Impact of Early Positive Culture Results on the Short-term Outcomes of Liver Transplants.
10.4285/jkstn.2011.25.4.257
- Author:
In CHO
1
;
Dong Jin JOO
;
Myoung Soo KIM
;
Dong Eun YONG
;
Kyu Ha HUH
;
Gi Hong CHOI
;
Jin Sub CHOI
;
Soon Il KIM
Author Information
1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. djjoo@yuhs.ac
- Publication Type:Original Article
- Keywords:
Infection;
Liver transplantation;
Culture
- MeSH:
Hospitalization;
Humans;
Intensive Care Units;
Liver;
Liver Transplantation;
Medical Records;
Prognosis;
Renal Replacement Therapy;
Retrospective Studies;
Risk Factors;
Tissue Donors;
Transplants
- From:The Journal of the Korean Society for Transplantation
2011;25(4):257-263
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Infection is a major cause of morbidity and mortality following liver transplants. We evaluated the risk factors of mortality within 1 month of liver transplantation caused by post-transplant infections. METHODS: We retrospectively reviewed the medical records of 199 patients who underwent liver transplants from September 2005 to August 2010. We divided the enrolled patients into 3 groups. The first group, the Culture(-) group, was defined as those who had no significant culture results. The second group, the Culture(+)/survival group, was defined as those who tested positive for culture but survived longer than 1 month after transplantation. The third group, the Culture(+)/mortality group, was defined as those who died within 1 month of the transplant with positive culture test results. RESULTS: The culture(+)/mortality group consisted of more deceased donor liver transplants than other groups. Also, the Culture(+)/mortality group showed more evidence of pre-transplant infections, intensive care unit (ICU) admission, continuous post-transplant renal replacement therapy (CRRT), and a higher MELD score than other groups. The risk factors of early mortality combined with infection 1 month after liver transplantation are hospitalization in ICU before transplantation (HR=16.3, CI=2.6~102.3, P=0.003) and the positive results of culture within 7 days of the operation (HR=38.7, CI=4.1~368.8, P=0.001). CONCLUSIONS: Hospitalization in ICU before transplantation and an early positive culture result can be an early clinical indicator of a good prognosis after liver transplantation.
