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

Hara, Takanobu; Soyama, Akihiko; Takatsuki, Mitsuhisa; Hidaka, Masaaki; Carpenter, Izumi; Kinoshita, Akio; Adachi, Tomohiko; Kitasato, Amane; Kuroki, Tamotsu; Eguchi, Susumu

doi:10.12659/aot.892095

Cited by 18 publications

(5 citation statements)

References 14 publications

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“…IgG had mild positive correlations with CD19, CD20, and CD22 at 4 weeks after LDLT (r=0.34, p=0.043; r=0.36, p=0.032; r=0.37, p=0.026, respectively). [8][9][10][11][12][13][14][15][16][17][18][19] mg/dL vs. 23 [18][19][20][21][22][23][24][25][26][27] mg/dL, p=0.0377). Although fresh frozen plasma contains complement components, including C3 and C4 (29), survivors had used both plasmapheresis and fresh frozen plasma with comparable frequency to non-survivors.…”

Section: Correlations Between Clinical Parameters and Laboratory Resultsmentioning

confidence: 99%

“…In ABO-incompatible LDLT cases, we used rituximab (375 mg/m 2 ) as an induction 10-14 days before LDLT and added mycophenolate mofetil (MMF) after LDLT. For patients who have renal dysfunction, trough levels of tacrolimus were intentionally kept lower by the administration of other immunosuppressants, including MMF and/or basiliximab (11).…”

Section: Immunosuppression Therapymentioning

confidence: 99%

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The Contribution of Serum Complement Component 3 Levels to 90-Day Mortality in Living Donor Liver Transplantation

et al. 2021

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The contributions of the complement system have been elucidated in the process of solid organ transplantation, including kidney transplantation. However, the role of complement in liver transplantation is unknown. We sought to elucidate the time-dependent changes of peritransplantational serum complement levels and the relationships with posttransplant outcomes and other immunological biomarkers. We enrolled 82 patients who underwent living-related donor liver transplantation (LDLT). Nine patients (11%) died within 90 days after LDLT (non-survivors). The following immunomarkers were collected preoperatively and at 1, 2, and 4 week(s) after LDLT: serum C3, C4, immunoglobulin G (IgG), and peripheral blood leukocyte populations characterized by CD3, CD4, CD8, CD16, CD19, CD20, CD22, and CD56. Consequently, C3 and C4 increased time-dependently after LDLT. Preoperatively, C3 was negatively correlated with the MELD score, Child–Pugh score, CD16-positive leukocyte percentage, and the CD56-positive leukocyte percentage. Non-survivors had lower levels of C3 at 2 weeks in comparison to survivors (median [interquartile range]: 56 [49-70] mg/dL vs. 88 [71-116] md/dL, p=0.0059). When the cutoff value of C3 at 2 weeks to distinguish non-survivors was set to 71 mg/dL, the sensitivity, specificity, and area under the ROC curve were 87.5%, 75.0%, and 0.80, respectively. A principal component analysis showed an inverse relationship between the C3 and C4 levels and the percentage of CD8-, CD16-, and CD56-positive leukocytes at 1 and 2 week(s). All non-survivors were included in the cluster that showed higher percentages of CD8-, CD16-, and CD56-positive leukocytes at 2 weeks. In conclusion, we demonstrated the relationship between complement, outcomes, and other immunomarkers in LDLT and suggested the usefulness of C3 at 2 weeks after LDLT in distinguishing the mortality.

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Section: Correlations Between Clinical Parameters and Laboratory Resultsmentioning

confidence: 99%

Section: Immunosuppression Therapymentioning

confidence: 99%

The Contribution of Serum Complement Component 3 Levels to 90-Day Mortality in Living Donor Liver Transplantation

et al. 2021

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“…Earlier studies found that patients with preoperative infection had higher rates of postoperative infection [5,6], and patients with preoperative bacterial infection often had higher baseline CRP levels, which is in agreement with our findings. However, the risk of infection in patients with previous infection was less than twofold that in patients without infection before LT (48% vs. 25% [6], 48% vs. 30.6% [5], and 85% vs. 63% [19]). In our study, the incidence of 30-day CSI in patients with a CRP level ≥ 9.48 mg/L was 36.1%, compared to 11.5% for those with a CRP level < 9.48 mg/L, the adjusted HR of CRP level ≥ 9.48 mg/L compared to a CRP level < 9.48 mg/L was 3.16 (95% CI 2.32-4.29, p < 0.001).…”

