Risk factor for lung infection in recipients after liver transplantation: A meta‐analysis

Zhang, Jiaxue; He, Qiang; Du, Ling; Ji, Renyue; Yuan, Lingyue; Zhang, Hongyang; Yuan, Xinyu; Shen, Lifei; Li, Yingli

doi:10.1111/aor.13826

Cited by 4 publications

(4 citation statements)

References 22 publications

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“…Nevertheless, a previous meta-analysis revealed several risk factors for all-cause infection and mortality that are not directly reflected by the MELD score, such as biliary complications, ascites, atelectasis, and the bilirubin level. 33,34 Furthermore, patients with hepatocellular carcinoma undergo LT at a rate that is not restricted by the MELD score. 35 This finding suggests that there may still be unidentified causal risk factors driving these associations.…”

Section: Discussionmentioning

confidence: 99%

Association of iron overload with infectious complications in liver transplant recipients: a systematic review and meta-analysis

Zhang,

Yan,

Shi

2024

J Int Med Res

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Objective This study was performed to examine the possible association of iron overload with infectious complications and survival among liver transplant recipients. Methods We conducted a systematic review and meta-analysis of studies published in the PubMed, Embase, Web of Science, and Cochrane Library databases up to September 2022. Hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted to estimate the association of iron overload with infectious outcomes and overall survival after liver transplantation. Results Eight studies involving 2817 recipients met the inclusion criteria. Iron overload was strongly associated with an increased risk of infection after liver transplantation (HR, 1.66; 95% CI, 1.03–2.68). An increase in the serum ferritin level was associated with an increased risk of infection after liver transplantation (HR, 1.44; 95% CI, 1.09–1.91). Iron overload was a significant predictor of worse overall survival (HR, 1.35; 95% CI, 1.11–1.64). In addition, a high serum ferritin level was significantly associated with an increased risk of death (HR, 1.34; 95% CI, 1.10–1.64). Conclusion Iron overload may be associated with a higher risk of infectious complications and a worse prognosis among liver transplant recipients.

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Section: Discussionmentioning

confidence: 99%

Association of iron overload with infectious complications in liver transplant recipients: a systematic review and meta-analysis

Zhang,

Yan,

Shi

2024

J Int Med Res

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“…Moreover, mechanical ventilation causes cyclic changes in cardiac load and puts extra pressure on the tracheal mucosa, thereby influencing physiological defence function [ 39 , 40 ]. Emma et al.…”

Section: Discussionmentioning

confidence: 99%

A comprehensive evaluation of risk factors for mortality, infection and colonization associated with CRGNB in adult solid organ transplant recipients: a systematic review and meta-analysis

Gao,

Huang,

Zhou

et al. 2024

Annals of Medicine

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Background The burden of carbapenem-resistant gram-negative bacteria (CRGNB) among solid organ transplant (SOT) recipients has not been systematically explored. Here, we discern the risk factors associated with CRGNB infection and colonization in SOT recipients. Methods This study included observational studies conducted among CRGNB-infected SOT patients, which reported risk factors associated with mortality, infection or colonization. Relevant records will be searched in PubMed, Embase and Web of Science for the period from the time of database construction to 1 March 2023. Results A total of 23 studies with 13,511 participants were included, enabling the assessment of 27 potential risk factors. The pooled prevalence of 1-year mortality among SOT recipients with CRGNB was 44.5%. Prolonged mechanical ventilation, combined transplantation, reoperation and pre-transplantation CRGNB colonization are salient contributors to the occurrence of CRGNB infections in SOT recipients. Renal replacement therapy, post-LT CRGNB colonization, pre-LT liver disease and model for end-stage liver disease score increased the risk of infection. Re-transplantation, carbapenem use before transplantation and ureteral stent utilization increaesd risk of CRGNB colonization. Conclusion Our study demonstrated that SOT recipients with CRGNB infections had a higher mortality risk. Invasive procedure may be the main factor contribute to CRGNB infection.

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“…However, to prevent organ rejection, LT recipients must undergo immunosuppression, inadvertently elevating their susceptibility to infections [1]. This vulnerability is further exacerbated by factors intrinsic to LT patients, such as impaired liver functionality, the presence of sarcopenia, and a higher propensity for hospital admissions, contributing to the elevated rates of infectious complications and associated morbidity and mortality in the postoperative phase [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Carbapenem-resistant gram-negative rod bacteremia in the early postoperative period following liver transplantation

Min,

Kim,

Kang

et al. 2024

Ann Liver Transplant

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Background: Carbapenem-resistant gram-negative rod bacteremia (CRGNR-B) is emerging as a formidable challenge, complicating patient management and outcomes in liver transplantation (LT). This study aimed to investigate the incidence, mortality, and risk factors associated with CRGNR-B within 90 days following LT. Methods: A retrospective nested case-control study was conducted using single centric LT data (n=1,379). CRGNR-B cases were matched 1:5 with control patients for analyzing survival and risk factors for CRGNR-B. Results:The incidence of CRGNR-B within 90 days post-LT was 6.5% (n=87). The CRGNR-B group showed significantly lower 1-year post-LT survival compared to the control group (37.9% vs. 90.0%, p<0.001). CRGNR-B was significantly correlated with increased mortality after adjustment of covariates (adjusted hazard ratio, 5.66; 95% confidence interval [CI], 3.89-8.24; p<0.001). Key risk factors identified include higher pretransplant model for end-stage liver disease scores (odds ratio [OR], 1.05; 95% CI, 1.01-1.09; p=0.006), encephalopathy prior to transplant (OR, 2.79; 95% CI, 1.48-5.30; p=0.002), retransplantation (OR, 10.4; 95% CI, 2.79-42.1; p<0.001), each 60-minute increase in cold ischemic time (OR, 1.20; 95% CI, 1.01-1.42; p=0.037), and bile duct complications (OR, 6.16; 95% CI, 2.66-14.2; p<0.001). Conclusion:The occurrence of CRGNR-B within 90 days post-LT poses a significant risk to patient survival, with identifiable pre-and peri-transplant risk factors. These findings underscore the importance of targeted preventive measures, early detection, and effective management strategies to enhance outcomes for LT recipients.

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Risk factor for lung infection in recipients after liver transplantation: A meta‐analysis

Cited by 4 publications

References 22 publications

Association of iron overload with infectious complications in liver transplant recipients: a systematic review and meta-analysis

Association of iron overload with infectious complications in liver transplant recipients: a systematic review and meta-analysis

A comprehensive evaluation of risk factors for mortality, infection and colonization associated with CRGNB in adult solid organ transplant recipients: a systematic review and meta-analysis

Carbapenem-resistant gram-negative rod bacteremia in the early postoperative period following liver transplantation

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