In:
Journal of Gastrointestinal and Liver Diseases, Romanian Society of Gastroenterology and Hepatology, Vol. 28, No. 3 ( 2019-09-01), p. 303-310
Abstract:
Background: Multidrug-resistant (MDR) pathogens represent an emerging challenge in end-stage liver disease and in liver transplant recipients. Methods: We evaluated the impact of MDR bacteria upon clinical outcomes in patients with end-stage liver disease (n = 777) at the time of enrollment on the liver transplant (LTx) waiting list, after first LTx (n = 645), and after second LTx (n = 128). Results: Colonization/infection with MDR bacteria was present in 72/777 patients on the waiting list, in 98/645 patients at first LTx, and in 46/128 patients at second LTx. While on the LTx waiting list, the time until first hydropic decompensation (p = 0.021), hepatic encephalopathy (p 〈 0.001) and hepatorenal syndrome (p 〈 0.001) was reduced in the presence of MDR bacteria, which remained an independent risk factor of poor survival in multivariate analysis (p 〈 0.001). Following first and second liver transplant, MDR bacteria were associated with an increased risk of infection-related deaths (first LTx: p 〈 0.001; second LTx: p = 0.037) and reduced actuarial survival (first LTx: p 〈 0.001; second LTx: p = 0.046). Conclusions: We showed that MDR pathogens are associated with poor outcomes before, after first and after recurrent LTx.
Type of Medium:
Online Resource
ISSN:
1842-1121
,
1841-8724
Language:
Unknown
Publisher:
Romanian Society of Gastroenterology and Hepatology
Publication Date:
2019
detail.hit.zdb_id:
2253255-9
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