Impact of the duration of posttransplant renal replacement therapy on bacterial infections in liver transplant recipients
Journal
Liver Transplantation
Journal Volume
17
Journal Issue
10
Pages
1212-1217
Date Issued
2011
Author(s)
Abstract
Whether the duration of renal replacement therapy (RRT) after liver transplantation influences the rate and types of bacterial infections is not known. In this study, 47 of 299 consecutive liver transplant recipients (16%) required posttransplant RRT. The incidence of bacterial infections was higher in the RRT group versus the non-RRT group (8.84 versus 1.38 per 1000 patient days, P < 0.001). In the RRT group, 49% of the patients (23/47) required long-term RRT (?30 days), and 51% (24/47) required short-term RRT (<30 days). Long-term RRT (hazard ratio = 2.27, 95% confidence interval = 1.16-4.47, P = 0.017) was a significant predictor of infections. Bacteremia and intra-abdominal infections were the most common sources of infections, and Enterobacteriaceae and enterococci were the predominant pathogens in both groups. The mortality rate for patients requiring RRT was higher than the rate for patients not requiring RRT (P < 0.001), but the mortality rates of the short-term RRT group and the long-term RRT group did not significantly differ (P = 0.654). In conclusion, although both short-term RRT and long-term RRT confer a higher risk of bacterial infections, only long-term RRT is a statistically significant predictor of these infections. ? 2011 AASLD.
SDGs
Other Subjects
amphotericin B lipid complex; ampicillin; cefotaxime; cotrimoxazole; ganciclovir; methylprednisolone; micafungin; prednisone; tacrolimus; valganciclovir; abdominal infection; adult; article; bacteremia; bacterial infection; catheter infection; clinical article; Clostridium difficile infection; cytomegalovirus infection; Enterobacteriaceae; Enterococcus; female; graft recipient; human; immunosuppressive treatment; intravascular catheter; liver graft rejection; liver transplantation; low drug dose; lung infection; male; methicillin resistant Staphylococcus aureus; morbidity; mortality; pneumocystosis; pneumonia; priority journal; Pseudomonas aeruginosa; renal replacement therapy; survival rate; treatment duration; Bacterial Infections; Chi-Square Distribution; Disease-Free Survival; Female; Humans; Liver Transplantation; Logistic Models; Male; Middle Aged; Odds Ratio; Pennsylvania; Proportional Hazards Models; Renal Replacement Therapy; Risk Assessment; Risk Factors; Time Factors; Treatment Outcome
Type
journal article