Journals / Turkish Journal of Pediatrics / 2020 / Cilt: 62 - Sayı: 1

Infection risk after paediatric liver transplantation

Pages
46–52
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

In conclusion, infection is still an important morbidity in paediatric LT and is in close relationship with other morbidities such as surgical complications.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Infections after liver transplantation (LT), despite prophylactic therapy, are still important causes of morbidity and mortality in children.
📊
Key Findings & Data:In this study, we retrospectively analysed the risk factors of bacterial, viral, and fungal infections after LT in a series of 167 children (median =5 yr.).
💡
Conclusion & Impact:In conclusion, infection is still an important morbidity in paediatric LT and is in close relationship with other morbidities such as surgical complications.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Özet

Infections after liver transplantation (LT), despite prophylactic therapy, are still important causes of morbidity and mortality in children. Although underlying disease and immunosuppression along with the complexity of LT procedure are the major predispositions to infections, there still might be under recognised factors predisposing infections in paediatric LT. In this study, we retrospectively analysed the risk factors of bacterial, viral, and fungal infections after LT in a series of 167 children (median =5 yr.). Of all children, 112 (67%) experienced infections: 93 (55.7%) bacterial, 56 (33.5%) viral and 15 (9%) fungal. Multilogistic regression analysis showed that the need of immunosuppressive switch increased total, bacterial, and viral infection risk 5.3, 2.5, and 2.5 times, respectively, (p=0.001, p=0.021, and p=0,019, respectively). Re-LT increased bacterial infection risk 4.2 times (p=0.040). Viral infection risk was 10 times higher in children who had more than two re-laparotomies (p=0,002). Children who had post-LT, cytomegalovirus (CMV) infection had 5.6 times increased risk for fungal infection (p=0.035). In conclusion, infection is still an important morbidity in paediatric LT and is in close relationship with other morbidities such as surgical complications. CMV infection, itself, is an independent risk factor for fungal infection.

🔖

Cite This Article

SELİMOĞLU, M. A., KAYA, S., GÜNGÖR, R. Ş., VAROL, F. İ., BAĞ, H. G. G., YILMAZ, S. (2020). Infection risk after paediatric liver transplantation. Turkish Journal of Pediatrics, Cilt: 62 - Sayı: 1, 46–52. https://ajindex.com/articles/411827

References (16)

  1. Kim SI. Bacterial infection after liver transplantation. World J Gastroenterol 2014
  2. Watt KD, Pedersen RA, Kremers WK, Heimbach JK, Charlton MR. Evolution of causes and risk factors for mortality post-liver transplant: Results of the NIDDK long-term follow-up study. Am J Transplant 2010
  3. Torbenson M, Wang J, Nichols L, Jain A, Fung J, Nalesnik MA. Causes of death in autopsied liver transplantation patients. Mod Pathol 1998
  4. Juntermanns B, Manka P, Hoyer DP, et al. Infectious complications in the era of MELD. Ann Transplant 2015
  5. Avkan-Oguz V, Ozkardesler S, Unek T, et al. Risk factors for early bacterial infections in liver transplantation. Transplant Proc 2013
  6. Kim SI, Kim YJ, Choi JY, et al. Strategies to reduce infectious complication using epidemiologic data analysis. Transplant Proc 2013
  7. Kusne S, Dummer JS, Singh N, et al. Infection after liver transplantation. An analysis of 101 consecutive cases. Medicine (Baltimore) 1988
  8. Kim SI, Kim YJ, Jun YH, et al. Epidemiology and risk factors for bacteremia in 144 consecutive living-donor liver transplant recipients. Yonsei Med J 2009
  9. Kaido T, Mori A, Ogura Y, et al. Pre- and perioperative factors affecting infection after living donor liver transplantation. Nutrition 2012
  10. Nafady-Hego H, Elgendy H, Moghazy WE, Fukuda K, Uemoto S. Pattern of bacterial and fungal infections in the first 3 months after pediatric living donor liver transplantation: an 11-year single-center experience. Liver Transpl 2011
  11. Merli M, Nicolini G, Angeloni S, Riggio O. Malnutrition is a risk factor in cirrhotic patients undergoing surgery. Nutrition 2002
  12. Moukarzel AA, Najm I, Vargas J, McDiarmid SV, Busuttil RW, Ament ME. Effect of nutritional status on outcome of orthotopic liver transplantation in pediatric patients. Transplant Proc 1990
  13. Li C, Wen TF, Mi K, Wang C, Yan LN, Li B. Analysis of infections in the first 3-month after living donor liver transplantation. World J Gastroenterol 2012
  14. Gane E, Saliba F, Valdecasas GJ, et al. Randomised trial of efficacy and safety of oral ganciclovir in the prevention of cytomegalovirus disease in liver-transplant recipients. Lancet 1997
  15. Paya C, Humar A, Dominguez E, et al
  16. Valganciclovir Solid Organ Transplant Study Group. Efficacy and safety of valganciclovir v