Year 2021 / Volume 113 / Number 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,

Abstract
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
New comment
Comments
No comments for this article
References
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).
Citation tools
Nikam V, Srivastava M. The outcome of living donor liver transplant recipients with recent episodes of spontaneous bacterial peritonitis. 6780/2019


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1107 visits.
This article has been downloaded 83 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 29/11/2019

Accepted: 28/04/2020

Online First: 19/11/2020

Published: 07/04/2021

Article revision time: 145 days

Article Online First time: 356 days

Article editing time: 495 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2024 y Creative Commons. The Spanish Journal of Gastroenterology