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- Title
Multidrug-Resistant Bacteria and Disease Progression in Patients with End-Stage Liver Disease and after Liver Transplantation.
- Authors
Friedrich, Kilian; Krempl, Jessica; Schamoni, Shigehiko; Hippchen, Theresa; Pfeiffenberger, Jan; Rupp, Christian; Gotthardt, Daniel Nils; Houben, Philip; von Haken, Rebecca; Heininger, Alexandra; Brenner, Thorsten; Mehrabi, Arianeb; Weiss, Karl Heinz; Mieth, Markus
- Abstract
Background: Multidrug-resistant (MDR) pathogens represent an emerging challenge in end-stage liver disease and in liver transplant recipients. Methods: We evaluated the impact of MDR bacteria upon clinical outcomes in patients with end-stage liver disease (n = 777) at the time of enrollment on the liver transplant (LTx) waiting list, after first LTx (n = 645), and after second LTx (n = 128). Results: Colonization/infection with MDR bacteria was present in 72/777 patients on the waiting list, in 98/645 patients at first LTx, and in 46/128 patients at second LTx. While on the LTx waiting list, the time until first hydropic decompensation (p = 0.021), hepatic encephalopathy (p < 0.001) and hepatorenal syndrome (p < 0.001) was reduced in the presence of MDR bacteria, which remained an independent risk factor of poor survival in multivariate analysis (p < 0.001). Following first and second liver transplant, MDR bacteria were associated with an increased risk of infection-related deaths (first LTx: p < 0.001; second LTx: p = 0.037) and reduced actuarial survival (first LTx: p < 0.001; second LTx: p = 0.046). Conclusions: We showed that MDR pathogens are associated with poor outcomes before, after first and after recurrent LTx.
- Subjects
LIVER diseases; LIVER transplantation; DISEASE progression; HEPATORENAL syndrome; HEPATIC encephalopathy; BACTERIA
- Publication
Journal of Gastrointestinal & Liver Diseases, 2019, Vol 28, Issue 3, p303
- ISSN
1841-8724
- Publication type
Article
- DOI
10.15403/jgld-212