Infectious complications in living related liver transplantation
| Autor: | Yukihiro Inomata, Eiji Yamamoto, Koichi Tanaka, Isao Shirahase, Shinji Uemoto, Kazue Ozawa, Kaoru Sano, Shiro Fujita, Hironori Kato |
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| Rok vydání: | 1994 |
| Předmět: |
Male
medicine.medical_specialty Cirrhosis Adolescent Premedication medicine.medical_treatment Liver transplantation Infections Gastroenterology Postoperative Complications Biliary atresia Internal medicine medicine Humans Child Fulminant hepatitis Ascending cholangitis business.industry Liver Diseases Candidiasis Infant Immunosuppression Bacterial Infections General Medicine medicine.disease Tissue Donors Liver Transplantation Transplantation Pneumonia Virus Diseases Child Preschool Pediatrics Perinatology and Child Health Immunology Female Surgery business |
| Zdroj: | Journal of Pediatric Surgery. 29:514-517 |
| ISSN: | 0022-3468 |
| DOI: | 10.1016/0022-3468(94)90080-9 |
| Popis: | During the last 31 months, 50 children between 3 months and 15 years of age have undergone living related liver transplantation (LRLT) for end-stage liver diseases (39 biliary atresia, 2 Budd-Chiari syndrome, 2 progressive intrahepatic cholestasis, 3 liver cirrhosis, 1 Wilson disease, 1 protoporphyria, 1 tyrosinemia, and 1 fulminant hepatitis). Combined FK-506 and low-dose steroids were routinely used for immunosuppression. There were seven deaths, two of which were related to infection (Candida pneumonia and Epstein-Barr virus [EBV]-associated lymphoproliferative syndrome [LPS]). Five patients had a bacterial infection, all of which were associated with surgical complications. Three patients had Candida infection, all of which were malnourished, had biliary atresia, and had been managed with prolonged antibiotics against obstinate ascending cholangitis. There were 14 symptomatic viral infections (1 herpes simplex virus, 1 herpes zoster virus, 5 cytomegalovirus [CMV], 6 EBV, and 1 EBV-associated LPS). Three of the five CMV infections appeared in patients whose graft was ABO-incompatible, who were managed with prophylactic OKT-3. Most of the viral infections (except 1 EBV-associated LPS) were minor and were treated successfully. The low incidence and successful treatment of CMV infection are related to the high compatibility and low incidence of allograft rejection in LRLT. Bacterial and fungal infections can be decreased by greater refinement of surgical technique and more aggressive preoperative management. Treatment of EBV infection is still an unsolved problem. |
| Databáze: | OpenAIRE |
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