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Multidrug-resistant bacteria and disease progression in patients with end-stage liver disease and after liver transplantation

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...

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Main Authors: Friedrich, Kilian (Author) , Schamoni, Shigehiko (Author) , Wenz, Theresa (Author) , Pfeiffenberger, Jan (Author) , Rupp, Christian (Author) , Gotthardt, Daniel (Author) , Houben, Philipp (Author) , Haken, Rebecca von (Author) , Heininger, Alexandra (Author) , Brenner, Thorsten (Author) , Mehrabi, Arianeb (Author) , Weiss, Karl Heinz (Author) , Mieth, Markus (Author)
Format: Article (Journal)
Language:English
Published: 13 July 2019
In: Journal of gastrointestinal and liver diseases
Year: 2019, Volume: 28, Issue: 3, Pages: 303-310
ISSN:1842-1121
DOI:10.15403/jgld-212
Online Access:Verlag, Volltext: https://doi.org/10.15403/jgld-212
Verlag: https://www.jgld.ro/jgld/index.php/jgld/article/view/212
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Author Notes:Kilian Friedrich, Jessica Krempl, Shigehiko Schamoni, Theresa Hippchen, Jan Pfeiffenberger, Christian Rupp, Daniel Nils Gotthardt, Philip Houben, Rebecca von Haken, Alexandra Heininger, Thorsten Brenner, Arianeb Mehrabi, Karl-Heinz Weiss, Markus Mieth
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Summary: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.
Item Description:Gesehen am 04.11.2019
Physical Description:Online Resource
ISSN:1842-1121
DOI:10.15403/jgld-212

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