Featured Research

from universities, journals, and other organizations

Risk Factors For Infection After Liver Transplantation Determined

Date:
June 5, 2008
Source:
Wiley-Blackwell
Summary:
Nearly 9 percent of patients who recently underwent liver transplantation suffered a subsequent surgical site infection (SSI). 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.

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.

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.


Story Source:

The above story is based on materials provided by Wiley-Blackwell. Note: Materials may be edited for content and length.


Journal Reference:

  1. Asensio et al. Effect of antibiotic prophylaxis on the risk of surgical site infection in orthotopic liver transplant. Liver Transplantation, 2008; 14 (6): 799 DOI: 10.1002/lt.21435

Cite This Page:

Wiley-Blackwell. "Risk Factors For Infection After Liver Transplantation Determined." ScienceDaily. ScienceDaily, 5 June 2008. <www.sciencedaily.com/releases/2008/06/080605124339.htm>.
Wiley-Blackwell. (2008, June 5). Risk Factors For Infection After Liver Transplantation Determined. ScienceDaily. Retrieved August 1, 2014 from www.sciencedaily.com/releases/2008/06/080605124339.htm
Wiley-Blackwell. "Risk Factors For Infection After Liver Transplantation Determined." ScienceDaily. www.sciencedaily.com/releases/2008/06/080605124339.htm (accessed August 1, 2014).

Share This




More Health & Medicine News

Friday, August 1, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Texas Quintuplets Head Home

Texas Quintuplets Head Home

Reuters - US Online Video (Aug. 1, 2014) After four months in the hospital, the first quintuplets to be born at Baylor University Medical Center head home. Linda So reports. Video provided by Reuters
Powered by NewsLook.com
Ebola Patient Coming to U.S. for Treatment

Ebola Patient Coming to U.S. for Treatment

Reuters - US Online Video (Aug. 1, 2014) A U.S. aid worker infected with Ebola while working in West Africa will be treated in a high security ward at Emory University in Atlanta. Linda So reports. Video provided by Reuters
Powered by NewsLook.com
Ebola Vaccine Might Be Coming, But Where's It Been?

Ebola Vaccine Might Be Coming, But Where's It Been?

Newsy (Aug. 1, 2014) Health officials are working to fast-track a vaccine — the West-African Ebola outbreak has killed more than 700. But why didn't we already have one? Video provided by Newsy
Powered by NewsLook.com
Study Links Certain Birth Control Pills To Breast Cancer

Study Links Certain Birth Control Pills To Breast Cancer

Newsy (Aug. 1, 2014) Previous studies have made the link between birth control and breast cancer, but the latest makes the link to high-estrogen oral contraceptives. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins