Methods of preventing bacterial sepsis and wound complications after liver transplantation

Abstract

Currently, there is no clear evidence for any intervention offering significant benefits in the reduction of bacterial infections and wound complications in liver transplantation. Selective bowel decontamination may even increase the rate of infections compared with prebiotics with probiotics. The confidence intervals were wide and further randomised clinical trials of low risk of bias are necessary.

Efficacy of Using Probiotics with Antagonistic Activity against Pathogens of Wound Infections: An Integrative Review of Literature

“…As noted by some [149], certain studies lacked placebo control groups [56] or were not double-blinded [91,94], thus limiting the ability to describe the efficacy of the administered probiotics. is was also confirmed in the review by Gurusamy and coauthors [150] on the methods for preventing wound complications after liver transplantation. e authors concluded that there were no statistically significant differences in the probiotics/synbiotics group in graft rejections, intensive unit stay, hospital stay, and mortality; however, it was found that a statistically significant lower proportion of these patients in the probiotics group developed infective complications, thus confirming at least one positive effect after probiotic administration.…”

Efficacy of Using Probiotics with Antagonistic Activity against Pathogens of Wound Infections: An Integrative Review of Literature

“…As noted by some [149], certain studies lacked placebo control groups [56] or were not double-blinded [91,94], thus limiting the ability to describe the efficacy of the administered probiotics. is was also confirmed in the review by Gurusamy and coauthors [150] on the methods for preventing wound complications after liver transplantation. e authors concluded that there were no statistically significant differences in the probiotics/synbiotics group in graft rejections, intensive unit stay, hospital stay, and mortality; however, it was found that a statistically significant lower proportion of these patients in the probiotics group developed infective complications, thus confirming at least one positive effect after probiotic administration.…”

Multidrug-Resistant Bacterial Infections before and after Liver Transplantation

“…A meta-analysis of four randomized studies published between 1994 and 2002 by Safdar et al [58] showed the benefit of oral decontamination in reducing the incidence of only gram-negative infections in the LT setting (84% reduction), whereas it had no effect on overall infections. These results have been confirmed in a further meta-analysis by Gurusamy et al [59], who did not find significant differences in mortality or post-LT infections when comparing oral decontamination with placebo, prebiotics and probiotics. Notably, an observational study by Katchman et al [60] focused on the role of intestinal decontamination in the setting of a living donor LT, where surgery could be more effectively planned.…”

Hepatic pannexin‐1 mediates ST2+ regulatory T cells promoting resolution of inflammation in lipopolysaccharide‐induced endotoxemia

“…This study showed that adaptive immunity, including regulatory cytokines and cells, plays a critical role in LPS‐induced endotoxemia, while innate immunity plays a vital role in MRSA infection in our previous study 9 . Furthermore, studies have reported a lack of currently available methods for reducing the incidence of sepsis in LT recipients 4 . Therefore, studying the underlying mechanism and identifying new therapeutic targets in sepsis are of great importance.…”

Efficacy of Using Probiotics with Antagonistic Activity against Pathogens of Wound Infections: An Integrative Review of Literature

“…As noted by some [149], certain studies lacked placebo control groups [56] or were not double-blinded [91,94], thus limiting the ability to describe the efficacy of the administered probiotics. is was also confirmed in the review by Gurusamy and coauthors [150] on the methods for preventing wound complications after liver transplantation. e authors concluded that there were no statistically significant differences in the probiotics/synbiotics group in graft rejections, intensive unit stay, hospital stay, and mortality; however, it was found that a statistically significant lower proportion of these patients in the probiotics group developed infective complications, thus confirming at least one positive effect after probiotic administration.…”

Multidrug-Resistant Bacterial Infections before and after Liver Transplantation

“…A meta-analysis of four randomized studies published between 1994 and 2002 by Safdar et al [58] showed the benefit of oral decontamination in reducing the incidence of only gram-negative infections in the LT setting (84% reduction), whereas it had no effect on overall infections. These results have been confirmed in a further meta-analysis by Gurusamy et al [59], who did not find significant differences in mortality or post-LT infections when comparing oral decontamination with placebo, prebiotics and probiotics. Notably, an observational study by Katchman et al [60] focused on the role of intestinal decontamination in the setting of a living donor LT, where surgery could be more effectively planned.…”

Hepatic pannexin‐1 mediates ST2+ regulatory T cells promoting resolution of inflammation in lipopolysaccharide‐induced endotoxemia

“…This study showed that adaptive immunity, including regulatory cytokines and cells, plays a critical role in LPS‐induced endotoxemia, while innate immunity plays a vital role in MRSA infection in our previous study 9 . Furthermore, studies have reported a lack of currently available methods for reducing the incidence of sepsis in LT recipients 4 . Therefore, studying the underlying mechanism and identifying new therapeutic targets in sepsis are of great importance.…”

Efficacy of Using Probiotics with Antagonistic Activity against Pathogens of Wound Infections: An Integrative Review of Literature

“…As noted by some [149], certain studies lacked placebo control groups [56] or were not double-blinded [91,94], thus limiting the ability to describe the efficacy of the administered probiotics. is was also confirmed in the review by Gurusamy and coauthors [150] on the methods for preventing wound complications after liver transplantation. e authors concluded that there were no statistically significant differences in the probiotics/synbiotics group in graft rejections, intensive unit stay, hospital stay, and mortality; however, it was found that a statistically significant lower proportion of these patients in the probiotics group developed infective complications, thus confirming at least one positive effect after probiotic administration.…”

Multidrug-Resistant Bacterial Infections before and after Liver Transplantation

“…A meta-analysis of four randomized studies published between 1994 and 2002 by Safdar et al [58] showed the benefit of oral decontamination in reducing the incidence of only gram-negative infections in the LT setting (84% reduction), whereas it had no effect on overall infections. These results have been confirmed in a further meta-analysis by Gurusamy et al [59], who did not find significant differences in mortality or post-LT infections when comparing oral decontamination with placebo, prebiotics and probiotics. Notably, an observational study by Katchman et al [60] focused on the role of intestinal decontamination in the setting of a living donor LT, where surgery could be more effectively planned.…”

Hepatic pannexin‐1 mediates ST2+ regulatory T cells promoting resolution of inflammation in lipopolysaccharide‐induced endotoxemia

“…This study showed that adaptive immunity, including regulatory cytokines and cells, plays a critical role in LPS‐induced endotoxemia, while innate immunity plays a vital role in MRSA infection in our previous study 9 . Furthermore, studies have reported a lack of currently available methods for reducing the incidence of sepsis in LT recipients 4 . Therefore, studying the underlying mechanism and identifying new therapeutic targets in sepsis are of great importance.…”