Section: Discussionmentioning

confidence: 87%

C-Reactive Protein Is an Independent Predictor of 30-Day Bacterial Infection Post-Liver Transplantation

Shi

et al. 2021

Biomolecules

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The relationship between aseptic systemic inflammation and postoperative bacterial infection is unclear. We investigated the correlation of systemic inflammation biomarkers with 30-day clinically significant bacterial infections (CSI) after liver transplantation (LT). This retrospective study enrolled 940 patients who received LT and were followed for 30 days. The primary end point was 30-day CSI events. The cohort was divided into exploratory (n = 508) and validation (n = 432) sets according to different centers. Area under the receiver operated characteristic (AUROC) and Cox regression models were fitted to study the association between baseline systemic inflammation levels and CSI after LT. A total of 255 bacterial infectious events in 209 recipients occurred. Among systemic inflammation parameters, baseline C-reactive protein (CRP) was independently associated with 30-day CSI in the exploratory group. The combination of CRP and organ failure number showed a good discrimination for 30-day CSI (AUROC = 0.80, 95% CI, 0.76–0.84) and the results were confirmed in an external verification group. Additionally, CRP levels were correlated with bacterial product lipopolysaccharide. In conclusion, our study suggests that pre-transplantation CRP is independent of other prognostic factors for 30-day CSI post-LT, and can be integrated into tools for assessing the risk of bacterial infection post-LT or as a component of prognostic models.

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“…Bertuzzo et al20 reported that bacterial infection 1 month before LT was related to a higher rate of infection after transplantation, but did not lead to a worse outcome. Also, Hara et al21 reported that 20 patients who underwent LDLT with an infection 1 month before transplant had a lower 1-year post-transplant survival rate than patients without infection (65% versus 86%, respectively).…”

Section: Discussionmentioning

confidence: 99%

<p>Impact of pre-transplant infection management on the outcome of living-donor liver transplantation in Egypt</p>

Saleh

Hassan

Gomaa

et al. 2019

IDR

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Background and aim Liver transplantation (LT) has emerged as an established therapeutic option for patients with chronic liver disease. Patients with end-stage liver disease are at high risk of infection with multidrug-resistant organisms, which may affect the outcome of LT. The aim of this study was to evaluate the impact of pre-transplant infection on the outcome of living-donor LT. Methods Prospective follow-up was done for 50 patients with chronic liver disease who had had LT performed from September 2013 to December 2017. We divided patients into group 1 (patients who had had infection within 3 months before transplantation with adequate treatment [n=20]), and group 2 (patients without infection [n=30]). Both groups were followed for 4 months post-operatively. Results Patients with high Model for End-Stage Liver Disease scores were more susceptible to infection pre- and post-operatively, and chest infection was the most common infection pre-transplant. There were no significant statistical differences regarding hospital and ICU stay and post-operative course between the groups, but the mortality rate was higher in group 1 (40%) than in group 2 (23.3%), and the causes of mortality in the group 1 were mainly due to medical causes (infections and sepsis, 75%) versus 28.6% in group 2. Conclusion Liver-cell failure and concomitant infection 3 months before LT with adequate treatment had no significant statistical differences regarding hospital, ICU stay, or medical complications, but post-operative infection and mortality rate were more frequent in group 1 and the causes of mortality were mainly medical.

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

Cited by 18 publications

References 14 publications

The Contribution of Serum Complement Component 3 Levels to 90-Day Mortality in Living Donor Liver Transplantation

The Contribution of Serum Complement Component 3 Levels to 90-Day Mortality in Living Donor Liver Transplantation

C-Reactive Protein Is an Independent Predictor of 30-Day Bacterial Infection Post-Liver Transplantation

<p>Impact of pre-transplant infection management on the outcome of living-donor liver transplantation in Egypt</p>

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