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Risk factors for early viral infections after liver transplantation

Purpose: Viral infections represent a serious threat for patients after liver transplantation (LT). The identification of risk factorsduring the early post-transplant period might help to improve prevention of viral infections after LT. Methods: Between 2004 and 2010, 530 adult patients underwent LT...

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Main Authors: Busch, Cornelius (Author) , Siegler, Benedikt Hermann (Author) , Werle, Heike (Author) , Lichtenstern, Christoph (Author) , Bruckner, Thomas (Author) , Heininger, Alexandra (Author) , Mehrabi, Arianeb (Author) , Weiss, Karl Heinz (Author) , Weigand, Markus A. (Author) , Hochreiter, Marcel (Author)
Format: Article (Journal)
Language:English
Published: 25 April 2018
In: Langenbeck's archives of surgery
Year: 2018, Volume: 403, Issue: 4, Pages: 509-519
ISSN:1435-2451
DOI:10.1007/s00423-018-1672-3
Online Access:Verlag, Volltext: https://doi.org/10.1007/s00423-018-1672-3
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Author Notes:Cornelius Johannes Busch, Benedikt Hermann Siegler, Heike Werle, Christoph Lichtenstern, Thomas Bruckner, Alexandra Heininger, Arianeb Mehrabi, Karl Heinz Weiss, Markus Alexander Weigand, Marcel Hochreiter
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Summary:Purpose: Viral infections represent a serious threat for patients after liver transplantation (LT). The identification of risk factorsduring the early post-transplant period might help to improve prevention of viral infections after LT. Methods: Between 2004 and 2010, 530 adult patients underwent LTat a large university hospital serving a metropolitan region inEurope. This retrospective single-centre study analysed putative risk factors for early viral infections with herpes simplex virus-1(HSV-1), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), hepatitis A/B/C (HAV/HBV/HCV) and cytomegalovirus(CMV) in the first 3 months after LT. Results: The final analysis included 501 patients of whom 126 (25.1%) had documented viral infections after LT. No significantdifferences could be detected between patients with or without viral infections concerning 30- and 90-day mortality. Risk factorsin the early post-transplant period identified by multivariate analysis included female gender (CMV, HSV-1), the post-operativeneed for continuous veno-venous hemofiltration (CMV), septic shock (CMV), detection of fungi (CMV) and the intraoperativeamount of transfused blood (EBV). Conclusions: Enhanced vigilance regarding opportunistic infections is crucial in the management of this high-risk population ofimmunocompromised patients. In particular, attention should be paid to avoidable conditions that increase the risk of renalreplacement therapies in the post-LT setting, especially among women.Trial registration: DRKS00010672 on German Clinical Trial Register
Item Description:Gesehen am 04.02.2020
Physical Description:Online Resource
ISSN:1435-2451
DOI:10.1007/s00423-018-1672-3

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