循环死亡后捐献同种异体肝移植患者术后短期细菌或真菌感染与住院时间延长有关:中国单中心回顾性观察研究

IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Hepatobiliary & Pancreatic Diseases International Pub Date : 2024-04-16 DOI:10.1016/j.hbpd.2024.04.001
Chen-Xue Guo, Jian-Hua Li, Zheng-Xin Wang, Wan-Zhen Li, Jing Zhang, Hao Xing, Su Liu, Tian Wei, Li Li, Rui-Dong Li
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引用次数: 0

摘要

正常胆汁是无菌的。研究表明,肝移植(LT)后胆管炎与相对较差的预后有关。目前仍不清楚细菌性胆汁炎或真菌性胆汁炎是否会影响肝移植受者的预后,尤其是循环死亡后捐献(DCD)的异体移植物,这与异体移植物失败的风险较高有关。这项回顾性研究纳入了2019年至2021年期间139名DCD移植的LT受者。根据是否存在细菌或真菌将所有患者分为两组。分析了术后菌血症或真菌病的发病率、微生物谱及其与预后(尤其是住院时间)可能存在的关联。第 1 周和第 2 周分别分离出 135 种和 171 种微生物。在所有参与分析的患者中,83人(59.7%)在移植后两周内出现了菌血症或真菌病。移植后两周内出现菌血症或真菌病(β=7.43,95% CI:0.02 至 14.82,=0.049),尤其是发现菌血症或真菌病(β=18.84,95% CI:6.51 至 31.07,=0.003)与住院时间延长有关。不过,这并不影响移植物和患者的存活率。细菌或真菌感染的发生,尤其是在移植后两周内,可能会影响肝功能的恢复,并且与住院时间的延长有关,但与移植物和患者的存活率无关。
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Short-term postoperative bacteriobilia or fungibilia in liver transplantation patients with donation after circulatory death allografts associated with a longer hospital stay: A single-center retrospective observational study in China
Normal bile is sterile. Studies have shown that cholangitis after liver transplantation (LT) was associated with a relatively poor prognosis. It remains unclear whether the bacteriobilia or fungibilia impact the patient outcomes in LT recipients, especially with donation after circulatory death (DCD) allografts, which was correlated with a higher risk of allograft failure. This retrospective study included 139 LT recipients of DCD grafts from 2019 to 2021. All patients were divided into two groups according to the presence or absence of bacteriobilia or fungibilia. The prevalence and microbial spectrum of postoperative bacteriobilia or fungibilia and its possible association with outcomes, especially hospital stay were analyzed. Totally 135 and 171 organisms were isolated at weeks 1 and 2, respectively. Among all patients included in this analysis, 83 (59.7%) developed bacteriobilia or fungibilia within 2 weeks post-transplantation. The occurrence of bacteriobilia or fungibilia (β = 7.43, 95% CI: 0.02 to 14.82, = 0.049), particularly the detection of (β = 18.84, 95% CI: 6.51 to 31.07, = 0.003) within 2 weeks post-transplantation was associated with a longer hospital stay. However, it did not affect the graft and patient survival. The occurrence of bacteriobilia or fungibilia, particularly within 2 weeks post-transplantation, could influence the recovery of liver function and was associated with prolonged hospital stay but not the graft and patient survival.
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来源期刊
CiteScore
5.40
自引率
6.10%
发文量
152
审稿时长
3.0 months
期刊介绍: Hepatobiliary & Pancreatic Diseases International (HBPD INT) (ISSN 1499-3872 / CN 33-1391/R) a bimonthly journal published by First Affiliated Hospital, Zhejiang University School of Medicine, China. It publishes peer-reviewed original papers, reviews and editorials concerned with clinical practice and research in the fields of hepatobiliary and pancreatic diseases. Papers cover the medical, surgical, radiological, pathological, biochemical, physiological and historical aspects of the subject areas under the headings Liver, Biliary, Pancreas, Transplantation, Research, Special Reports, Editorials, Review Articles, Brief Communications, Clinical Summary, Clinical Images and Case Reports. It also deals with the basic sciences and experimental work. The journal is abstracted and indexed in SCI-E, IM/MEDLINE, EMBASE/EM, CA, Scopus, ScienceDirect, etc.
期刊最新文献
Raman spectroscopy in the diagnosis of malignant biliary stricture: A feasibility study. Central pancreatectomy: An uncommon but potentially optimal choice of pancreatic resection. Comparison of the efficacy and safety of basket catheters and balloon catheters for endoscopic pancreatic duct stone clearance. Chinese contributions to liver transplantation. "No-donor" liver transplantation.
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