Impact of bacterial infections prior to liver transplantation on post-transplant outcomes in patients with cirrhosis

作者：Simone Incicco, Marta Tonon, N. Zeni, Carmine Gambino, Roberta Gagliardi, Valeria Calvino, Anna Barone, Gianluca Zilio, Paolo Feltracco, Patrizia Burra, Umberto Cillo, Paolo Angeli, Salvatore Piano · 发表于：JHEP Reports · 年份：2023 · DOI：10.1016/j.jhepr.2023.100808 · 被引用次数：24 · 研究领域：Liver Disease and Transplantation、Organ Transplantation Techniques and Outcomes、Cytomegalovirus and herpesvirus research

Background and aims Bacterial infections (BI) are frequent in patients with cirrhosis and increase the risk of death and drop-out from liver transplant (LT) waiting list. In patients with BI, LT is frequently delayed due to the fear of poor outcomes. We evaluated the impact of pre-LT infections on post-LT complications and survival. Methods from 2012 to 2018 consecutive patients transplanted at the Hospital of Padua were identified and classified in two groups: patients surviving an episode of BI within three months prior LT (study group) and patients without infections prior LT (control group). Post-LT outcomes (complications, new infections, survival) were collected. Results 466 LT recipients were identified (study group n=108; control group n=358). After LT, study group had a higher incidence of new bacterial (57% vs 20%, p<0.001) and fungal infections (14% vs 5%, p=0.001) and of septic shock (8% vs 2%, p=0.004) than control group. Along with MELD score, and alcohol-related cirrhosis, BI pre-LT was an independent predictor of post-LT infections (OR=3.92; p<0.001). Nevertheless, no significant difference was found in one-year (88% vs 89%, p=0.579) and five-year survival rates (76% vs 75%, p=0.829) between study group and control group. Within study group, no association was found between the time elapsed from infection improvement/resolution to LT and post-LT outcomes. Conclusions Patients with pre-LT infections have higher risk of new bacterial and fungal infections and of...