Open AccessVitamin D status and risk of infections after liver transplantation in the Swiss Transplant Cohort Study
Author(s) -
Schreiber Peter W.,
BischoffFerrari Heike A.,
Boggian Katia,
Delden Christian,
Enriquez Natalia,
Fehr Thomas,
Garzoni Christian,
Hirsch Hans H.,
Hirzel Cédric,
Manuel Oriol,
Meylan Pascal,
Saleh Lanja,
Weisser Maja,
Mueller Nicolas J.
Publication year - 2019
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.13328
Subject(s) - medicine , liver transplantation , vitamin d and neurology , vitamin d deficiency , transplantation , incidence (geometry) , cohort , poisson regression , cohort study , proportional hazards model , confounding , risk factor , vitamin , gastroenterology , population , environmental health , physics , optics
Summary Increasing evidence indicates a role of vitamin D in the immune system affecting response to infections. We aimed to characterize the role of vitamin D status, i.e. deficiency [25‐ OH vitamin D (25‐ OHD ) <50 nmol/l] and no deficiency (25‐ OHD ≥50 nmol/l) in incident infections after liver transplantation. In 135 liver transplant recipients, blood samples drawn at time of liver transplantation and 6 months afterwards were used to determine 25‐ OHD levels. Incident infections episodes were prospectively collected within the Swiss Transplant Cohort Study database. Poisson regression was applied to address associations between vitamin D status and incident infections. Vitamin D deficiency was common at time of transplantation and 6 months afterwards without a significant change in median 25‐ OHD levels. In univariable analyses, vitamin D deficiency was a risk factor for incident infections in the first 6 months post‐transplant incidence rate ratio ( IRR 1.52, 95% CI 1.08–2.15, P = 0.018) and for bacterial infections occurring after 6 up to 30 months post‐transplant ( IRR 2.29, 95% CI 1.06–4.94, P = 0.034). These associations were not detectable in multivariable analysis with adjustment for multiple confounders. Efforts to optimize vitamin D supplementation in liver transplant recipients are needed. Our data question the role of vitamin D deficiency in incident infections.