Early complications in adult liver transplant recipients at the Wits Donald Gordon Medical Centre, South Africa

2020 ◽  
pp. 1-24
Author(s):  
Sheetal Chiba ◽  
Warren Lowman ◽  
Gunter Schleicher
Keyword(s):  
Demographic Data ◽  
Deceased Donor ◽  
Infectious Complications ◽  
Meld Score ◽  
Medical Centre ◽  
Transplant Recipients ◽  
Donor Liver ◽  
Donor Liver Transplantation ◽  
Tract Infections ◽  
Liver Transplant Recipients

Background Deceased donor liver transplantation (DDLT) is the transplant modality performed routinely in adults at Wits Donald Gordon Medical Centre (WDGMC). Infection, graft dysfunction, surgical and medical complications are common in the early post-transplant period, accounting for early morbidity and mortality. Objectives To provide a descriptive analysis of all complications in the first 30 days post DDLT. To investigate associations between recipient demographic data, comorbid diabetes, MELD score, and subsequent complications. Methods A retrospective review of adult DDLT recipients for the first 30 days post-transplant performed at WDGMC for the period January 2015 - December 2016. Fischer’s exact test was used to assess relationships between demographic data and infectious complications, whilst an independent sample t-test was used for non-infectious complications. Results Seventy-eight DDLT were performed, with 6 (8%) mortalities in the first 30 days. The median age was 54 years; 54% were male. In total, 24 recipients (31%) developed infectious complications. Sixteen patients (67% of the infectious cohort) had intra-abdominal sepsis, 6 (25%) developed lower respiratory tract infections, 6 (25%) skin and soft tissue infections, and 3 (13%) urinary tract infections. Of all infectious complications, 7 patients (29%) developed bacteremia. Non-infectious complications developed in 55 patients (71%) of which renal complications were more common (67%). No significant association between age, gender, ascites, diabetes mellitus, MELD score, and any complications was found. Conclusion Non-infectious complications were more prominent than infectious complications in the first 30 days post-DDLT in adult recipients, with no significant association between recipient demographic data, comorbid diabetes, CMV status, and MELD score. Keywords: Early complications, liver transplant recipients, Deceased donor liver transplantation, Wits Donald Gordon Medical Centre, Model for End-Stage Liver Disease

Early complications in adult liver transplant recipients at the Wits Donald Gordon Medical Centre, South Africa

2020 ◽  
Vol 3 (1) ◽  
pp. 1-24
Author(s):  
Sheetal Chiba ◽  
Warren Lowman ◽  
Gunter Schleicher
Keyword(s):  
Demographic Data ◽  
Descriptive Analysis ◽  
Deceased Donor ◽  
Abdominal Sepsis ◽  
Infectious Complications ◽  
Meld Score ◽  
Medical Centre ◽  
Donor Liver Transplantation ◽  
Post Transplant ◽  
Tract Infections

Background Deceased donor liver transplantation (DDLT) is a transplant modality performed routinely in adults at Wits Donald Gordon Medical Centre (WDGMC). Infection, graft dysfunction, surgical and medical complications are common in the early post-transplant period, accounting for early morbidity and mortality. Objectives Provide a descriptive analysis of all complications in the first 30 days post DDLT. To investigate associations between recipient demographic data, comorbid diabetes, MELD score, and subsequent complications. Methods A retrospective review of adult DDLT recipients for the first 30 days post-transplant was performed at WDGMC for the period January 2015 - December 2016. Fischer’s exact test was used to assess relationships between demographic data and infectious complications, whilst an independent sample t-test was used for non-infectious complications. Results Seventy-eight DDLTs were performed, with 6 (8%) mortalities in the first 30 days. The median age was 54 years; 54% were male. In total, 24 recipients (31%) developed infectious complications. Sixteen patients (67% of the infectious cohort) had intra-abdominal sepsis, 6 (25%) developed lower respiratory tract infections, 6 (25%) skin and soft tissue infections, and 3 (13%) urinary tract infections. Of all infectious complications, 7 patients (29%) developed bacteremia. Non-infectious complications were developed in 55 patients (71%) of which renal complications were more common (67%). No significant association between age, gender, ascites, diabetes mellitus, MELD score, and any complications was found. Conclusion Non-infectious complications were more prominent than infectious complications in the first 30 days post-DDLT in adult recipients, with no significant association between recipient demographic data, comorbid diabetes, CMV status, and MELD score.

scholarly journals Hepatitis C disease severity in living versus deceased donor liver transplant recipients: An extended observation study

Hepatology ◽  
2014 ◽  
Vol 59 (4) ◽  
pp. 1311-1319 ◽  
Author(s):  
Norah A. Terrault ◽  
R. Todd Stravitz ◽  
Anna S.F. Lok ◽  
Greg T. Everson ◽  
Robert S. Brown ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Liver Transplant ◽  
Disease Severity ◽  
Deceased Donor ◽  
Transplant Recipients ◽  
Donor Liver ◽  
Observation Study ◽  
Donor Liver Transplant ◽  
Liver Transplant Recipients

scholarly journals Tacrolimus Pharmacokinetics in Living-Donor and Deceased-Donor Liver Transplant in Saudi Patients

