scholarly journals 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

2017 ◽  
Vol 49 (1) ◽  
pp. 92-97
Author(s):  
N.M. Abdelhamid ◽  
Y.-C. Chen ◽  
Y.-C. Wang ◽  
C.-H. Cheng ◽  
T.-J. Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Liver Disease ◽  
Fungal Infection ◽  
Immune Cell ◽  
Cell Distribution ◽  
Post Transplant ◽  
End Stage Liver Disease ◽  
End Stage

scholarly journals Infection within 2 weeks before liver transplantation closely related to prognosis of posttransplant infection: a single-center retrospective observational study in China

2019 ◽  
Author(s):  
Yue Ying ◽  
Rui-Dong Li ◽  
Jing-Wen Ai ◽  
Yi-Min Zhu ◽  
Xian Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Prognostic Factors ◽  
Liver Disease ◽  
Klebsiella Pneumoniae ◽  
Postoperative Infection ◽  
Transplant Recipients ◽  
Biliary Tract Infection ◽  
End Stage Liver Disease ◽  
End Stage

Abstract Background Infections still represent the main factors influencing morbidity and mortality following liver transplantation. This study is to evaluate the incidence and risk factors for infection and survival after liver transplantation. Methods We retrospectively examined medical records in 210 recipients who underwent liver transplantation between April 2015 and October 2017 in our center. Results During the median follow-up days of 214, the incidence of infection after liver transplantation was 46.7% (n=98): namely, pneumonia (43.4%), biliary tract infection (21.9%) and peritonitis (21.4%). Among the pathogens in pneumonia, the most frequently isolated was Acinetobacter baumanii (23.5%) and Klebsiella pneumoniae (21.1%). For biliary tract infection, the first rank was Strenotrophomonas maltophilia (14.0%) and then Klebsiella pneumoniae (11.6%). Pseudomonas aeruginosa, Strenotrophomonas maltophilia, and Klebsiella pneumoniae accounted for 21.4%, 11.9% and 11.9% of pathogens in peritonitis, respectively. The independent risk factors for infection after liver transplantation are model for end-stage liver disease (MELD) or pediatric end-stage liver disease (PELD) score, total blood loss in operation and duration of drainage tube. All-cause mortality was 11.0% (n=23). The prognostic factors for postoperative infection in transplant recipients are infection, especially pneumonia within 2 weeks before transplantation, complication with impaired renal function and higher MELD or PELD score after 7 days of transplantation. Kaplan–Meier curves of survival showed that recipients with infection within 2 weeks before transplantation had a significantly lower cumulative survival rate compared with those without infection (66.7% vs 91.9%, HR=4.480, 95% CI, 3.377-47.85; p<0.001). Conclusions Infection, especially pneumonia within 2 weeks before transplantation are independent prognostic factors for postoperative infection in transplant recipients.

scholarly journals COVID-19 in liver transplant candidates: pretransplant and post-transplant outcomes - an ELITA/ELTR multicentre cohort study

Gut ◽  
2021 ◽  
pp. gutjnl-2021-324879
Author(s):  
Luca Saverio Belli ◽  
Christophe Duvoux ◽  
Paolo Angelo Cortesi ◽  
Rita Facchetti ◽  
Speranta Iacob ◽  
...  
Keyword(s):  
Liver Disease ◽  
Respiratory Failure ◽  
Meld Score ◽  
Decompensated Cirrhosis ◽  
Cox Regression Analysis ◽  
Post Transplant ◽  
End Stage Liver Disease ◽  
Significant Difference ◽  
End Stage ◽  
The Impact

