Strategies to Reduce Infectious Complication Using Epidemiologic Data Analysis in Liver Transplant Recipients

Kim, S.I.; Kim, Y.J.; Choi, Jung‐Hyun; Yoon, Seung Kew; Choi, Ho Joong; Na, G.H.; You, Yong‐Ouk; Kim, D.G.; Kang, Moon‐Won

doi:10.1016/j.transproceed.2013.08.072

Cited by 10 publications

(4 citation statements)

References 8 publications

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“…4 In accordance with the findings of Avkan-Oğuz et al 5 , we did not find pre-LT encephalopathy to be a risk for post-LT infection. On the other hand, re-laparotomy and biliary complications were reported as risk factors for infection 6,7 , like we found in our study.…”

Section: Discussionsupporting

confidence: 84%

Infection risk after paediatric liver transplantation

et al. 2020

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Infections after liver transplantation (LT), despite prophylactic therapy, are still important causes of morbidity and mortality in children. Although underlying disease and immunosuppression along with the complexity of LT procedure are the major predispositions to infections, there still might be under recognised factors predisposing infections in paediatric LT. In this study, we retrospectively analysed the risk factors of bacterial, viral, and fungal infections after LT in a series of 167 children (median =5 yr.). Of all children, 112 (67%) experienced infections: 93 (55.7%) bacterial, 56 (33.5%) viral and 15 (9%) fungal. Multilogistic regression analysis showed that the need of immunosuppressive switch increased total, bacterial, and viral infection risk 5.3, 2.5, and 2.5 times, respectively, (p=0.001, p=0.021, and p=0,019, respectively). Re-LT increased bacterial infection risk 4.2 times (p=0.040). Viral infection risk was 10 times higher in children who had more than two re-laparotomies (p=0,002). Children who had post-LT, cytomegalovirus (CMV) infection had 5.6 times increased risk for fungal infection (p=0.035). In conclusion, infection is still an important morbidity in paediatric LT and is in close relationship with other morbidities such as surgical complications. CMV infection, itself, is an independent risk factor for fungal infection.

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Section: Discussionsupporting

confidence: 84%

Infection risk after paediatric liver transplantation

et al. 2020

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“…The study revealed that 67 of our patients (67%) developed early post-operative infections; bacterial infection was the predominant type of infection followed by viral then fungal infections. Bacterial infection was the commonest form of infection as observed by previous studies [1, 12, 13].…”

Section: Discussionmentioning

confidence: 81%

Risk index for early infections following living donor liver transplantation

Elkholy

Mansour

Elhamid

et al. 2019

aoms

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Introduction Post-operative infections in patients undergoing living donor liver transplantation (LDLT) are a major cause of morbidity and mortality. This study aims to develop a practical and efficient prognostic index for early identification and possible prediction of post-transplant infections using risk factors identified by multivariate analysis. Material and methods One hundred patients with post-hepatitic cirrhosis, HCV positive, genotype 4, Child B/C or MELD score 13-25 undergoing LDLT were included. All potential predictors of infection were analyzed by backward logistic regression. Cut-off values were obtained from ROC curve analysis. Significant predictors were combined into a risk index, which was further tested and compared by ROC curve analysis. Results Post-operative infection was associated with a significantly higher mortality (50.7% vs. 33.3%). Total leucocyte count, total bilirubin, early biliary complications, fever and C-reactive protein were found to be independent predictors of early infectious complications after LDLT. The risk index predicted infection with the highest sensitivity and specificity as compared with each predictor on its own (AUC = 0.91, 95% CI: 0.830–0.955, p < 0.0001). Conclusions The use of a combined risk index for early diagnosis of post-operative infections can efficiently identify high risk patients.

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“…Bacteremia or bloodstream infection is more common in patients undergoing liver transplantation than in patients undergoing other solid organ surgery [5] . In a previous study, of all pathogens isolated from liver transplant recipients, 26% were found to be S. aureus, and the morbidity rate related to S. aureus bacteremia in these patients ranged from 0.6 to 29% [6] . Extensive exposure to broad-spectrum antibiotics and the subsequent increase in antibiotic resistance is a fundamental risk factor for transplant patients and an additional concern for clinicians.…”

Section: Introductionmentioning

confidence: 84%

Prevalence of MRSA Bacteremia in Liver Transplant Patients: A Systematic Review and Meta-Analysis

Emami

Javanamardi²,

Rezaei³

et al. 2022

IEM

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Backgrounds: Infection is one of the major threats to liver transplant patients and significantly affects associated mortality and morbidity. Serious infections are likely to occur a few months after transplantation, and most of them are bacterial. The aim of this study was to evaluate the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia in liver transplant patients. Materials & Methods: In this systematic review and meta-analysis, Preferred Reporting Items for systematic reviews and meta-analysis guidelines were used. International databases including PubMed, Scopus, Web of Sciences, Embase, and Cochrane were searched by related MeSH terms and keywords for studies published until July 26, 2020. The current study was registered by a pre-defined protocol in PROSPRO. Findings: After a comprehensive literature search, 11 articles were selected for inclusion in the analysis. The prevalence of MRSA in liver transplant patients was 75% (95% CI: 58% -89%); however, an evident heterogeneity was observed between the studies (I 2 = 87.84%, p< .001). Conclusion:In conclusion, this study results demonstrate that the prevalence of posttransplant MRSA colonization bacteremia is high among liver transplant patients. This should be considered seriously, and efforts should be made to prevent mortality in this group of patients.

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Strategies to Reduce Infectious Complication Using Epidemiologic Data Analysis in Liver Transplant Recipients

Cited by 10 publications

References 8 publications

Infection risk after paediatric liver transplantation

Infection risk after paediatric liver transplantation

Risk index for early infections following living donor liver transplantation

Prevalence of MRSA Bacteremia in Liver Transplant Patients: A Systematic Review and Meta-Analysis

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