The role of gut barrier dysfunction in postoperative complications in liver transplantation : pathophysiological and therapeutic considerations
© 2024. The Author(s)..
PURPOSE: Gut barrier dysfunction is a pivotal pathophysiological alteration in cirrhosis and end-stage liver disease, which is further aggravated during and after the operational procedures for liver transplantation (LT). In this review, we analyze the multifactorial disruption of all major levels of defense of the gut barrier (biological, mechanical, and immunological) and correlate with clinical implications.
METHODS: A narrative review of the literature was performed using PubMed, PubMed Central and Google from inception until November 29th, 2023.
RESULTS: Systemic translocation of indigenous bacteria through this dysfunctional barrier contributes to the early post-LT infectious complications, while endotoxin translocation, through activation of the systemic inflammatory response, is implicated in non-infectious complications including renal dysfunction and graft rejection. Bacterial infections are the main cause of early in-hospital mortality of LT patients and unraveling the pathophysiology of gut barrier failure is of outmost importance.
CONCLUSION: A pathophysiology-based approach to prophylactic or therapeutic interventions may lead to enhancement of gut barrier function eliminating its detrimental consequences and leading to better outcomes for LT patients.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
|---|---|
| Enthalten in: |
Infection - (2024) vom: 07. Feb. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Assimakopoulos, Stelios F [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Bacterial translocation |
|---|
| Anmerkungen: |
Date Revised 07.02.2024 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1007/s15010-024-02182-4 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM368133494 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM368133494 | ||
| 003 | DE-627 | ||
| 005 | 20240207232452.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240207s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s15010-024-02182-4 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1283.xml |
| 035 | |a (DE-627)NLM368133494 | ||
| 035 | |a (NLM)38324146 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Assimakopoulos, Stelios F |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The role of gut barrier dysfunction in postoperative complications in liver transplantation |b pathophysiological and therapeutic considerations |
| 264 | 1 | |c 2024 | |
| 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 Revised 07.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © 2024. The Author(s). | ||
| 520 | |a PURPOSE: Gut barrier dysfunction is a pivotal pathophysiological alteration in cirrhosis and end-stage liver disease, which is further aggravated during and after the operational procedures for liver transplantation (LT). In this review, we analyze the multifactorial disruption of all major levels of defense of the gut barrier (biological, mechanical, and immunological) and correlate with clinical implications | ||
| 520 | |a METHODS: A narrative review of the literature was performed using PubMed, PubMed Central and Google from inception until November 29th, 2023 | ||
| 520 | |a RESULTS: Systemic translocation of indigenous bacteria through this dysfunctional barrier contributes to the early post-LT infectious complications, while endotoxin translocation, through activation of the systemic inflammatory response, is implicated in non-infectious complications including renal dysfunction and graft rejection. Bacterial infections are the main cause of early in-hospital mortality of LT patients and unraveling the pathophysiology of gut barrier failure is of outmost importance | ||
| 520 | |a CONCLUSION: A pathophysiology-based approach to prophylactic or therapeutic interventions may lead to enhancement of gut barrier function eliminating its detrimental consequences and leading to better outcomes for LT patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Bacterial translocation | |
| 650 | 4 | |a Endotoxemia | |
| 650 | 4 | |a Intestinal barrier | |
| 650 | 4 | |a Intestinal permeability | |
| 650 | 4 | |a Liver transplantation | |
| 650 | 4 | |a Postoperative infections | |
| 700 | 1 | |a Bhagani, Sanjay |e verfasserin |4 aut | |
| 700 | 1 | |a Aggeletopoulou, Ioanna |e verfasserin |4 aut | |
| 700 | 1 | |a Tsounis, Efthymios P |e verfasserin |4 aut | |
| 700 | 1 | |a Tsochatzis, Emmanuel A |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Infection |d 1973 |g (2024) vom: 07. Feb. |w (DE-627)NLM00001740X |x 1439-0973 |7 nnns |
| 773 | 1 | 8 | |g year:2024 |g day:07 |g month:02 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s15010-024-02182-4 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2024 |b 07 |c 02 | ||