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Titolo:
Posttransplantation dialysis-associated infections: Morbidity and impact on outcome in liver transplant recipients
Autore:
Singh, N; Gayowski, T; Wagener, MM;
Indirizzi:
Vet Affairs Med Ctr, Pittsburgh, PA 15240 USA Vet Affairs Med Ctr Pittsburgh PA USA 15240 Ctr, Pittsburgh, PA 15240 USA Univ Pittsburgh, Thomas E Starzl Transplantat Inst, Pittsburgh, PA USA Univ Pittsburgh Pittsburgh PA USA Transplantat Inst, Pittsburgh, PA USA
Titolo Testata:
LIVER TRANSPLANTATION
fascicolo: 2, volume: 7, anno: 2001,
pagine: 100 - 105
SICI:
1527-6465(200102)7:2<100:PDIMAI>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE-RENAL-FAILURE; RISK-FACTORS; COMPLICATIONS; DYSFUNCTION; TACROLIMUS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
19
Recensione:
Indirizzi per estratti:
Indirizzo: Singh, N Vet Affairs Med Ctr, Univ Dr C, Pittsburgh, PA 15240 USA Vet Affairs Med Ctr Univ Dr C Pittsburgh PA USA 15240 A 15240 USA
Citazione:
N. Singh et al., "Posttransplantation dialysis-associated infections: Morbidity and impact on outcome in liver transplant recipients", LIVER TRANS, 7(2), 2001, pp. 100-105

Abstract

The aim of this study is to assess the predictors, impact on infectious morbidity, and outcome of posttransplantation dialysis in liver transplant recipients and to compare the results with data from patients who did not require dialysis after transplantation. The study sample included 176 consecutive patients undergoing liver transplantation; the median follow-up was 4.3years. All patients were administered tacrolimus as primary immunosuppression. Overall, 16% (28 of 176 patients) of the patients required dialysis after transplantation. Patients requiring dialysis had significantly greater pretransplantation creatinine levels (2.4 v 1.2 mg/dL; P = .009), were morelikely to require pretransplantation dialysis (21% v 1%; P = .0001), and had a greater rate of biopsy-proven rejection episodes (50%, 14 of 28 episodes v 20%, 30 of 148 episodes; P = .0009) and longer posttransplantation intensive care unit lengths of stay (P = .0001). The incidence of infections (91% v 41%; P = .0001) and episodes of infection per patient (2.4 v 0.7 episodes; P = .0001) were significantly greater in patients undergoing dialysiscompared with those not undergoing dialysis. There was no difference in the frequency of cytomegalovirus (CMV) infection or disease; however, bacterial infections (87% v 31%; P = .0001) and invasive fungal infections (39% v 7%; P = .0001) were significantly more likely to occur in patients requiring dialysis. In logistic regression, dialysis (P = .0006) and CMV infection (P = .007) were independent significant predictors of major infections. Overall survival (assessed by Kaplan-Meier probability) was less in patients undergoing dialysis compared with those not undergoing dialysis (P = .0001). Among dialyzed patients, only 10% of those who survived had an invasive fungal infection compared with 46% of those who died (P = .08); 5 of 6 patients died within 1 month of the fungal infection. The need for dialysis portended a grave outcome in liver transplant recipients and identified a subgroup of patients at a significantly greater risk for major infections, particularly fungal infections, after liver transplantation.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 07:13:10