Año 2021 / Volumen 113 / Número 4
Original
The outcome of living donor liver transplant recipients with recent episodes of spontaneous bacterial peritonitis

251-254

DOI: 10.17235/reed.2020.6780/2019

Vinayak Nikam, Manish Srivastava,

Resumen
Background: spontaneous bacterial peritonitis (SBP) is a common complication in patients with cirrhosis and is associated with a high mortality rate. Only a few reports have analyzed the impact of treated SBP that occurs in the immediate pre-operative period on outcome after a living donor liver transplantation (LDLT). The results of whether post-transplant patients are dependent on pre-transplant infections are still debatable and unclear. Therefore, this study examined the outcomes of LDLT recipients with recent episodes of SBP and LDLT recipients without prior episodes of SBP. Patients: the records of 62 LDLT recipients who underwent LDLT were retrospectively reviewed. Twenty-four (36 %) recipients had at least one episode of SBP before LDLT. However, active SBP was not present in any of the recipients at the time of LDLT. Both recipient groups were compared in terms of demographic profile, perioperative and postoperative variables and outcomes. Results: higher pre-operative Child-Turcotte-Pugh (CTP) score (mean [SD] 11.77 [1.37] vs 10.5 [1.22], p < 0.001) and prior history of renal dysfunction (mean serum creatinine [SD] 1.715 [1.08] vs 1.02 [0.479] mg/dl, p = 0.002) were more commonly associated with the SBP group as compared to the non-SBP group. However, there was no statistically significant difference between the two groups in terms of the following variables: previous diabetes mellitus (3 [12.5 %] vs 6 [15.8 %]), pre-operative model for end-stage liver disease (MELD) score (median [IQR] 21 [10-37] vs 22 [9-39]), operative time (mean [SD] 789.57 [153.49] vs 800.86 [138.69] min), total number of blood transfusion (median [IQR] 10 [2-19] vs 8 [1-18]), hospital stay (median 21 vs 20 days), re-exploration (4 [16.6 %] vs 2 [5.3 %]), postoperative sepsis (8 [33 %] vs 5 [13 %]) and 30-day mortality (3 [12.5 %] vs 2 [5.3 %]). Conclusions: the presence of previous episodes of pre-operative SBP in LDLT recipients does not result in adverse post-operative short-term outcomes.
Share Button
Nuevo comentario
Comentarios
No hay comentarios para este artículo.
Bibliografía
1. Organ Procurement and Transplantation Network/Scien- tific Registry of Transplant Recipients. The 2008 OPTN/ SRTR annual report. Available at: http://www.ustransplant. Org. Accessed August 2009.
2. Foreman MG, Mannino DM, Moss M. Cirrhosis as a risk factor for sepsis and death: analysis of the National Hospital Discharge Survey. Chest 2003; 124:1016-1020.
3. Tandon P, Garcia-Tsao G. Bacterial infections, sepsis, and multiorgan failure in cirrhosis. Semin Liver Dis 2008; 28:26-42.
4.Fernandez J, Navasa M, Gomez J, Colmenero J, Vila J, Arroyo V, et al. Bacterial infections in cirrhosis: epidemiological changes with invasive procedures and norfloxacin prophylaxis. Hepatology 2002; 35:140-148.
5. Garcia-Tsao G. Spontaneous bacterial peritonitis: a historical perspective. J Hepatol 2004;41:522-527.
6. Rimola A, Garcia-Tsao G, Navasa M, et al. Diagnosis, treatment and prophylaxis of spontaneous bacterial peritonitis: a consensus document. International Ascites Club. J Hepatol 2000;32: 142–153.
7.Titó L, Rimola A, Ginès P, et al. Recurrence of spontaneous bac- terial peritonitis in cirrhosis: Frequency and predictive factors. Hepatology 1988; 8: 27-31.
8. Jamil S, Ahmed S, Memon A, et al. Factors predicting the recurrence of spontaneous bacterial peritonitis in patients with cirrhosis. J Coll Phys Surg Pak. 2011;21:407–410.doi: 07.2011/JCPSP.407410.
9. Ginès P, Angeli P, Lenz K, et al. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis. J Hepatol 2010; 53: 397-417.
10. Malik S, Madani B, Ahmad J. Spontaneous bacterial peritonitis is not a risk factor for poor outcome after liver transplantation. Paper presented at American Transplant Congress 2009; May 30-June 3, 2009; Boston, MA. Abstract 1613.
11. Rawad M, Shahid M. M, John N, Bahar M, Michael E. D et al. Spontaneous bacterial peritonitis before liver transplantation does not affect patient survival; Clinical Gastroenterology And Hepatology 2010;8:623–628.10.1016/j.cgh.2010.04.013. Epub 2010 Apr 24
12.Van Thiel DH, Hassanein T, Gurakar A, Wright HI et al; Liver transplantation after an acute episode of spontaneous bacterial peritonitis. Hepatogastroenterology. 1996 Nov-Dec; 43(12):1584-8.
13. Hsin-Yun Sun, Thomas V. Cacciarelli, and Nina Singh. Impact of pretransplant infections on clinical outcomes of liver transplant recipients; Liver Transplantation 16:222-228, 2010.
14. V. R. Bertuzzo, M. Giannella, A. Cucchetti, A. D. Pinna , A. Grossi, M. Ravaioli et al. Impact of preoperative infection on outcome after liver transplantation; BJS 2017; 104: e172–e181.
15. B.-S. Kim, S.G. Lee, S. Hwang, C.S. Ahn, K.H. Kim et al. Influence of Pretransplantation Bacterial and Fungal Culture Positivity on Outcome after Living Donor Liver Transplantation; Transplantation Proceedings, 41, 250–252 (209).
Instrucciones para citar
Nikam V, Srivastava M. The outcome of living donor liver transplant recipients with recent episodes of spontaneous bacterial peritonitis. 6780/2019


Descargar en un gestor de citas

Descargue la cita de este artículo haciendo clic en uno de los siguientes gestores de citas:

Métrica
Este artículo ha sido visitado 650 veces.
Este artículo ha sido descargado 79 veces.

Estadísticas de Dimensions


Estadísticas de Plum Analytics

Ficha Técnica

Recibido: 29/11/2019

Aceptado: 28/04/2020

Prepublicado: 19/11/2020

Publicado: 07/04/2021

Tiempo de revisión del artículo: 145 días

Tiempo de prepublicación: 356 días

Tiempo de edición del artículo: 495 días


Compartir
Este artículo aun no tiene valoraciones.
Valoración del lector:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
La REED es el órgano oficial de la Sociedad Española de Patología Digestiva, la SociedadEspañola de Endoscopia Digestiva y la Asociación Española de Ecografía Digestiva
Política de cookies Política de Privacidad Aviso Legal © Copyright 2023 y Creative Commons. Revista Española de Enfermedades Digestivas