Risk factors and outcomes of early infection in liver transplant recipients with acute‐on‐chronic liver failure

Autor: Yong Bing Qian, Fang Chen, Hua Lian Hang, Chuan Shen, Long Zhi Han, Yu Xiao Deng, Lei Xia, Jian Jun Zhang, Qiang Xia
Rok vydání: 2022
Předmět:
Zdroj: Journal of Digestive Diseases. 23:642-650
ISSN: 1751-2980
1751-2972
DOI: 10.1111/1751-2980.13151
Popis: Patients with acute-on-chronic liver failure (ACLF) have a high risk of infection after liver transplantation. Herein, we aimed to evaluate the survival, prevalence and characteristics of bacterial and fungal infections on the recipients with ACLF after liver transplantation.193 cases of liver transplantation recipients with ACLF were included retrospectively in this study between January 2015 and December 2017 in a high-volume center.62 patients with ACLF have developed bacterial and fungal infections after LT. The 30-day, 90-day and 1-year survival rate in the infected group were found significantly lower than those in the non-infected group (71.0%, 64.5% and 56.5% vs. 98.5%, 98.5% and 97.7%, respectively) (P0.001). The most common pathogens involved were Carbapenem-resistant gram-negative bacteria (50.1%), included Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter lwoffi. Multivariate analysis demonstrated that re-operation and ICU length of stay of recipients were independently associated with the development of post-LT infection. In addition, living donor and EAD were independently associated with 30-day all-cause mortality, while RBC transfusion and post-LT infections were both showed independently associated with both all-cause 30-day and 90-day in mortality after LT.Early infection post-LT is a major prognostic determinant in the patients with ACLF after liver transplantation. Constant vigilance for the risk factors of early infection post-LT is needed in order to strive for the timing of diagnosis and intervention promptly.
Databáze: OpenAIRE
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