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- Title
Impact of preoperative infection on outcome after liver transplantation.
- Authors
Bertuzzo, V. R.; Giannella, M.; Cucchetti, A.; Pinna, A. D.; Grossi, A.; Ravaioli, M.; Del Gaudio, M.; Cristini, F.; Viale, P.; Cescon, M.
- Abstract
Background Bacterial infection in patients with liver failure can lead to a dramatic clinical deterioration. The indications for liver transplantation and outcome in these patients is still controversial. Methods All adult patients who underwent liver transplantation between 1 January 2010 and 31 December 2015 were selected from an institutional database. Characteristics of the donors and recipients, and clinical, biochemical and surgical parameters were retrieved from the database. Post-transplant survival rates and complications, including grade III-IV complications according to the Dindo-Clavien classification, were compared between patients with an infection 1 month before transplantation and patients without an infection. Results Eighty-four patients with an infection had statistically significant higher Model for End-stage Liver Disease ( MELD), D- MELD and Balance of Risk ( BAR) scores and a higher rate of acute-on-chronic liver failure compared with findings in 343 patients with no infection. The rate of infection after liver transplantation was higher in patients who had an infection before the operation: 48 per cent versus 30·6 per cent in those with no infection before transplantation ( P = 0·003). The percentage of patients with a postoperative complication (42 versus 40·5 per cent respectively; P = 0·849) and the 90-day mortality rate (8 versus 6·4 per cent; P = 0·531) was no different between the groups. Multivariable analysis showed that a BAR score greater than 18 and acute-on-chronic liver failure were independent predictors of 90-day mortality. Conclusion Bacterial infection 1 month before liver transplantation is related to a higher rate of infection after transplantation, but does not lead to a worse outcome.
- Subjects
BACTERIAL diseases; LIVER transplantation; PATIENT acceptance of health care; HEALTH outcome assessment; MEDICAL microbiology; PATIENTS
- Publication
British Journal of Surgery, 2017, Vol 104, Issue 2, pe172
- ISSN
0007-1323
- Publication type
Article
- DOI
10.1002/bjs.10449