Navigation Links
Researchers determine risk factors for infection after liver transplantation
Date:6/5/2008

Nearly 9 percent of patients who recently underwent liver transplantation suffered a subsequent surgical site infection (SSI). Risk factors included having had biliary-enteric anastomosis (choledocho-jejunal or hepatic-jejunal reconstruction), previous liver or kidney transplant, and more than four red blood cell units transfused. These findings are published in the June issue of Liver Transplantation, a journal by John Wiley & Sons. The article is also available online at Wiley Interscience (www.interscience.wiley.com).

SSIs are common after liver transplantation and are a major cause of morbidity and mortality. They result from the technical complexity of the procedure, the fact that it occurs within a potentially infected area of the body and the poor medical condition of many recipients. Researchers aimed to determine the incidence, timing, location and risk factors, including antibiotic prophylaxis, for such infections.

They designed a prospective study that included 1,222 consecutive patients who received liver transplants in 11 Spanish hospitals between August 2003 and September 2005. They included all infections that developed up to six months after surgery, including both wound incisional and organ/space infection, hepatic and intra-abdominal abscess, and peritonitis. To assess risk factors for surgical site infections, they looked at patients who became ill in the first 30 days after their surgery. They then examined possible risk factors for their infections.

SSIs occurred in 8.8 percent of patients, most within the first few weeks after the transplant. About 10 percent of these were fatal, which is a great improvement over the past. The predominant infection site was the incision (42 percent) while 39 percent of infections were peritonitis; 16 percent intraabdominal abscess and 10 percent hepatic abscess.

Most infections were caused by gram-negative aerobic bacteria, which are inhabitants of the digestive tract. Infection risk was related to choice of antibiotic prophylaxis, with the highest risk seen with the use of cefazolin. Fungal infection occurred in 10 cases, a remarkably high number because many of the participant institutions used fluconazole.

After multivariate analysis, the authors found that, biliary-enteric anastomosis, previous liver or kidney transplant, and more than four red blood cell units transfused were independently associated with the development of SSIs.

The results provide insight into the risk of SSIs in relation to previous transplantation, choledocho-jejunal reconstruction and red blood cell transfusion which could motivate new studies to aid the understanding of pathogenesis if SSI in liver transplantation.

An accompanying editorial considers the history of liver transplantation and the new study by Asensio and colleagues within the context of the literature on SSIs.

It concludes that bacterial prophylaxis should be used in liver transplantation in order to decrease surgical site infections. The agent or agents should provide therapeutic concentration not only in the wound, but also within the biliary tract where anastomosis is created. Randomized trials are needed to determine the optimal antibiotic therapy to prevent surgical site infections after liver transplantation.


'/>"/>

Contact: Sean Wagner
swagner@wiley.com
781-388-8550
Wiley-Blackwell
Source:Eurekalert

Related medicine news :

1. Researchers ID Inflammation-Fighting Pathway in Fat Cells
2. Virginia Tech researchers find human virus in chimpanzees
3. Brown researchers work toward ending cartilage loss
4. NARSAD researchers identify specific genes and family traits linked to mental illnesses
5. Researchers identify proteins making up mechanosensitive ion channels
6. OHSU Cancer Institute researchers find novel chemo drug helps treat prostate cancer
7. UNC health researchers explore how to take interactive video games to the next level
8. OHSU Cancer Instutute researchers find abnormalities in gene for melanoma
9. Penn researchers gain new insights on spinal muscular atrophy
10. OHSU Cancer Institute researchers find many stomach cancer patients are not gertting best therapy
11. Researchers Develop Stem Line With Sickle Cell Mutation
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:12/2/2016)... ... 02, 2016 , ... Two years ago, Arizona State University ... live by 1 million viewers and won numerous honors, including the region’s top ... the Walter Cronkite School of Journalism and Mass Communication are following up their ...
(Date:12/2/2016)... ... December 02, 2016 , ... ... the launch of its 60-day free trial program for all of the company’s ... the offer a truly hassle free experience. , FlexiSpot’s unique desktop risers use ...
(Date:12/2/2016)... ... December 02, 2016 , ... ... of two ostomy patients, standing as living proof that attitude and determination can ... diseases and issues that spike around the holidays. This campaign will offer patients ...
(Date:12/2/2016)... ... December 02, 2016 , ... The PAINWeekEnd Regional Conference will ... Spa in Honolulu, offering local frontline clinicians the opportunity to extend their certified ... demand for supplemental training related to pain management has surged dramatically in recent ...
(Date:12/2/2016)... (PRWEB) , ... December 02, 2016 , ... "Pro3rd Accents ... FCPX editors to create versatile lower third titles with just a few clicks of ... Accents Volume 2 includes 30 lower third animations. Choose from various styles with accented ...
Breaking Medicine News(10 mins):
(Date:12/2/2016)... ALEXANDRIA, Va. , Dec. 2, 2016 /PRNewswire-USNewswire/ ... year by the Academy of Managed Care Pharmacy ... care organizations can better address the opioid addiction ... Medication Assisted Therapies (MAT). ATAG,s newly ... in Improving Access to Naloxone," addresses many issues ...
(Date:12/2/2016)... 2016  Maxor National Pharmacy Services, LLC ("Maxor"), today announced ... ("PSI").  The combination of Texas -based Maxor ... PSI bring together both company,s clinical expertise and high-touch patient ... industry-leading specialty pharmacy. About Maxor ... , , ...
(Date:12/2/2016)... , Dec. 2, 2016 CVS Health Corporation ... Analyst Day in New York City on Thursday, December 15, 2016, beginning ... leadership team will provide an in-depth review of the ... value. The company will also discuss 2017 earnings guidance ... webcast of the event will be broadcast simultaneously on ...
Breaking Medicine Technology: