Impact of pretransplant infections on clinical outcomes of liver transplant recipients
Journal
Liver Transplantation
Journal Volume
16
Journal Issue
2
Pages
222-228
Date Issued
2010
Author(s)
Abstract
Whether pretransplant nonviral infections influence outcomes after transplantation in liver transplant recipients in the current era is not well defined. One hundred consecutive patients undergoing liver transplantation in 2005-2008 were studied. Demographics, posttransplant clinical events, and mortality were compared between recipients with and without infections within 12 months before transplantation. In all, 32% of the patients (32/100) developed 45 episodes of pretransplant infections, which included spontaneous bacterial peritonitis (35.6%), bloodstream infections (28.9%), cellulitis (13.3%), pneumonia (8.9%), urinary tract infections (6.7%), and other infections (6.7%). Compared with 68 recipients without pretransplant infections, those with infections had a higher Model for End-Stage Liver Disease score and a lower likelihood of transplantation from home and required longer and more frequent hospital care before and after transplantation (P < 0.05). Mortality at 90 (9.4% versus 2.9%) and 180 days (15.6% versus 10.3%) post-transplant did not differ significantly between recipients with and without pretransplant infections (P = not significant). A higher Model for End-Stage Liver Disease score (P < 0.05) and posttransplant infections (P < 0.05 and P < 0.001), but not pretransplant infections, were associated with posttransplant mortality at 90 and 180 days. In conclusion, pretransplant infections that have been adequately treated do not pose a significant risk for poor outcomes, including posttransplant mortality. ? 2010 AASLD.
SDGs
Other Subjects
ampicillin; cefotaxime; ganciclovir; methylprednisolone; prednisone; sulfamethoxazole; tacrolimus; trimethoprim; valganciclovir; adult; aged; antibiotic prophylaxis; article; bacterial peritonitis; bloodstream infection; candidiasis; cellulitis; controlled study; corticosteroid therapy; cytomegalovirus infection; demography; enterococcal infection; Escherichia coli infection; female; graft recipient; Gram negative infection; hepatitis C; hospital care; hospital readmission; human; intensive care unit; intubation; Klebsiella pneumoniae infection; liver graft; liver graft rejection; liver transplantation; low drug dose; major clinical study; male; outcome assessment; Pneumocystis pneumonia; pneumonia; postoperative care; postoperative infection; preoperative evaluation; priority journal; recurrent infection; reoperation; repeat procedure; scoring system; spontaneous bacterial peritonitis; Streptococcus infection; surgical mortality; urinary tract infection; vancomycin resistant Enterococcus; Adult; Aged; Bacterial Infections; Cellulitis; Comorbidity; Female; Humans; Liver Failure; Liver Transplantation; Male; Middle Aged; Pneumonia, Bacterial; Preoperative Period; Risk Factors; Urinary Tract Infections
Type
journal article