ObjectiveExplore the impact of COVID-19 on patients on the waiting list for liver transplantation (LT) and on their post-LT course.DesignData from consecutive adult LT candidates with COVID-19 were collected across Europe in a dedicated registry and were analysed.ResultsFrom 21 February to 20 November 2020, 136 adult cases with laboratory-confirmed SARS-CoV-2 infection from 33 centres in 11 European countries were collected, with 113 having COVID-19. Thirty-seven (37/113, 32.7%) patients died after a median of 18 (10–30) days, with respiratory failure being the major cause (33/37, 89.2%). The 60-day mortality risk did not significantly change between first (35.3%, 95% CI 23.9% to 50.0%) and second (26.0%, 95% CI 16.2% to 40.2%) waves. Multivariable Cox regression analysis showed Laboratory Model for End-stage Liver Disease (Lab-MELD) score of ≥15 (Model for End-stage Liver Disease (MELD) score 15–19, HR 5.46, 95% CI 1.81 to 16.50; MELD score≥20, HR 5.24, 95% CI 1.77 to 15.55) and dyspnoea on presentation (HR 3.89, 95% CI 2.02 to 7.51) being the two negative independent factors for mortality. Twenty-six patients underwent an LT after a median time of 78.5 (IQR 44–102) days, and 25 (96%) were alive after a median follow-up of 118 days (IQR 31–170).ConclusionsIncreased mortality in LT candidates with COVID-19 (32.7%), reaching 45% in those with decompensated cirrhosis (DC) and Lab-MELD score of ≥15, was observed, with no significant difference between first and second waves of the pandemic. Respiratory failure was the major cause of death. The dismal prognosis of patients with DC supports the adoption of strict preventative measures and the urgent testing of vaccination efficacy in this population. Prior SARS-CoV-2 symptomatic infection did not affect early post-transplant survival (96%).

Low psoas muscle index as an unfavorable factor in children with end‐stage liver disease undergoing liver transplantation

2021 ◽  
Author(s):  
Settapong Jitwongwai ◽  
Chatmanee Lertudomphonwanit ◽  
Thitiporn Junhasavasdikul ◽  
Praman Fuangfa ◽  
Pornthep Tanpowpong ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Psoas Muscle ◽  
End Stage Liver Disease ◽  
End Stage

scholarly journals RIPK3-Mediated Necroptosis and Neutrophil Infiltration Are Associated with Poor Prognosis in Patients with Alcoholic Cirrhosis

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Zhenzhen Zhang ◽  
Guomin Xie ◽  
Li Liang ◽  
Hui Liu ◽  
Jing Pan ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Poor Prognosis ◽  
Alcoholic Cirrhosis ◽  
Normal Liver ◽  
Neutrophil Infiltration ◽  
Meld Score ◽  
End Stage Liver Disease ◽  
Cirrhotic Patients ◽  
End Stage

Alcoholic cirrhosis is an end-stage liver disease with impaired survival and often requires liver transplantation. Recent data suggests that receptor-interacting protein kinase-3- (RIPK3-) mediated necroptosis plays an important role in alcoholic cirrhosis. Additionally, neutrophil infiltration is the most characteristic pathologic hallmark of alcoholic hepatitis. Whether RIPK3 level is correlated with neutrophil infiltration or poor prognosis in alcoholic cirrhotic patients is still unknown. We aimed to determine the correlation of RIPK3 and neutrophil infiltration with the prognosis in the end-stage alcoholic cirrhotic patients. A total of 20 alcoholic cirrhotic patients subjected to liver transplantation and 5 normal liver samples from control patients were retrospectively enrolled in this study. Neutrophil infiltration and necroptosis were assessed by immunohistochemical staining for myeloperoxidase (MPO) and RIPK3, respectively. The noninvasive score system (model for end-stage liver disease (MELD)) and histological score systems (Ishak, Knodell, and ALD grading and ALD stage) were used to evaluate the prognosis. Neutrophil infiltration was aggravated in patients with a high MELD score (≥32) in the liver. The MPO and RIPK3 levels in the liver were positively related to the Ishak score. The RIPK3 was also significantly and positively related to the Knodell score. In conclusion, RIPK3-mediated necroptosis and neutrophil-mediated alcoholic liver inflammatory response are highly correlated with poor prognosis in patients with end-stage alcoholic cirrhosis. RIPK3 and MPO might serve as potential predictors for poor prognosis in alcoholic cirrhotic patients.

Diastolic Dysfunction in Patients with End-Stage Liver Disease Is Associated with Development of Heart Failure Early after Liver Transplantation

2011 ◽  
Vol 17 (8) ◽  
pp. S19
Author(s):  
Taylor F. Dowsley ◽  
David B. Bayne ◽  
Alan N. Langnas ◽  
Ioana Dumitru ◽  
John R. Windle ◽  
...  
Keyword(s):  
Heart Failure ◽  
Liver Transplantation ◽  
Liver Disease ◽  
Diastolic Dysfunction ◽  
End Stage Liver Disease ◽  
End Stage
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