Risk factors for cytomegalovirus and severe bacterial infections following liver transplantation: a prospective multivariate time-dependent analysis

Payá, Carlos V.; Wiesner, Russell H.; Hermans, Paul E.; Larson-Keller, Jeffrey J.; Ilstrup, Duane M.; Krom, Ruud A.F.; Rettke, Steven R.; Smith, Thomas F.

doi:10.1016/s0168-8278(05)80245-4

Cited by 143 publications

(82 citation statements)

References 33 publications

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“…Otherwise, cholangitis (23 YO), septicemia (19 %), and pneumonia (15 %) were the predominant bacterial infections. These findings are in agreement with those of other studies showing incidences of 3 %-lo %, 15 Y0-35 %, and 7 %-I5 %, respectively [4,8,10,15,17,25,26,37,38].…”

Section: Discussionsupporting

confidence: 93%

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Stool cultures obtained before liver transplantation are useful for choice of perioperative antibiotic prophylaxis

Barkholt

Andersson

Ericzon

et al. 1997

Transplant International

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Stool cultures obtained before liver transplantation are useful for choice of perioperative anti biotic prophylaxisAbstract Bacterial infections, especially cholangitis, are still common complications after liver transplantation (LTx). During recent years, multiresistant enterococci have become a nosocomial problem in transplant units. The present prospective study on 26 patients, including 24 patients with chronic liver disease, demonstrated that enterococci were the predominant micro-organism involved in post-LTx bacterial infections. They were cultured in the feces and in other sites of 10 out of 13 (77 %) patients who underwent extensive examinations. Ampicillin-resistant Enterococcus faecium strains were isolated in urine or feces of 2 of the 13 patients prior to LTx. Similarly, resistance to ampicillin and gentamicin, the empirically used antibiotics for patients with fever of unknown origin, was found in E. faecium strains in 3 and 2 patients, respectively. Moreover, multiresistant E. faecium and E. faecalis strains were demonstrated in 46 % of the patients in the postoperative period (3 months). However, no vancomycin-resistant enterococci were isolated. The use of antibiotics within 4 months prior to LTx significantly increased the risk of developing ampicillin-resistant bacteria at the time of LTx and of infections with bacteria of enteric origin after LTx ( P = 0.03 and 0.01, respectively). We conclude that stool and urine cultures performed prior to LTX may be useful for selecting prophylactic antibiotic regimens.

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Section: Discussionsupporting

confidence: 93%

“…Approximately two-thirds of all liver recipients had at least one episode of bacterial infections during the first 3 months after LTx [4,8,15,17,26,37,38]. The high incidence of asymptomatic UTIs may be explained by bacterial colonization or contamination.…”

Section: Discussionmentioning

confidence: 99%

Stool cultures obtained before liver transplantation are useful for choice of perioperative antibiotic prophylaxis

Barkholt

Andersson

Ericzon

et al. 1997

Transplant International

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“…28 Steroids as monotherapy have a minimal effect on reactivation of latent CMV in vivo; however, when high doses are used, a greater incidence and increased severity of CMV disease has been observed, most likely by decreasing cellular immune function. 29 Mycophenolate mofetil has dramatically reduced the incidence of acute allograft rejection in renal transplant Rejection and antirejection therapy 5,11,22 Fulminant hepatic failure 22,26 Hepatic artery thrombosis 11 HHV-6 and HHV-7 infections 36,76 Hepatitis C infection 77 recipients, and this has been associated with an increase in the frequency and severity of CMV invasive disease. [30][31][32] Last, the conventional antilymphocyte preparations (OKT3 and antilymphocyte globulin, among others) not only increase CMV replication by suppressing the immune system, but most importantly, by directly reactivating latent CMV by means of the activation of transcription factors.…”

Section: Pathogenesismentioning

confidence: 99%

Management of cytomegalovirus infection after liver transplantation

Sampathkumar

Payá

2000

Liver Transpl

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“…Important risk factors for developing CMV disease include retransplantation and the use of lymphocyte-depleting antibodies for immunosuppression (6). Cytomegalovirus infection increases the risk of rejection and predisposes the immunosuppressed recipient to opportunistic infections (9), which ultimately increase hospitalization and cost (10).…”

Section: Introductionmentioning

confidence: 99%

Cytomegalovirus Prevalence and Transmission After Islet Allograft Transplant in Patients with Type 1 Diabetes Mellitus

Hafiz¹,

Poggioli²,

Caulfield³

et al. 2004

American Journal of Transplantation

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Cytomegalovirus (CMV) serological status of transplant donors and recipients has important implications on antiviral prophylaxis, morbidity/mortality, donor selection and hospital stay. We evaluated CMV prevalence in our islet transplant candidates (ITC) in comparison with organ donors. We correlated the CMV serological status of our ITC with serology for Epstein-Barr virus and Parvovirus B19, auto-antibodies, patient's age, age at DM onset, duration of DM, gender, race, ABO group, HLA haplotype and C-peptide levels. Cytomegalovirus transmission after islet transplant using the Edmonton regimen was also evaluated. Cytomegalovirus seropositivity varied according to patient group, age, gender and race. Type 1 DM patients had reduced odds of CMV seropositivity when compared with organ donors. In all groups studied, older patients, females, and non-Caucasians were more likely to be CMV seropositive. In addition, no CMV reactivation, infection or disease was observed among our transplanted patients using this steroid-free regimen even after donor/recipient CMV mismatch.

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Risk factors for cytomegalovirus and severe bacterial infections following liver transplantation: a prospective multivariate time-dependent analysis

Cited by 143 publications

References 33 publications

Stool cultures obtained before liver transplantation are useful for choice of perioperative antibiotic prophylaxis

Stool cultures obtained before liver transplantation are useful for choice of perioperative antibiotic prophylaxis

Management of cytomegalovirus infection after liver transplantation

Cytomegalovirus Prevalence and Transmission After Islet Allograft Transplant in Patients with Type 1 Diabetes Mellitus

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