Pyogenic liver abscesses in liver transplant recipients versus non-transplant population. Outcome and risk factors of patient survival
© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd..
Pyogenic liver abscess (PLA) is a life-threatening infection in both liver transplant (LT) and non-LT patients. Several risk factors, such as benign and malignant hepatopancreatobiliary diseases and colorectal tumors have been associated with PLA in the non-LT population, and hepatic artery stricture/thrombosis, biliary stricture, and hepaticojejunostomy in the LT patients. The objective of this study is to compare the outcomes of patients with PLA in LT and non-LT patients and to determine the risk factors associated with patient survival. From January 2000 to November 2020, a total of 296 adult patients were diagnosed of PLA in our institution, of whom 26 patients had previously undergone liver transplantation (LTA group), whereas 263 patients corresponded to the non-LTA population. Seven patients with PLA who had undergone previous kidney transplantation were excluded from this retrospective study. Twenty-six patients out of 1503 LT developed PLA (incidence of 1.7%). Median age was significantly higher in non-LTA patients (p = .001). No significant differences were observed in therapy. PLA recurrence was significantly higher in LTA than in non-LTA (34.6% vs. 14.8%; p = .008). In-hospital mortality was greater in the LT group than in the non-LT group (19.2% vs. 9.1% p = .10) and was identified in multivariable analysis as a risk factor for mortality (p = .027). Mortality rate during follow-up did not show significant differences between the groups: 34.6% in LTA patients versus 26.2% in non-LTA patients (p = .10). The most common causes of mortality during follow-up were malignancies, Covid-19 infection, and neurologic disease. 1-, 3-, and 5-year actuarial patient survival rates were 87.0%, 64.1%, and 50.4%, respectively, in patients of LTA group, and 84.5%, 66.5%, and 51.0%, respectively, in patients with liver abscesses in non-LTA population (p = .53). In conclusion, LT was a risk factor for in hospital mortality, but not during long-term follow-up.
Medienart: |
E-Artikel |
---|
Erscheinungsjahr: |
2023 |
---|---|
Erschienen: |
2023 |
Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
---|---|
Enthalten in: |
Clinical transplantation - 37(2023), 6 vom: 28. Juni, Seite e14966 |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Jiménez-Romero, Carlos [VerfasserIn] |
---|
Links: |
---|
Themen: |
Abdominal infections |
---|
Anmerkungen: |
Date Completed 09.06.2023 Date Revised 11.06.2023 published: Print-Electronic Citation Status MEDLINE |
---|
doi: |
10.1111/ctr.14966 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM354492128 |
---|
LEADER | 01000naa a22002652 4500 | ||
---|---|---|---|
001 | NLM354492128 | ||
003 | DE-627 | ||
005 | 20231226062335.0 | ||
007 | cr uuu---uuuuu | ||
008 | 231226s2023 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1111/ctr.14966 |2 doi | |
028 | 5 | 2 | |a pubmed24n1181.xml |
035 | |a (DE-627)NLM354492128 | ||
035 | |a (NLM)36943872 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Jiménez-Romero, Carlos |e verfasserin |4 aut | |
245 | 1 | 0 | |a Pyogenic liver abscesses in liver transplant recipients versus non-transplant population. Outcome and risk factors of patient survival |
264 | 1 | |c 2023 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ƒaComputermedien |b c |2 rdamedia | ||
338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
500 | |a Date Completed 09.06.2023 | ||
500 | |a Date Revised 11.06.2023 | ||
500 | |a published: Print-Electronic | ||
500 | |a Citation Status MEDLINE | ||
520 | |a © 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. | ||
520 | |a Pyogenic liver abscess (PLA) is a life-threatening infection in both liver transplant (LT) and non-LT patients. Several risk factors, such as benign and malignant hepatopancreatobiliary diseases and colorectal tumors have been associated with PLA in the non-LT population, and hepatic artery stricture/thrombosis, biliary stricture, and hepaticojejunostomy in the LT patients. The objective of this study is to compare the outcomes of patients with PLA in LT and non-LT patients and to determine the risk factors associated with patient survival. From January 2000 to November 2020, a total of 296 adult patients were diagnosed of PLA in our institution, of whom 26 patients had previously undergone liver transplantation (LTA group), whereas 263 patients corresponded to the non-LTA population. Seven patients with PLA who had undergone previous kidney transplantation were excluded from this retrospective study. Twenty-six patients out of 1503 LT developed PLA (incidence of 1.7%). Median age was significantly higher in non-LTA patients (p = .001). No significant differences were observed in therapy. PLA recurrence was significantly higher in LTA than in non-LTA (34.6% vs. 14.8%; p = .008). In-hospital mortality was greater in the LT group than in the non-LT group (19.2% vs. 9.1% p = .10) and was identified in multivariable analysis as a risk factor for mortality (p = .027). Mortality rate during follow-up did not show significant differences between the groups: 34.6% in LTA patients versus 26.2% in non-LTA patients (p = .10). The most common causes of mortality during follow-up were malignancies, Covid-19 infection, and neurologic disease. 1-, 3-, and 5-year actuarial patient survival rates were 87.0%, 64.1%, and 50.4%, respectively, in patients of LTA group, and 84.5%, 66.5%, and 51.0%, respectively, in patients with liver abscesses in non-LTA population (p = .53). In conclusion, LT was a risk factor for in hospital mortality, but not during long-term follow-up | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a abdominal infections | |
650 | 4 | |a hepatic artery thrombosis | |
650 | 4 | |a liver abscess | |
650 | 4 | |a liver transplantation | |
700 | 1 | |a Marcacuzco, Alberto |e verfasserin |4 aut | |
700 | 1 | |a Caso, Óscar |e verfasserin |4 aut | |
700 | 1 | |a Lechuga, Isabel |e verfasserin |4 aut | |
700 | 1 | |a Manrique, Alejandro |e verfasserin |4 aut | |
700 | 1 | |a García-Sesma, Álvaro |e verfasserin |4 aut | |
700 | 1 | |a Calvo, Jorge |e verfasserin |4 aut | |
700 | 1 | |a Aguado, José María |e verfasserin |4 aut | |
700 | 1 | |a López-Medrano, Francisco |e verfasserin |4 aut | |
700 | 1 | |a Juan, Rafael San |e verfasserin |4 aut | |
700 | 1 | |a Justo, Iago |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t Clinical transplantation |d 1987 |g 37(2023), 6 vom: 28. Juni, Seite e14966 |w (DE-627)NLM07493306X |x 1399-0012 |7 nnns |
773 | 1 | 8 | |g volume:37 |g year:2023 |g number:6 |g day:28 |g month:06 |g pages:e14966 |
856 | 4 | 0 | |u http://dx.doi.org/10.1111/ctr.14966 |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |d 37 |j 2023 |e 6 |b 28 |c 06 |h e14966 |