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Impact of pretransplant infections on clinical outcomes of liver transplant recipients
Author(s) -
Sun HsinYun,
Cacciarelli Thomas V.,
Singh Nina
Publication year - 2010
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.21982
Subject(s) - medicine , liver transplantation , transplantation , pneumonia , gastroenterology , liver disease , urinary system , cellulitis , spontaneous bacterial peritonitis , surgery , cirrhosis
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. Liver Transpl 16:222–228, 2010. © 2010 AASLD.