+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Surgical site infections in liver transplant recipients in the model for end-stage liver disease era: an analysis of the epidemiology, risk factors, and outcomes



Surgical site infections in liver transplant recipients in the model for end-stage liver disease era: an analysis of the epidemiology, risk factors, and outcomes



Liver Transplantation 19(9): 1011-1019



In recipients of liver transplantation (LT), surgical site infection (SSIs) are among the most common types of infection occurring in the first 60 days after LT. In 2007, the Model for End-Stage Liver Disease (MELD) scoring system was adopted as the basis for prioritizing organ allocation. Patients with higher MELD scores are at higher risk for developing SSIs as well as other health care-associated infections. However, there have been no studies comparing the incidence of SSIs in the pre-MELD era with the incidence in the period since its adoption. Therefore, the objectives of this study were to evaluate the incidence, etiology, epidemiology, and outcomes of post-LT SSIs in those 2 periods and to identify risk factors for SSIs. We evaluated all patients who underwent LT over a 10-year period (2002-2011). SSI cases were identified through active surveillance. The primary outcome measure was an SSI during the first 60 days after LT. Risk factors were analyzed via logistic regression, and 60-day survival rates were evaluated via Cox regression. We evaluated 543 patients who underwent LT 597 times. The SSI rates in the 2002-2006 and 2007-2011 periods were 30% and 24%, respectively (P = 0.21). We identified the following risk factors for SSIs: retransplantation, the transfusion of more than 2 U of blood during LT, dialysis, cold ischemia for >400 minutes, and a cytomegalovirus infection. The overall 60-day survival rate was 79%. Risk factors for 60-day mortality were retransplantation, dialysis, and a longer surgical time. The use of the MELD score modified the incidence and epidemiology of SSIs only during the first year after its adoption. Risks for SSIs were related more to intraoperative conditions and intercurrences after LT than to a patient's status before LT.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 056034859

Download citation: RISBibTeXText

PMID: 23744748

DOI: 10.1002/lt.23682


Related references

Surgical site infection in liver transplant recipients in the MELD era Analysis of the epidemiology, risk factors, and outcomes. 2013

Analysis of liver transplant outcomes for United Network for Organ Sharing recipients 60 years old or older identifies multiple model for end-stage liver disease-independent prognostic factors. Liver Transplantation 16(8): 950-959, 2010

Wound infections in liver transplant recipients Incidence, risk factors, and impact on outcomes The NIDDK liver transplantation database. Hepatology 18(4 Part 2): 324A, 1993

Outcomes of Liver Transplant Recipients With Model for End-Stage Liver Disease Exception: Single-Center Experience in the Northeast of Brazil. Transplantation Proceedings 50(5): 1428-1430, 2018

Survival outcomes in liver transplant recipients with Model for End-stage Liver Disease scores of 40 or higher: a decade-long experience. Hpb 17(12): 1074-1084, 2016

Pre-Transplantation Immune Cell Distribution and Early Post-Transplant Fungal Infection Are the Main Risk Factors of Liver Transplantation Recipients in Lower Model of End-Stage Liver Disease. Transplantation Proceedings 49(1): 92-97, 2017

Tu1055 High Model for End-Stage Liver Disease (Meld) Score Disproportionately Worsens Liver Transplant Outcomes for Older Recipients. Gastroenterology 144(5): S-1042, 2013

Model for End-Stage Liver Disease (MELD) score does not predict outcomes of hepatitis B-induced acute-on-chronic liver failure in transplant recipients. Transplantation Proceedings 46(10): 3502-3506, 2015

Is liver transplantation an emergency or an elective surgical procedure? Analysis of risk factors related to early mortality in 139 liver transplant recipients. Transplantation Proceedings 27(4): 2321-2322, 1995

Mortality Risk Factors Among Patients With Cirrhosis and a Low Model for End-Stage Liver Disease Sodium Score (≤15): An Analysis of Liver Transplant Allocation Policy Using Aggregated Electronic Health Record Data. American Journal of Transplantation 17(9): 2410-2419, 2017

Risk factors and outcomes of carbapenem-resistant Klebsiella pneumoniae infections in liver transplant recipients. Liver Transplantation 22(1): 130, 2016

Risk factors and outcomes of carbapenem-resistant Klebsiella pneumoniae infections in liver transplant recipients. Liver Transplantation 22(5): 698-699, 2017

Risk factors and clinical outcomes of pediatric liver transplant recipients with post-transplant lymphoproliferative disease in a multi-ethnic Asian cohort. Transplant Infectious Disease 20(1), 2017

Risk factors for development of surgical site infections among liver transplantation recipients: An integrative literature review. American Journal of Infection Control 46(1): 88-93, 2017

Comparison of risk factors and outcomes of daptomycin-susceptible and -nonsusceptible vancomycin-resistant Enterococcus faecium infections in liver transplant recipients. Transplant Infectious Disease 20(3): E12856, 2018