2019 ◽  
pp. 288-294
Author(s):  
Hisham S. Abou-Auda ◽  
Eqbal Qaddour ◽  
Hussein Alsisi ◽  
Azizah Ajlan ◽  
Mohammad Alsebayel
Keyword(s):  
Liver Transplant ◽  
Deceased Donor ◽  
Apparent Volume ◽  
Volume Of Distribution ◽  
Transplant Recipients ◽  
Donor Liver ◽  
Apparent Clearance ◽  
Donor Liver Transplant ◽  
Liver Transplant Recipients ◽  
Apparent Volume Of Distribution

Introduction: Tacrolimus is a macrolide immunosuppressant. It has a narrow therapeutic index and serious side effects which necessitate monitoring of tacrolimus blood concentration. The trough concentration of the drug may also differ based on the type of liver transplant. This study was conducted to investigate differences in pharmacokinetics between transplant types and to determine tacrolimus population pharmacokinetic in liver transplant recipients in Saudi Arabia. Method: Patients on tacrolimus, as the main immunosuppressant, who underwent liver transplant throughout2012-2014 were retrospectively studied. Demographic characteristic, tacrolimus blood trough concentrations, liver, renal, biochemistry, and hematology lab results were all collected. The pharmacokinetic parameters were estimated assuming one compartment model. Results: Tacrolimus pharmacokinetic parameters were found to be as following; elimination rate constant () 0.094 ±  0.0123, apparent volume of distribution () 112.48±63.033 L/hr, elimination half-life () 7.46± 1.01 hr and apparent total body clearance () 10.27± 5.69 L/hr (mean ± SD). Statistically significant difference was found between living-donor and deceased-donor liver transplant with respect to apparent clearance and apparent volume of distribution. Living-donor liver transplant recipients have apparent volume of distribution of 97.39±47.00 L (mean ± SD) and an apparent clearance of 8.89±4.24L/hr (mean± SD). On the other hand, deceased-donor liver transplant has an apparent clearance of 12.97±7.09L/hr (mean ± SD) and an apparent volume of distribution of 142.17± 78.65 L (mean ± SD). Conclusions: Tacrolimus pharmacokinetics parameters were accurately determined in liver transplant recipients in Saudi Arabia. The results of the present study can be clinically used in the therapeutic drug monitoring of tacrolimus in the individualization of drug dosage and taking the appropriate clinical decisions to prevent allograft rejection.

Su1439 Impact of Pre Transplant HCV Treatment With DAAs on Post-Transplant Survival Among Deceased-Donor Liver Transplant Recipients

2016 ◽  
Vol 150 (4) ◽  
pp. S1100
Author(s):  
Abdelhai Abdelqader ◽  
Arif M. Cosar ◽  
Ashwini Niranjan-Azadi ◽  
Harry T. Luu ◽  
Saleh Alqahtani ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Deceased Donor ◽  
Transplant Recipients ◽  
Donor Liver ◽  
Hcv Treatment ◽  
Transplant Survival ◽  
Post Transplant ◽  
Donor Liver Transplant ◽  
Liver Transplant Recipients

scholarly journals Importance of daptomycin dosage on the clinical outcomes in early post-liver transplant recipients with vancomycin-resistant enterococci infection

2021 ◽  
Author(s):  
Ing-Kit Lee ◽  
Yi-Ping Sng ◽  
Wei-Feng Li ◽  
Chao-Long Chen ◽  
Chih-Chi Wang ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Transplant Recipients ◽  
Donor Liver ◽  
Level Of Evidence ◽  
Donor Liver Transplantation ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Liver Transplant Recipients ◽  
The Impact

Abstract Background: The prevalence of vancomycin-resistant enterococci (VRE) is increasing among liver transplant recipients. This study aimed to explore the clinical features of liver transplant recipients with VRE infection/colonization and to determine the impact of daptomycin dosage on the outcomes. Methods: We retrospectively enrolled pre-transplant and post-transplant patients with VRE colonization/infection from 2016 to 2019. Results: Altogether, 428 patients underwent liver transplantation. Among these, 22 (5.1%) patients developed VRE colonization/infection. All VRE isolates were Enterococcus faecium. Two (9%) patients acquired VRE in the pre-transplant period, 16 (3 colonizations and 13 infections) (72.7%) in the early post-liver transplant period (≤60-day after transplantation), and 4 (2 colonization and 2 infections) (18.1%) in the late post-liver transplant period (>6-month after transplantation). Among 13 patients with early post-liver transplant VRE infection, 12 (92.3%) underwent living-donor liver transplantation and 1 underwent deceased donor liver transplantation. Among these 13 patients, the median time from transplant to emergence of VRE infection was 12 days. The median interval from VRE infection to death was 27 days and the 30-day mortality was 67%. Of these 13 patients, eleven patients (8 survived; 3 died) received daptomycin therapy for VRE. Among them, 4 (36.3%) received daptomycin doses <8 mg/kg. Non-survivors (n=3) received significantly lower daptomycin dose than survivors (n=8) (P=0.040). Daptomycin doses <8mg/kg were more frequently associated with non-survivors (n=3) than with survivors (n=8) (P=0.024). Conclusions: In summary, the suboptimal dosage of daptomycin may have contributed to a higher rate of in-hospital mortality. Doses ≥8 mg/kg may be needed to adequately treat VRE infection in early post-liver transplant recipients.Level of evidence: Level III

Sign in / Sign up

Export Citation Format

Share Document