科研之友
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摘要
BackgroundSeveral studies have suggested an association between post-transplant immunoglobulin (Ig) levels and the development of infection in solid organ transplantation. We therefore conducted exploratory analyses of potential factors associated with bacterial infection/sepsis after living-donor liver transplantation (LDLT). MethodsBlood samples from 177 recipients who received primary LDLT between September 1999 and November 2011 were available for study. Hypogammaglobulinemia was defined as having at least 1 IgG level <650mg/dL within 7days after LDLT. Risk factors for developing post-transplant bacterial infection and sepsis within 3months after LDLT were analyzed. ResultsFifty (28.2%) recipients experienced bacterial infection within 3months of LDLT. Eighty-four (47.5%) recipients had hypogammaglobulinemia, although no recipients had hypogammaglobulinemia before LDLT. Hypogammaglobulinemia, undergoing hepaticojejunostomy, and portal pressure at closure >15mmHg were independent risk factors for developing bacterial infection within 3months of LDLT (P < 0.0001 P=0.0008, and P=0.011, respectively). The odds ratio (OR) and confidence interval (CI) for hypogammaglobulinemia were 4.79 and 2.27-10.7, respectively. Twenty-four (13.6%) recipients developed bacterial sepsis within 3months. Hypogammaglobulinemia, operative time >14h, model for end-stage liver disease score >15, and no mycophenolate mofetil use were independent risk factors for developing bacterial sepsis (P=0.009, P=0.001, P=0.003, and P=0.005, respectively). The OR and CI for hypogammaglobulinemia were 3.83 and 1.38-12.0, respectively. ConclusionsHypogammaglobulinemia within 7days of LDLT was a significant risk factor for post-transplant bacterial infection and sepsis.
- 出版日期2014-4
