Surgical Site Infection after Liver Transplantation: Single-Center Experience

Softness Kenneth A, E. Ahmed, K. Alexander, H. Jason, Matsumoto Cal S, F. Thomas, G. Raffaele
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引用次数: 3

Abstract

Infections are frequent complications after liver transplantation. The impact of surgical site infections on patient outcome remains unclear. The aim of our retrospective study is to analyze the incidence and predictors of surgical site infections after liver transplant at our program and to determine their impact on patient outcome. Twenty-four (9.5%) surgical site infections were recorded among 252 liver transplants performed between January 2011 and December 2013. Among perioperative variables, re-transplantation was the only significant risk factor on univariate analysis (P = 0.015, CI 1.448-29.259), whereas age, gender, ethnicity, MELD score, donor type and cold ischemia time were not. The length of hospital stay was increased in the surgical site infection group (median 12 (5-152)) compared to the rest of the patients (median 9 (5-145)) (p = 0.032), while rejection rate was lower although not significantly different (0% versus 4.4%) (p = 0.295). Patient and graft survival at 1, 3 and 5 years were lower in the SSI group compared to non-SSI (p = 0.001 and 0.003, respectively). Conclusion: In our experience, re-transplants pose higher risk for SSI compared to primary transplants. SSI increase the length of hospital stay and impact negatively on survival after liver transplantation.
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肝移植术后手术部位感染:单中心经验
感染是肝移植术后常见的并发症。手术部位感染对患者预后的影响尚不清楚。我们回顾性研究的目的是分析肝移植术后手术部位感染的发生率和预测因素,并确定其对患者预后的影响。在2011年1月至2013年12月间进行的252例肝移植手术中,有24例(9.5%)发生手术部位感染。在围手术期变量中,单因素分析显示,再次移植是唯一显著的危险因素(P = 0.015, CI 1.448-29.259),而年龄、性别、种族、MELD评分、供体类型和冷缺血时间均不显著。手术部位感染组的住院时间(中位数12(5-152))比其他患者(中位数9(5-145))增加(p = 0.032),而排异率较低,但无显著差异(0%对4.4%)(p = 0.295)。与非SSI组相比,SSI组患者和移植物在1、3和5年的生存率较低(p分别= 0.001和0.003)。结论:根据我们的经验,与初次移植相比,再次移植有更高的SSI风险。SSI增加了肝移植术后的住院时间,对肝移植术后的生存有负面影响。
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