality rate was 10.3%. Conclusions: Blood product transfusions are associated with an increased rate of nosocomial infections, which contributes to higher morbidity and mortality.

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Section: Discussionmentioning

confidence: 93%

Effects of Blood Products on Nosocomial Infections in Liver Transplant Recipients

Özkardeşler

Avkan-Oğuz²,

Akan³

et al. 2013

Exp Clin Transplant

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“…Liver transplant recipients have historically had a markedly higher rate of infection, including SSI, than any other solid organ transplant recipients or general surgical patients [1,[9][10]. Prolonged operative time, surgical complexity, risk of gastrointestinal contamination, immunosuppression, metabolic derangements, and the compromised ability of the immunosuppressed host to clear residual bacterial contamination all make liver transplant recipients particularly susceptible to infection [1][2].…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, patients with SSI following liver transplantation utilize more resources and accrue at least $2,000-$4,000 in additional hospital cost [9,[11][12]. Beyond this, SSIs have been associated with a significant increase in graft loss and patient mortality within the first year following transplantation (RR 3.06, 95% CI 1.66-5.64; p < 0.001) [10]. It is clear that postoperative infections in liver transplant recipients are a substantial burden, and an attempt should be made to predict and prevent these complications.…”

Section: Rosenberger Et Almentioning

confidence: 99%

Donor Risk Index Predicts Graft Failure Reliably But Not Post-Transplant Infections

Rosenberger

Gillen

Hranjec

et al. 2014

Surgical Infections

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“…[28][29][30][31] Recognizing infections in transplant recipients is difficult; clinical signs and symptoms are often not specific and might be muted. 3,11 One-third of patients with infected hepatic fluid collections (bilomas) were asymptomatic.…”

Section: Clinical Aspects Of Candida Infectionsmentioning

confidence: 99%

Management of Candida infections in liver transplant recipients: current perspectives

Lingegowda¹,

Tan²

2014

TRRM

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Liver transplantation has emerged as a widely accepted lifesaving therapeutic option for many patients with a variety of liver diseases. Improved surgical and medical management has led to significant improvements in post-transplant survival rates with a 1 year and 5 year patient survival of 87% and 73%, respectively. A high mortality rate due to infections during the first post-transplant year persists. Invasive candidiasis is recognized as a significant problem associated with high morbidity and mortality. Recent surveillance data has helped to understand the changes in the epidemiology and the evolving trends in the use of antifungal agents for prophylaxis and treatment combined with the challenges of managing these invasive fungal infections, which has led the transplant community to explore the best management strategies. The emergence of resistant fungi and excess costs in managing these invasive fungal infections has added to the complexities of management. In this context, current perspectives in the management of Candida infections in liver transplant recipients will be reviewed.

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Surgical Site Infection After Liver Transplantation: Risk Factors and Association With Graft Loss or Death

Abstract: SSI is associated with increased risk of death or graft loss during the first year after liver transplantation. Increased operative time and decreased donor liver-to-recipient body mass ratio showed evidence of association with SSI.

Cited by 75 publications

References 29 publications

Effects of Blood Products on Nosocomial Infections in Liver Transplant Recipients

Effects of Blood Products on Nosocomial Infections in Liver Transplant Recipients

Donor Risk Index Predicts Graft Failure Reliably But Not Post-Transplant Infections

Management of Candida infections in liver transplant recipients: current perspectives

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